Drugs are a global problem. In no place is it more prevalent than Russia.
As reported in the New York Times, it is common knowledge that illicit drug use in the Russian Federation has reached critical proportions. It is also common knowledge that people who use drugs are among those most at-risk of infection with H.I.V. And it is common knowledge that since the beginning of the H.I.V./AIDS epidemic three decades ago simple tools such as Medication Assisted Therapy (methadone, buprenorphine) and clean needle-exchange services have proven very effective in decreasing drug abuse and reducing risk of infection with H.I.V., Hepatitis C and other diseases.
Russians Shoot Up
Russia has one of the world’s highest levels of injecting drug use. There are almost 2 million injecting drug users, and over 1.6 million opiate users. The number of HIV users has grown from 100,000 people to over a million in the last 10 years in Russia. Today there are over 1 million, and injecting drug users represent some 78 percent of all H.I.V. cases in the country.
This means that more than one third of all injecting drugs users are H.I.V.-positive — with peaks at three-quarters in some cities — and three-quarters of them are also living with the Hepatitis C virus. The human cost is devastating, and the social fallout is appalling: Russia now accounts for two thirds of the Eastern Europe and Central Asian H.I.V. epidemic, the fastest growing in the world.
Russia restricts such measures as needle and syringe exchange programs. The new National Drug Strategy proclaims a “zero-tolerance” approach to drug use in a country that already incarcerates enormous numbers of young people for substance use — and does so without drug treatment for those who need it.
These policies fuel poor treatment, discrimination and vulnerability to disease among drug users. They are contrary to WHO and U.N. recommendations, and go against the “E.U.-Russia Roadmap on the Common Space of Freedom, Security and Justice,” which emphasizes the principles of nondiscrimination and respect for human rights. They also contradict the 2001 Declaration of Commitment on H.I.V./AIDS and the 2006 Political Declaration on H.I.V./AIDS, both of which have been signed by the Russian Federation.
Yet the policies implemented by the Russian authorities have resulted in desperate situations for most of the people who use drugs in the country.
Russia’s national policies have driven drug use underground, and only made people who inject drugs harder to reach — with only 25 percent of them having access to anti-retroviral treatment. Drug offenses now account for 20 percent of the prison population.
Russia has the means to enshrine health as a human right. Combination prevention is the future. For injecting drugs users, this means clean needles and syringes, Medication Assisted Therapy for those who want drug treatment, and access to anti-retroviral therapies for all H.I.V.-positive drug users. That combination works.
The country cannot stop trying to educate and rehabilitate their drug users. Nobody wants to stay addicted to drugs. Nobody wishes their addiction on their children or those they care about. Russia must continue to provide drug classes and work toward reducing use.