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For the purposes of IDPC’s regional work, Eurasia encompasses the following countries: Armenia, Azerbaijan, Belarus, the Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, the Kyrgyz Republic, Lithuania, Poland, the Republic of Moldova, the Russian Federation, Slovakia, Tajikistan, Turkmenistan, Turkey, Ukraine and Uzbekistan.
Cannabis is produced in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Ukraine and Uzbekistan mainly to supply the domestic market and for export to other countries in Central and Eastern Europe. (The World Factbook. Central Intelligence Agency - CIA). Amphetamine-type stimulants (ATS) production has been found in Poland, Ukraine, Moldova, the Czech Republic and Slovakia (World Drug Report. 2012). Domestically grown opium poppies are processed for consumption locally in Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Belarus, Russia and Ukraine. (The World FactBook)
Eurasia is located on two of the major transit routes for the heroin trafficked from Afghanistan into Central Asia, Eastern Europe and beyond. The Northern Route into the Russian Federation passes through Uzbekistan, Tajikistan, Turkmenistan, Kyrgyzstan and Kazakhstan. The Balkan Route runs from Afghanistan through Iran, Azerbaijan, Armenia and Turkey onto South East Europe (World Drug Report. 2012).
The main drugs used in the region are cannabis and opiates. There is also widespread use of non-prescribed medications such as sedatives and tranquilisers and these are commonly injected. The prevalence of injecting drug use is high, with over 3.7 million people who inject drugs across the region, representing almost one fourth of all people who inject drugs worldwide. In the Russia Federation alone, there are approximately 2 million people who inject drugs. (Global State of Harm Reduction, 2012)
According to recent reports, in Estonia and some other Eurasian countries, synthetic opioids such as fentanyl and buprenorphine might have displaced the use of opioids, such heroin (a semi-synthetic). The Russian authorities have reported that, due to a heroin shortage, desomorphine (known as ‘krokodil’), acetylated opium and fentanyl have been used as substitutes for heroin throughout the Russian Federation (World Drug Report. 2012).
Regional Drug Policies
Drug policy in many Eurasian countries is dominated by measures aimed at the reduction of drug supply, through suppression of drug production, combating drug trafficking, and law enforcement programs aiming to combat drug markets. Drug demand reduction measures receive much less attention. This imbalance is reflected in region’s the legislation and in the distribution of resources.
In Georgia, for example, a few years ago more than 80 per cent of the government funding was directed at law enforcement and only €9 annually were allocated per person who uses drugs. In Lithuania’s case, government spending is estimated as €500 for each user. The average spending in the EU is €2000 per person who uses drugs (read more). Russia spent $100 million in 2010 prosecuting drug offenders (for use and supply only) but under the Budget Law for 2011, HIV prevention programs received around 3 per cent of the total $640 million allocated in 2012 through the Federal Budget Law for HIV, hepatitis B and C (The war against people who inject drugs: The Cost).
Eurasian governments continue to impose severe criminal sanctions on people who use drugs and dealers. The sharp increase of the prevalence of drug use after the fall of the USSR and the social and health problems related to it have caused a moral panic, and as a result, has generated repressive policy responses based almost exclusively on law enforcement. These have led to users facing numerous barriers to accessing health care services and represent an infringement of the right to the highest attainable standard of health.
The criminalisation of petty, non-violent drug crimes – which also includes the criminalisation of people who use drugs – results in stigma and discrimination, and creates a political climate in which human rights norms are not applied in relation to people who use drugs. Such policies lead to police harassment, misuse of power and extortion of money from people who use drugs and/or their relatives (Read more).
However, recently countries such as Armenia, Czech Republic, Estonia and Poland have been moving towards the decriminalisation of possession of small quantities of drugs for personal use. In the Czech Republic, for example, after a two-year research project that was concluded in 2002, it was found that penalisation of drug use had not affected the availability of illicit drugs; there was an increase in the levels of drug use within the country; and the social costs of illicit drug use increased significantly. As a result of this analysis of the impact of introducing penalties for drug possession, the Czech Republic formally decriminalised possession of illegal drugs in 2010 (Release: A quiet Revolution).
According to the UNODC, some countries in the region experienced an increase in drug related crime between 1993 and 2000, followed by declining levels from 2000 onwards. The reasons for this tendency are unclear, although rising levels of violence have sometimes been linked to increases in opiate production in Afghanistan and the rising volume of opiates trafficked through the region. Most drug-related crimes recorded in the region were related to distribution or storage of drugs and not for smuggling (Illicit Drug Trends in Central Asia).
People who use drugs have also reported high levels of violence from police and prison authorities across Eurasia. The situation of women who use drugs is particularly concerning in Russia, Ukraine and Georgia, as they experience systematic and widespread violence, harassment, extortion, and sexual abuse at the hands of law enforcement officers. They are not only denied their right to healthcare, but are often forced into drug treatment centres where they are subject to physical and psychological abuse (Read more).
Health programmes have suffered as a consequence of the law-enforcement focus of Eurasia’s policy makers. The region has experienced a 250 per cent increase in HIV cases over the past 10 years. NSPs and OST programmes are, at best, reaching an estimated 10 per cent and 3 per cent (respectively) of people who use drugs (The war against people who inject drugs: The cost). The high number of people who inject drugs and lack of appropriate health services directed at them has had such a profound impact on HIV in the region. Since 2006 the majority of new HIV cases were attributable to injecting drug use. Ukraine has 296,000 PWIDs, and adult HIV prevalence among this group is over 21 per cent. In Estonia, the prevalence is over 54 per cent. In Russia, more than 37 per cent of people who inject drugs are living with HIV; the latest official figures state that approximately 200 new cases are recorded each day. Meanwhile, the UN estimates that one in 100 people are living with HIV, which translates into more than one million people (Read more).
Information is limited about hepatitis C prevalence in the region. However, data drawn from the work of the UN reference group indicate a relatively high prevalence among people who inject drugs. Drug-related deaths are generally high across the region. These are predominantly linked to opioid overdose and lack of medication to prevent them.
Harm reduction measures have increasingly become available in some countries from the region, although needle and syringe exchange programs (NSPs) coverage remains low, many opioid substitution therapy (OST) programs are still at a pilot stage and there are often strict intake criteria attached to accessing them. For instance, Bulgaria, the Czech Republic, Lithuania and Poland, among other Eurasian countries, have imposed an age limit of 18 to access harm reduction services. (Opioid substitution therapy in Eurasia: How to increase the access and improve the quality).
Those harm reduction services that exist in Eurasia generally struggle to meet the demand, and are rarely in line with human rights principles (Global State of Harm Reduction. 2012) and the World Health Organisation (WHO) recommendations on access to essential medicines such as methadone and buprenorphine.
Policy change in this domain is further complicated by the Russian Federation’s position on harm reduction and its influence in neighbouring countries. In recent years, and despite global evidence on the effectiveness of harm reduction to reduce drug-related health harms, the Russian Federation has positioned itself as being against OST and other harm reduction programmes, and proclaimed a ‘total war on drugs’. The country is in the process of adopting new drug laws, which would further criminalise people who use drugs who would face a choice between compulsory treatment and prison.
Despite this political resistance to change, a few Eurasian countries have led the way in developing more health and human rights based drug policies. This is the case, for example, in Kyrgyzstan. At the end of the 1990s, the Kyrgyz government acknowledged the extensive negative consequences of its repressive approach towards drug users and decided to decriminalise the possession of small amounts of drugs for personal use. This policy was accompanied by training sessions on harm reduction for all law enforcement staff, enabling them to react more positively towards drug use and related harms. Although the Kyrgyz government has drawn criticism due to the existence of shortcomings in some of its policies, this represents a positive step towards better drug policies. Another noteworthy example is that of Ukraine, which has recently developed a comprehensive package of harm reduction services to respond to the extremely high level of HIV infections among people who inject drugs. However, the complexity of the political context in Ukraine raises continuing problems in the practical delivery of the harm reduction services the state has introduced. Possession of used syringes remains a criminal offence, rendering it highly problematic for clients and service providers to utilise and operate NSPs. Similar legal conflicts surround the provision of OST, with staff at OST facilities risking arrest and prosecution, and clients in substitution therapy liable to lose access to the medication if they commit a minor administrative offence such a crossing the road against a red traffic light (Read more).
For more information regarding drug policy in Eurasia, please click here.
For a full list of IDPC members in Eurasia, please click here:
- HIV in Europe Conference
- First International Conference on Novel Psychoactive Substances
- Regional dialogue on HIV and legislation for Eastern European and Central Asian countries
- 1st European Harm Reduction Meeting
- Harm reduction in Eurasia: what are regional advocacy priorities?