Drawing by Natalia Mikhaylenko
Russian society views drug abuse as one of the country’s most urgent problems. The HIV epidemic continues to spread across Russia, even as it is receding elsewhere in the world, even in Africa. The problem of drug-resistant tuberculosis has joined the mix at least since 2007.
From the purely medical standpoint, the government is really spending a lot of money to purchase antiretroviral drugs to support HIV patients, yet it totally ignores WHO-recommended measures to prevent the spread of HIV among injection drug users, such as needle exchange programmes or replacement therapy.
Death from overdose is another real-world problem. A prevention system is used worldwide where Naloxone, a 100 percent opioid antidote, is distributed among drug addicts while social workers hold seminars on how to use it. This is also part of the so-called non-medical drug use damage reduction programmes; in Russia, however, the government does not support such programmes, merely tolerating them temporarily.
In May 2012, President Putin signed a decree ‘On Improving State Healthcare Policy’, which envisages, among other things, reform of the drug addiction treatment service by January 1, 2016. A conclusion that can be drawn at the moment is that this work is clearly slanted in favour of repression and control practices, to the detriment of healthcare-related and scientifically proven ones.
Here is just one example. It is no secret that removal of the abstinence syndrome – aka withdrawal – is not the main challenge when treating drug addiction resulting from opiate injection. Subsequent rehabilitation involving protracted psychological and social work with the patient is much more difficult. Our country has a whopping three (!) specialised rehabilitation centres for drug addicts. At the same time, according to Federal Drug Control Service chief General Ivanov, Russia is home to some 8 million users of controlled psychoactive substances, including 2.5 million injected drug users. (Bear in mind that relevant scientific studies in all 83 Russian regions do not corroborate the General’s opinion.)
It is little wonder, then, that all kinds of non-state “rehabs” have been flourishing, such as Evgeny Roizman’s notorious ‘Drug-Free City’ or Andrei Charushnikov’s ‘Russia’s Transfiguration’ (the latter having recently been convicted of killing a patient in Kemerovo). Drug addicts are subjected to torture rather than treatment in such establishments. Yet, lo and behold!: the Federal Drug Control Service could receive some 200 billion rouble to establish... a national rehabilitation system. Now how could narco cops, whose job is supposedly to bust drug traffickers, double as medics or psychologists? Here is how: the newly established “national system” started out by incorporating existing private rehabs and even Roizman’s ‘Drug-Free City’ has found its way on to the Federal Drug Control Service’s list of drug treatment centres.
Remarkably, Europe is going in a totally different direction, curtailing enforcement measures in favour of treatment and social counselling. Perhaps Russia lacks the financial resources needed for massive social aid? Granted, we are poorer, but apparently not poor enough to eschew the multibillion spending on the Federal Drug Control Service’s “list of rehabs” or on wholesale purchases of drug tests – another popular idea of “the war on drugs”. It posits that, if school and college students are tested in a timely fashion for controlled substance use, the related problems might be averted. The Ministry of Health’s
Chief Narcologist Evgeny Bryun is among the enthusiastic proponents of this idea.
Alas, concern for patients’ well-being is hardly the driving force behind all this. What might be the results of drug testing? Indiscriminate testing does not envisage any follow-up medical or social work with problem children or teenagers. Any results can only be punitive: identified users will be expelled from school and college and registered as drug addict.
Such measures will only increase the social stigmatisation of drug users, who, to quote the narco-populist Roizman, are treated as animals, not humans, here. And what rights do animals have? None. They need to be detected and isolated. Well, that is exactly what Roizman is doing, having set up a kind of semi-criminal forced treatment system. Unfortunately, the state drug addiction treatment service is yet to provide Russia’s citizens with a viable alternative.
Alexander Delfinov is co-founder and moderator of the Narcophobia project.
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