Integration of Public Social Rehabilitation Programs for Drug Addicts into the State Regulation System

This article addresses the critical systemic failure within Ukraine's drug addiction rehabilitation sector, examining the tension between state medical institutions and non-state, often faith-based, residential programs. It identifies a dual crisis: the widely acknowledged ineffectiveness of the state medical model, contrasted with the legal vulnerability and frequent targeting by law enforcement of alternative community centers that have gained significant expert and social trust. The research employs a mixed-method approach, combining documentary analysis of law enforcement practices (2017–2025) with a quantitative expert survey (n=100) among professionals in narcology, public health, and social work. The survey data reveals a near-unanimous expert consensus on the insufficiency of the state system (93%) and a predominant view that law enforcement raids are excessively harsh (87%). Crucially, it identifies a strong expert mandate for systemic reform: a majority supports the integration of alternative models (63%), specific licensing frameworks (62%), and an overwhelming demand for mandatory medical supervision (97%). The analysis frames this conflict through the theoretical lenses of institutional legitimacy and competing paradigms – pitting a bio-psycho-social medical model against a punitive state response. Synthesizing these findings with international standards for treatment (WHO/UNODC), the study proposes a pragmatic model for integration, advocating an intermediate legal status for residential social rehabilitation centers operating under licensed medical supervision. The conclusion argues that a shift from suppression to regulated partnership is essential to ensure patient safety, system effectiveness, and humane care in the context of war-related trauma and rising addiction rates.