Andrey Rylkov Foundation
for Health and Social Justice

Russia at a loss on effective addict rehabilitation

By Alexander Delfinov

Society views drug abuse as one of our country’s most urgent problems. The HIV epidemic continues to spread across Russia, even as it is retreating elsewhere in the world, even in Africa. The problem of drug-resistant tuberculosis has joined the mix since 2007.

From a 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 programs or replacement therapy.

Death from overdose is another real-world problem. A prevention system is used worldwide, in which Naloxone (a 100-percent opioid antidote) is distributed among drug addicts and social workers hold seminars on how to use it.

This is also part of non-medical drug use damage reduction programs; in Russia, however, the government does not support such programs, but merely tolerates 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.

The conclusion to be drawn at the moment is that this work is clearly slanted in favor 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 the removal of the abstinence syndrome — also known as 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 (!) specialized rehabilitation centers for drug addicts. At the same time, according to Federal Drug Control Service head Gen. 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 Ivanov’s opinion).

It is little wonder, then, that all kinds of non-state “rehabs” have been flourishing, such as Yevgeny 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 rubles ($6.1 billion) to establish… a national rehabilitation system.

Now how could narcotics 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 onto the Federal Drug Control Service’s list of drug treatment centers.

Remarkably, Europe is going in a totally different direction, curtailing enforcement measures in favor of treatment and social counseling. Perhaps Russia lacks the financial resources needed for massive social aid? Granted, we are poorer — but apparently not poor enough to eschew the multi-billion spending on the Federal Drug Control Service’s “list of rehabs,” or on wholesale purchases of drug tests, which is another popular idea in “the war on drugs.”

The war on drugs posits that, if school-aged and college students are tested in a timely fashion for controlled substance use, the related problems might be averted. The Ministry of Health’s Yevgeny 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, registered as drug addicts, etc.

Such measures will only increase the social stigmatization 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 has yet to provide Russia’s citizens with a viable alternative.

Alexander Delfinov is the co-founder and moderator of the Narcophobia project.


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