Although people who use drugs (PWUD) in Russia could benefit from harm reduction services, these services do not always reach them. Harm reduction organizations are adapting to these conditions with mHealth initiatives. The newest one involves a doctor providing medical assistance anonymously and free-of-charge to PWUD in an instant messenger (Telegram). Thematic analysis was applied to 161 anonymized text conversations between PWUD and the doctor to explore the needs of PWUD and the services provided to them. Theme 1 included needs for online only medical assistance: PWUD asked for help with drug-related health problems and consultations on drug consumption. Theme 2 consisted of needs for online and offline medical assistance: PWUD wanted to get help with more severe health problems and treat their substance misuse. The doctor helped most PWUD online by instructing them how to manage their problems by themselves, while he helped connect others to ambulances and hospitals.
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