by Delaney Nolan, Louisiana Illuminator
June 22, 2025

NEW ORLEANS – Every morning, to avoid getting sick, Jessica Baudean must take a long trip across the Mississippi. Baudean, who is disabled, lived in a tent near Tchoupitoulas Street until she received housing support in 2022, and now lives with her partner in an apartment in Avondale.

Beaudean and her partner, Terry Asevado, are methadone patients. Once heroin users, they now take a prescribed daily dose of methadone – a synthetic opioid medication which relieves them of their withdrawal symptoms and cravings. Baudean and Asevado say it’s changed their lives and allowed them to function. 

But to get the medication, the couple must travel for hours every day. If they can’t get a ride through Medicaid, Baudean must climb into her wheelchair and have Asevado push her 1.4 miles to the nearest bus stop. Then they spend an hour taking two buses,crossing the river to reach the only clinic on the city’s East Bank which is allowed to give them their medicine. If they arrive even a minute past noon, they miss their dose. If they miss a dose, they may be denied the next one. And if they’re arrested?

“Poor Terry,” sighs Baudean. “I know he’s still going to be sick right now.”

As the Trump administration cracks down on immigrants and hikes tariffs on Mexican imports, largely in the name of fighting the fentanyl crisis, a look at the experience of local people wrestling with substance use disorder suggests different approaches could be more effective.

Louisiana has among the highest overdose death rates nationwide. It’s also embattled by repeated disasters, internal migration and displacement, and poor public health support. And examples of effective drug policy under similar pressures can be found in a surprising place, far from the Gulf South: Ukraine.

Prison here, prison there

In a corridor within Strizhavka Detention Center, a medium-security prison complex in Vinnytsia, Ukraine, Iana Romaniuk smacks the glowing blue button of a vending machine. Inside, a sterile syringe tumbles to the bottom. 

“There are clean needles, lubricants and condoms” – and no cameras, explains Romaniuk, who works with Free Zone, an organization providing harm reduction services in Ukrainian prisons. 

“It’s new, installed 10 days ago,” she adds, with a hint of pride. 

Romaniuk, an unassuming woman with glasses and straight brown hair, spends her days advocating for the men in this sprawling prison complex and attached hospital. Though far from the frontlines, the specter of war hangs overhead. Security guards forbid photos of an old sign written in Russian, the language of their invaders.

The vending machine at the facility in central Ukraine is just part of one of the world’s most effective harm reduction networks, still going – and growing – after three years of war. 

Harm reduction is a public health approach that emphasizes minimizing the negative physical and social impacts of risky behavior. It aims to inform and support, rather than punish, drug users. It can mean supplying clean needles and naloxone, which can reverse an overdose. And it involves testing for HIV, hepatitis, tuberculosis, and other diseases. 

In Strizhavka, about 3½ hours southeast of Kyiv, more than 25% of the 400 inmates receive opioid substitution therapy, or OST, just like Baudean and Asevado back in Louisiana. Here, a doctor distributes it in tiny paper cups from a pump bottle.

Since the prison began offering inmates free, clean syringes, it has seen zero new HIV cases. The prison even has a program that trains interested inmates to be social workers. Trained inmates support their incarcerated peers and can potentially work in addiction recovery after their release. 

The radically different approach is striking because, though 5,000 miles apart, Ukraine and Louisiana wrestle with similar public health challenges. Ukraine has among the highest HIV and intravenous drug use rates in Europe, trailing only Russia. Louisiana has the fourth highest HIV rate in the U.S., the fifth highest rate for drug overdose mortality and disproportionately high levels of hepatitis C, a viral infection commonly spread through sharing needles.

“Louisiana is very unique with its positioning,” said Ellis Lee, a former employee of New Orleans’ Syringe Access Program (NOSAP) at Crescent Care. “We have so many viral illnesses, historically, in part because we’re a port city.”

To grapple with the crisis, Louisiana has made some policy updates in recent years. New Orleans’ City Council decriminalized fentanyl test strips in 2021, and Narcan has helped slow overdose deaths. But drug policy in the U.S. South – and in Russia – has remained largely punitive, while Ukraine’s has grown steadily more progressive – partly in reaction to Russia’s approach.

The contrasts are many. Hypodermic needle exchanges exist all over Ukraine and are rapidly expanding. In Louisiana, needle exchanges are only allowed in East Baton Rouge Parish, New Orleans, Shreveport and Alexandria. NOSAP is the Gulf South’s largest needle exchange, serving over 2000 people in six months. There are no syringe exchanges in Louisiana prisons. 

The results speak for themselves. Before the war, Ukraine had seen an 81% reduction in AIDS mortality since 2010, according to the Ukrainiain Public Health Center, and drug overdose rates fell in 2021. 

Meanwhile, drug overdoses in Louisiana rates more than quintupled between 2017 and 2022 – from 401 to 2,376 – and hepatitis C infections are increasing, based on numbers from the state health department and U.S. Centers for Disease Control and Prevention.

Since the war began in February 2022, Ukraine’s harm reduction networks have successfully pushed the government to expand services in light of the crisis. That’s partly how, as one incarcerated person put it, “civilization came to this place.”

‘The best way to torture somebody’

Beaudean’s partner, Terry Asevado, was arrested this spring in Jefferson Parish for bringing contraband into a correctional center. He’s still in jail because they can’t afford his $10,000 bail. Baudean said she knows he’s suffering because the Jefferson Parish Sheriff’s Office does not facilitate prescribed methadone for people in jail. Baudean remembers a time she was arrested and cut off from her medication.

“I wanted to kill myself, straight up, but I didn’t have the guts to do it,” she recalls. 

Baudean remembers weeks of sleeplessness, being unable to hold down food or water, throwing up bile, finding all noise excruciating. 

“It’s the best way to torture somebody. Get them addicted to some stuff, and then put them in a room and lock it.”

Federal and state regulations permit jailed patients to receive methadone, but parishes would need to coordinate with the local methadone clinic to do so, according to Traci Perry, Louisiana’s State Opioid Treatment Authority. Gretna’s methadone clinic is run by Behavioral Health Group. They say they’ve never been contacted by Jefferson Parish Corrections, nor by CorrectHealth, the company that provides medical services for the jail.

“We would look forward to the opportunity to begin a relationship with them, so they can best serve our patients,” said Michelle Peres-Tenorio, BHG’s program director. 

Most correctional facilities bring in an outside contractor to provide medication-assisted treatment services, Peres-Tenoria added. The treatment typically involves a non-methadone medication for “a very limited amount of days,” followed by only over-the-counter medication, she said. “The staff is typically not educated on methadone treatment.”

A JPSO public information officer told the Illuminator the department has no policy on the matter and referred questions to CorrectHealth, which did not respond to queries.

Mobile outreach testing

Harm reduction also entails making sure people can get testing and treatment for illnesses associated with drug use. That’s why, inside a van parked near a Kyiv methadone clinic, behind sheer peach-colored curtains, Mykolai, an addicted man who declined to share his last name, folded himself into a seat at a tiny plastic table. Leaning in, Valeriy Timoshenko, a social worker with the Ukrainian harm reduction organization Convictus, helped him prick his finger. Mykolai pinched a plastic dropper to carefully take a few drops of blood, releasing them onto two HIV and hepatitis testing strips laid out before him.

“You’re living with a partner, so I can give you one to take home,” Timoshenko told him. The results of the tests – HIV and hepatitis – take a few minutes to appear. “If your results are positive, I will describe where you should go to get free treatment.” 

Mykolai, a 38-year-old former landscaper, handed Timoshenko a card. Printed on the card is a QR code that Timoshenko can scan to see how often Mykolai has gotten tested and some of his medical history. The card also qualifies Mykolai to receive a small payment – 100 Ukrainian hryvnia, equal to about $2.40 – for being tested. Mykolai also got five cards to hand out to friends, slowly building a kind of self-testing network.

Mykolai looked down, his expression neutral. The HIV test was negative, but he’d tested positive for hepatitis C. 

Louisiana does have some mobile outreach testing units. Some groups, like Below Sea Level Aid, also offer incentives when they can. But while Ukrainian police are forbidden from approaching the clinic or Timoshenko’s van, “police used to stake out NOSAP,” said Below Sea Level Aid founder Jack Waguespack, which he said deters the group from parking its testing unit outside clinics.

War, storms, and displacement

Already, there has been some exchange of expertise between Ukraine and Louisiana.

On a February afternoon, Velta Parkhomenko, project manager of the NGO Club Eney, a woman-focused harm reduction organization in Kyiv, sat before a screen as chatter from a sobriety meeting filtered in from the next room. Parkhomenko and another Ukrainian harm reduction worker were meeting online with two of their peers from Louisiana, who asked their names not be disclosed for fear of reprisal at their workplace. Talking excitedly through the screens, they ticked through some policy differences in their respective homes.

Perhaps the biggest: prescription parity.

In Ukraine, where about 20,000 people receive opioid substitution treatment, patients can go to government or private clinics for methadone prescriptions, get them filled at any pharmacy, and then take home a 10-day supply. Thanks to advocacy efforts, patients were given 30-day supplies during certain periods of the war.

“That is not how that works here,” one Louisiana worker said, startled enough to laugh. Patients “have to fight really hard to be able to even just get a seven-day take home” supply, they said.

Methadone is among the most controlled substances in the U.S., meaning it’s under restrictions that make acquiring it especially difficult for patients. In the event of a natural disaster, it has to be transported to impacted areas under armed guard.  

Just one methadone clinic exists on Orleans Parish’s east bank, serving more than 900 OST patients. 

Clinics are meant to hand out extra take-home supply before storms, but adoption of that policy is up to the discretion of clinics, and has not been widespread, according to sources familiar with the issue. During evacuations, there is no protocol in place for ensuring an OST patient has continued access to medication, nor gauging need – unlike, say, dialysis patients. 

Louisiana’s State Opioid Treatment Authority, part of its state health department, makes decisions about methadone dosing sites and transportation during declared emergencies, which then require approval from federal officials.

The divergence in policy is notable since Ukraine and Louisiana are both deeply familiar with displacement and evacuations.

Sitting in her office in a quiet apartment block in Kyiv, Tatiana Lebid wears a pink headband and sparkling eye shadow. She’s the founder of VONA, an organization for women who use drugs, as well as a recovering addict. 

She lists the effects of the war on her country, many of which will sound familiar to those who lived through Hurricane Katrina and other major storms: post-traumatic stress disorder, the destruction of medical facilities, a “brain drain” that’s reduced the number of health care workers, and a spike in domestic violence. Lost documents, displacement, unemployment and increased police encounters with curfews in effect are also commonplace, she said. 

Lebid herself was shaken last year when a drone dropped bombs just behind her apartment block. She recalled leaning out her window to try and see the damage, certain the bomb had destroyed her car. It was spared, but she has felt the fear that has driven millions to flee Ukraine. 

A major part of VONA’s work is to ensure people forced to flee can continue receiving treatment and support. They help Ukrainians replace lost identification documents and refer users to nearby OST clinics using a simple tool: a telephone hotline.

Lebid’s colleagues field calls from every region in the country, from prisons, and even from Ukrainian soldiers on the frontlines. OST recipients were exempt from being conscripted into the military until March 2024, though some still are not draft eligible because of their HIV or tuberculosis status. 

Bodhan Protsenko, manning the phones, says the beginning of war saw a dramatic uptick in calls: 50-70 per day, up from eight before the war, he said. 

Protsenko pays special attention to the soldiers’ calls. He served a year and a half on the frontline and knows how hard it can be. Lately, he’s seen an uptick in soldiers using opiates. He isn’t surprised – the drugs can help with stress and sleep, he said.

‘I understand how to do this in a smart way’

Back in Strizhavka, Romaniuk leaves the vending machine behind and enters a small office. Yellow light falls over the wallpaper. Outside, an inmate chops firewood.

Advocates say prisons are where the need for harm reduction services, like clean needles, are most needed. Syringes on the black market can cost a hundred times more what they cost outside prison, which leads to reuse and illness. HIV rates are 25 times higher for the incarcerated. 

Needle exchange programs in Ukraine count more than 900 incarcerated clients and some 20,000 syringes replaced as of this spring. Before beginning its exchange program a year ago, the Strizhavka prison used to see a handful of new HIV cases each year. This year, they’ve seen none.

Oleksandr Lushnia, sitting against the wall and smiling shyly, is one of the prison’s incarcerated people who’ve been trained as addiction social workers. A former construction worker, he was put in prison about three years ago for stealing a bicycle. 

“Before this program, people could take dirty needles from trash bins – broken, dirty needles. Or they’d pay money to get clean needles, which meant they had to do different harmful things,” Lushnia said. “Now, people get infections less. I feel good. I understand how to do this [manage addiction] in a smart way, and tell other people how to.”

Lushnia took eight lessons in social work over one month, and was trained in how to administer Narcan and treat overdoses. He hopes to continue working in addiction recovery once released. Out of more than 400 inmates trained through the program, 77 have become certified social workers within the prison program.

And the war has only spurred Ukraine to bolster its efforts.

In fall 2022, Russian forces entered and occupied the southern city of Kherson, including the prisons there. Soldiers cut off OST, which is banned in Russia, for all inmates – then flaunted the decision on Russian state media. 

In response, Ukraine stood firm – and in fact further expanded OST services, from three prisons to 10, now serving more than 500 people.

Now, there are fears U.S. policy on opioid addiction treatment could become more regressive under the Trump administration. Robert F. Kennedy Jr., head of the Department of Health and Human Services, has talked about “healing farms” or work camps for people with addiction, similar to the system once used in Soviet Russia.

Baudean would like to see Louisiana, instead, draw some lessons from Ukraine – like having more clinics, staffed by more counselors with lived experience of addiction, like Parkhomenko. There are formerly addicted people “that really changed their life, and they did the right thing and turned it around,” says Baudean. “So why don’t we hire the ones that did, to teach the ones that can’t?”

This reporting was supported by the International Women’s Media Foundation’s Women on the Ground: Reporting from Ukraine’s Unseen Frontlines Initiative in partnership with the Howard G. Buffett Foundation”

Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com.

The post War-torn Ukraine provides possible model for Louisiana addiction treatment appeared first on lailluminator.com

Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This article reflects a center-left bias by focusing on progressive drug policy and harm reduction approaches, highlighting the shortcomings of punitive measures and advocating for public health-oriented solutions. It contrasts the more progressive policies in Ukraine regarding addiction treatment with the more restrictive and punitive approaches in Louisiana under U.S. governance. The piece implicitly criticizes conservative or right-leaning policies like incarceration over treatment and supports expanded access to healthcare and social services as more effective. Overall, it leans towards promoting social justice and public health reforms aligned with center-left political perspectives.

SUMMARY: A 38-year-old man, Ronnie Lee, was arrested in Santa Ana for a murder earlier this week, police said. According to an affidavit, Lee got into an argument with his cousin at a home on North Pinto Street on the West Side. During the dispute, Lee reportedly pointed a gun at his cousin and shot him, leading to the cousin’s death at the hospital. Police found the 32-year-old victim deceased upon arrival. A witness related to both the victim and suspect provided officers with video evidence of the shooting. Authorities are still investigating the motive and circumstances surrounding the incident.

A man was arrested after allegedly shooting and killing his relative on the West Side, according to an arrest affidavit.

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SUMMARY: This weekend brings continued heat and storm chances, with a heat advisory in effect until 7 PM today and another starting tomorrow. Current temperatures range from 90 to 93 degrees but feel like over 100 due to high humidity. Showers and thunderstorms are mostly located near Lafourche Parish, with the rest of the region dry. Storms will diminish overnight but resume by early afternoon tomorrow, continuing in a cycle through Sunday and Monday with a 30-40% chance daily. An upper-level heat dome is causing hot, humid conditions, with limited widespread storms expected next week. The tropics remain quiet.

More heat and storms this weekend

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