Evidence-Based Drug Policy in Russia?

A commentary on the United Nations General Assembly Special Session on the World Drug Problem Panel Discussion

Addiction (Source: Flickr)

At UNGASS, the Russian Federation hosted a panel discussion on the topic of science-based evidence and drug policy.

Panelists included Mr. Aldo Lale-Demoz, Director of the Division for Operations and Deputy Executive Director, United Nations Office on Drugs and Crime; Dr. Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse, World Health Organization; HE Mr Khaled Abdel-Rahman Shamaa Chair of the UNGASS Board, as well as a representative from the Russian Federation.

The panelists argued that drug policy decisions are often made with insufficient consideration of scientific evidence and are heavily influenced by ideological and political motivations. They offered evidence-based recommendations which they hoped would be reflected in future drug policy such as the adoption of non-punitive approaches to drug use prevention and treatment.

The representative from the Russian Federation echoed that drug policy needs to be based on scientific evidence and asserted that their current drug policies are in line with these principles. Throughout UNGASS similar assertions were often made – virtually every country justifies their drug policy as evidence based and in alignment with human rights.

However, in many cases, these statements are purely rhetorical.

In Russia, there is an ongoing epidemic of HIV and hepatitis C, spread mainly through intravenous drug use. Their drug and health policies prohibit funding of widely accepted harm-reduction programmes such as methadone treatments and needle exchange programs. These policies, in part, have led to the rising prevalence of HIV and Hepatitis C. Projections suggest that HIV prevalence among the Russian population will double by 2019, reaching two million cases.

After the panel’s presentation, I had the chance to address the Russian representative about her assertions. I referenced the rising prevalence of HIV and Hepatitis C in Russia and asked what kind of evidence needs to be realized for Russian authorities to endorse and implement harm reduction practices such as methadone treatments.

The Russian delegate responded that they view drug addition as a disease of the brain and thus could not be appropriately addressed by the measures I suggested. She added, in reference to methadone treatments for heroin addicts, that it would not be right to substitute one drug of abuse for another. She continued along these lines of reasoning, suggesting that those harm reduction policies would never allow for a drug-free world.

Following the Russian delegate’s response, Dr. Saxena, the representative from the WHO, also addressed my comments, providing support to my assertions. Dr. Saxena stated there was evidence that both methadone treatment and needle exchange programs are effective in reducing individual and societal harms of drug use. According to her, there is no scientific rationale for prohibiting these harm reduction policies.

In reflecting upon this exchange, it is necessary to consider the real-world consequences of drug policy. On one level these prohibitive drug policies implemented by Russian authorities are abstract political discussions, but in application the policies are responsible for tangible harm and suffering. Russia’s refusal to implement evidence-based drug treatment and harm reduction measures has contributed to hundreds of thousands of cases of HIV and hepatitis C. The human rights and dignity of drug users are violated – they are not able to access safe and effective treatment for their substance use problems.

Read more about the consequences of Russian drug policy here:

HIV and AIDS in Eastern Europe & Central Asia

The Guardian: Russian HIV-Aids epidemic worsening under Kremlin policies, says expert

Vice News: Russia’s AIDS Epidemic Reaches Crisis Levels