Coordinating Referrals for Repeat Medical Examinations of Servicemembers on Substitution Supportive Therapy
Coordinating Referrals for Repeat Medical Examinations of Servicemembers on Substitution Supportive Therapy
Under current legislation, being on Substitution Supportive Therapy (SST) is a ground for unfitness for military service. However, such individuals continue to be drafted into the military. Due to the forced interruption of therapy, they develop acute withdrawal syndrome within 72 hours. This completely negates a servicemember's combat readiness, increases the risks of suicide or desertion, and leads to conflicts within units as well as an additional burden on commanders and military medicine.
To resolve this issue, the Office of the Military Ombudsman initiated interagency cooperation involving the Ministry of Defense, the Land Forces Command, the Central Military Medical Commission (MMC – ВЛК), and medical experts, and also sent an appeal to the Commander-in-Chief of the Armed Forces of Ukraine.
First Results of Interagency Cooperation
● Initial Referrals: As a result of cooperation between the Office, military units, and the Land Forces Command of the AFU, 163 servicemembers have been referred for consultations with specialized doctors, with 82 of them directed to a repeat MMC.
● Comprehensive Review: Because this issue requires systemic regulatory and organizational solutions, the Office of the Military Ombudsman is conducting an analytical study on the impact of drug addiction on military service.
This work is being carried out in two directions:
● Conducting in-depth interviews with military medicine experts.
● Running confidential surveys among servicemembers who are or have been on SST.
Preliminary Findings of the Study
The preliminary results of the study have highlighted several critical gaps:
● Infrastructure Gaps: Military medicine is currently entirely devoid of the infrastructure required to administer SST. The logistical supply of medications under combat conditions is completely unregulated.
● Restricted Information Access: Military Medical Commissions have limited access to registers of individuals with drug addiction to properly assess their health status and needs.
● Lack of Unified Criteria: There are no standardized diagnostic criteria to determine the fitness for military service of individuals with drug addiction.
Next Steps and Strategic Solutions
The Office of the Military Ombudsman is currently developing recommendations to improve MMC procedures. We are also working on the issue of medical support for servicemembers on SST in the interim period before they are referred for specialist consultations and a repeat MMC.
Ultimately, the final results of the study will help define a unified state approach, proposing one of two strategic paths:
● Complete Exclusion: Fully exempting individuals with severe forms of addiction from mobilization.
● Alternative Rear Service: Establishing a separate framework for them to serve in rear positions. To implement this second option, it will be necessary to create conditions for continuous therapy in civilian hospitals, introduce rapid testing within units, and develop rehabilitation programs.