In the article below, The Lancet calls the Russian Government to create a drug dependence treatment infrastructure and reform its health policy, rather than resorting to imprisonment, to tackle increasingly high rates of HIV infection among drug users (please download the article in PDF below).


The Lancet, Volume 377, Issue 9783, Page 2056, 18 June 2011

Life is especially difficult for the 6 million drug addicts living in Russia because methadone is banned, and they are reluctant to use the few available needle and syringe exchange programmes for fear of being exposed. New drug laws are being drawn up by the Russian Government in its “total war on drugs”. These will go against the recommendations of the report by the Global Commission on Drugs Policy, on June 2, to “End the criminalization, marginalization and stigmatization of people who use drugs but who do no harm to others”, and the evidence-based treatments endorsed by organisations such as the UN Office on Drugs and Crime, UNAIDS, and WHO.

If the new laws are enacted, drug addicts will face imprisonment or be forced to undergo treatment for their addiction. And the treatment of drug dealers will be akin to that of serial killers. The new laws will stigmatise drug addicts, and violate their human rights, notably their right to health. Imprisonment of drug users is counterproductive and will only compound the transmission of HIV. Prisoners are also exposed to tuberculosis, hepatitis C, violence, and abuse. According to Chris Beyrer, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, “…the narcologic and psychiatric establishments must join the mainstream of modern science and support and use opioid substitution therapy, with methadone, buprenorphine, or Suboxone. Continuing to make evidence-based addiction treatment illegal will only maintain Russia's very high rates of dependence”.

Although Russia is attempting to deal with its increasing rate of drug addiction, albeit without compassion, the HIV epidemic will continue unabated if imprisonment and forced treatment are the only options given to addicts. Substitution therapy and needle and syringe exchange programmes will not encourage addiction, but will bring drug addicts into contact with people who will, hopefully, be able to help them. So rather than enacting punitive laws that will discourage addicts from seeking help for their chronic illness, the Russian Government needs to have a treatment infrastructure and reform its public health policy.

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