Evolution of addiction services and drug policy in Moldova during the Covid-19 pandemic and armed conflict in Ukraine

Introduction:

Over the past few years, there have been significant changes in the structure of drug use, as well as an
explosive increase in requests for medical help from people who use psychoactive substances. We examine the period
spanning the years of the Covid 19 pandemic, as well as the period of the war in Ukraine.

Objectives:

The main objectives of our research are the next:
1. to study the phenomenon of changes in the structure of consumption of psychoactive substances
2. to study the age of consumers
3. to study the number of people seeking medical help among drug users
4. to study the impact of the war in Ukraine and migration flows of refugees on these phenomena.

Methods:

In our research we use statistical data and annual reports of the Republican Dispensary of Addictions.

Results:

Based on the results of our research, we can present the following data:
1. there is a steady trend towards a transition from injection to other forms of consumption (inhalation, oral,
smoking), as well as the replacement of “classic” drugs with new, “legal” ones (salts, crystals, smoking mixtures)
2. the portrait of a drug user is “rejuvenating”. There is a significant number of visits to addiction specialists among
young people (under 18 years of age)
3. In 2019, before the Covid pandemic, the number of hospitalizations for drug addiction treatment was 250. In 2020,
during a period of acute Covid crisis, the number of hospitalizations for drug users was 239, and the total number of
ambulatory visits was about 200. In 2021, hospitalizations for drug addiction increased to 294 and visits for detoxification
were about 450. In 2022 (with the outbreak of the war in Ukraine), the number of hospitalizations almost doubled (382
hospitalizations), as well as visits to outpatient services also doubled, amounting to more than 800. In 6 months of 2023,
hospitalizations amounted to 183 and outpatient visits to more than 500
4. due to the flow of refugees, a program of assistance to citizens of Ukraine and other countries has been launched
at the dispensary.

Conclusions:

The presented data indicate a transition from injection consumption to other forms, a decrease in the age of
drug users (“rejuvenating”), decriminalization of drug use, better diagnosis and detection of drug users (“coming out of
the shadows”), the emergence of new substances (synthetic drugs, “legal” drugs), migration because of the war in
Ukraine.