{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T02:55:46Z","timestamp":1784343346817,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Following the full-scale invasion of Ukraine by the Russian Federation on 24 February 2022, over 6,000 patients were at risk of potential disruptions in treatment with medications for opioid use disorder (MOUD) in Ukraine. Before 2022, privatized MOUD clinics had emerged, partly driven by restrictive governmental policies and practices in state-funded facilities. Nevertheless, scant information exists regarding their operation and the patient\u2019s experiences, especially during crises. This study seeks to elucidate the initial lived experiences of patients utilizing private MOUD clinics, integrating these insights with an analysis of the responding health system during war.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The findings are derived from 20 qualitative semi-structured interviews conducted between March and June 2022, engaging participants from five major Ukrainian cities: Kharkiv, Kyiv, Odesa, Poltava, and Zaporizhzhya. Employing a rapid analysis procedure, we examined the data through descriptive and analytical summaries aligned with the domains of the data collection instrument.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Emergent themes encompassed stress and uncertainty following the invasion\u2019s onset, challenges accessing MOUD, and consequent perceptions concerning state-funded versus private clinics. The study identified disruptions in the operation of private MOUD clinics across most cities examined. Issues pertaining to MOUD medication availability were linked to dosage reductions at state-funded clinics or pharmacy medication shortages or closures. Despite varied experiences at different MOUD clinics and cities, most participants continued their treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This qualitative exploration provides a perspective on lived experiences with MOUD treatment at private clinics amidst the initial months of the invasion, illuminating how the early days\u2019 stress, access challenges, varied responses from private MOUD clinics, and precarious conditions informed or altered preferences regarding MOUD treatment options. Moreover, these findings corroborate previously documented efforts by myriad stakeholders to mitigate war-related disruptions to MOUD delivery. These insights contribute to the international understanding of health system navigation and resilience during major crises, offering valuable lessons for preparedness development.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1238188","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T15:17:22Z","timestamp":1702394242000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Qualitative exploration of the early experiences of opioid use disorder patients from private clinics after Russia\u2019s invasion of Ukraine in five major cities in Ukraine"],"prefix":"10.3389","volume":"11","author":[{"given":"Alyona","family":"Mazhnaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Meteliuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Pykalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Altice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"ref1","volume-title":"Health needs assessment of the adult population in Ukraine: survey report: April","year":"2023"},{"key":"ref2","volume-title":"Health needs assessment of the adult population in Ukraine: survey report: December 2022","year":"2022"},{"key":"ref3","volume-title":"Health needs assessment of the adult population in Ukraine: survey report September 2022","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"5253","DOI":"10.3389\/fpubh.2022.1044677","article-title":"Responding to health policy recommendations on managing opioid use disorder during Russia\u2019s invasion of Ukraine: divergent responses from the frontline to the west","volume":"10","author":"Ivasiy","year":"2023","journal-title":"Front Public Health"},{"key":"ref5","volume-title":"Ukraine: Millions of displaced traumatized and urgently need help, say experts | OHCHR","year":""},{"key":"ref6","volume-title":"Internally displaced persons (IDP) \u2013 UNHCR Ukraine","year":""},{"key":"ref7","volume-title":"Official statistics on the opioid substitution treatment program in Ukraine: 2018\u20132023","year":"2023"},{"key":"ref8","volume-title":"Internally displaced persons | UNHCR","year":"1994"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1016\/S0140-6736(19)32229-9","article-title":"Global patterns of opioid use and dependence: harms to populations, interventions, and future action","volume":"394","author":"Degenhardt","year":"2019","journal-title":"Lancet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1080\/01459740.2018.1532422","article-title":"Sovereign rules and rearrangements: banning methadone in occupied Crimea","volume":"38","author":"Carroll","year":"2019","journal-title":"Med Anthropol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"g3118","DOI":"10.1136\/bmj.g3118","article-title":"Russia\u2019s ban on methadone for drug users in Crimea will worsen the HIV\/AIDS epidemic and risk public health","volume":"348","author":"Kazatchkine","year":"2014","journal-title":"BMJ"},{"key":"ref12","volume-title":"Ensuring access to health care: Operational guidance on refugee protection and solutions in urban areas | UNHCR","year":"2011"},{"key":"ref13","volume-title":"Public health equity in refugee and other displaced persons settings, April 2010 | UNHCR","year":"2010"},{"key":"ref14","volume-title":"Support for people with substance use disorder in Ukraine during the war","author":"Pinchuk","year":"2023"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"104062","DOI":"10.1016\/j.drugpo.2023.104062","article-title":"Treatment of opioid use disorder in Ukraine during the first year of the Russia\u2013Ukraine war: lessons learned from the crisis","volume":"117","author":"Morozova","year":"2023","journal-title":"Int J Drug Policy"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s13033-023-00598-3","article-title":"The battle for mental well-being in Ukraine: mental health crisis and economic aspects of mental health services in wartime","volume":"17","author":"Seleznova","year":"2023","journal-title":"Int. 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