The Deputy Chief of the Russian Drug Control Service, Olga Mishina, is reported by the TASS news agency and Russia Today to have announced that there are around 100, 000 drug-related deaths in Russia each year, with a steeply increasing trend. Acknowledging the uncharacteristic candour with which Ms Mishina made the announcement, this is a shocking figure, even to those campaigners who have long predicted that Russia’s punitive approach to drug users, and the denial to them of access to proven health protection services, would result in death and disease rates that reach epidemic levels.
We should be careful of direct international comparisons because of varying definitions and counting mechanisms, but the historical patterns are clear – those countries that have implemented widespread support, treatment and harm reduction services for drug users have been able to maintain low population rates of premature deaths amongst this group, while those countries who have favoured harsh repression and punishment models, have seen high rates of death and life-threatening infections such as HIV or hepatitis (see this graph from the Global Commission on Drug Policy).
If the international community truly took its commitment to operate the drug control system ‘for the health and welfare of mankind’ seriously, these rates of preventable death and disease amongst a relatively young population would be totally unacceptable, and the subject of urgent political action and investment. Indeed, reducing such health harms should be the ultimate measure of whether any given drug policy was working.
Instead, these damning statistics are announced by the Russian authorities with no associated campaign for prevention, or commitment to review policy – the implication being that the Russian government thinks that a continuation of its current repressive policies will ultimately prevail..
And Russia is not alone in its apparent willingness to write off the lives of thousands of its citizens – the drug-related death rate in the USA has for decades been one of the main causes of early mortality in that country, but has raised little concern from mainstream political or public health leaders. Indeed, premature deaths due to overdose or acute reactions to psychoactive drugs are higher than the annual number of deaths attributed to road traffic accidents in the USA, as is also the case in many European and Australasian countries.
Overdose deaths are preventable – for example, the provision of the WHO Essential Medicine naloxone to people who use opioid drugs can help reverse the life-threatening effects of overdose. When these measures are overlooked, it is hard to avoid the conclusion that the deaths of people who use drugs are seen as less tragic, less worthy of attention, than purely accidental deaths. I find this deeply disturbing on both a human, and a philosophical level.
So let’s have some really simple policy commitments – one of the key objectives of any government’s drug policy is to reduce these deaths and infections, and success is measured by lives saved and prolonged. We have the methodologies to measure this and, as is rarely the case for drug control objectives, the goal is achievable. Right now, most countries – definitely Russia, probably the USA, and arguably most of Europe – are failing against this measure. But with the right commitment to health protection activities, this is one area where we should be able to declare success in the future.
Mike Trace, IDPC Chair
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