Russia and Harm Reduction

In Russia, numbers of those with problematic drug use issues have been increasing. This is especially true where opiate narcotics are concerned.  The numbers of those dependent on heroin are increasing at alarming rates.  Reasons for this trend reflect the usual culprits.  Poverty, increased desperation, trauma.  Once hooked, users have little chance of escape.  Russia bans substitution therapies like methadone.   Government officials and health experts alike have publically stated that substitution therapies are "no way to treat addiction."  Leaders in psychiatry and addiction issued this statement: “The effective way to solve the problem of drug addiction treatment is an intensive search for and introduction of new methods and means that focus on complete cessation of drugs use by patients with addiction, their socialization into a new life style free from drugs, but not on exchanging from one drug to another.” With the high levels of poverty in Russia many users cannot afford to purchase heroin.  Desperate to shake off the terrible flu like symptoms, users have turned to a homemade substance referred to as "Krocodile". The technical term, desomorphine is a derivative of morphine.   It is cheap and made fairly simply from codeine, which does not require a prescription.  It won its street name, Krocodile because of its effects on the user.   Injected without further purification, Krocodile literally rots the flesh.  Skin becomes scaly and green. These symptoms are actually signs of phlebitis and gangrene. Some studies have estimated the life span of Krocodile users to be 2-3 years.

Russia is facing a time of great civil unrest. People are tired of the awful conditions under which they have been forced to struggle for many years, tired of the lack of commitment from their leaders regarding change, and sickened by wide spread corruption. While “leaders” feel they are entitled to take from the people, even while the people do without basic necessities.

It has finally become widely accepted in many parts of the world that those who use drugs problematically do so in order to temper emotional agony.  Finally the misinformed belief that  drug use itself is the problem has been put to rest. There are underlying issues which make it undesirable to stop. If getting high is your only means of escaping from terrible life circumstances, and depression, then people really have no right to demand that you simply quit without providing opportunity and hope.

Unfortunately many countries like Russia criminalise drug use itself, and the treatments (save abstinence) which are known to save lives. This creates conditions where drug users are unnecessarily exposed to HIV, and HCV; a mentality of judgment; stigma which prevents people from seeking medical treatment; and high rates of preventable deaths.

Russia is faced with the fastest growing HIV/AIDS epidemic in the world. And unlike many other countries sex is not the primary method of transmission. Injection drug use accounts for as many as 80% of new infections. See the following stats on Russia from 1996-2006 as documented by the UN.

• Of the nearly 400,000 people living with HIV approximately 14,000 are receiving treatment.

• 55% of those diagnosed with HIV are persons between 15-24 years of age.

Despite the degree of hopelessness, there are those who are fighting back and speaking out.

Alexei, a former prisoner advocates for drug users one person at a time. His sister is HIV positive and terrified to seek medical attention for fear of judgment and mis-treatment.

Read thier story here:
Tear Fund - Hope to the Marginalised

Masha Ovchinnikova is an activist and project coordinator at FrontAIDS, a Russian AIDS activist group in Moscow. The group advocates for expansion of needle distribution and exchange programs, as well as access to discrimination free AIDS treatment and for methadone maintenance programs to be widely instituted.

See their web page at: 
FrontAIDS