Russian Federation

Subsections:

Page last updated June 10, 2020 by Doug McVay, Editor/Senior Policy Analyst.

1. Human Rights Violations and Russian Drug "Treatment"

"Recently, this opposition to science and human rights reached a new frontier. In 2010, Russia’s Chief Narcologist announced his endeavor to create a four-level system of “social pressure” in order to respond to the country’s “drug problem” [26]. The first level of this system involves “early detection” of drug use by way of school and workplace testing; the second level is voluntary drug treatment; the third level is compulsory treatment by referral from the criminal justice system; and the fourth level is compulsory treatment within the criminal justice system. By 2013, this system was fully implemented as state policy. Despite the fact that compulsory drug treatment was proclaimed unconstitutional in Russia in 1989, the punitive principles underlying Russia’s current drug policy allowed for widespread ignorance of this fact—not an unusual practice in Russia [27]. Correspondingly, in 2013–2014, several federal laws and regulations were amended to establish compulsory drug treatment [28–30], purportedly to motivate DDP and people who use illegal drugs to undergo medical treatment and rehabilitation [31]. For example, these amendments empower law enforcement agencies to coerce PWUD to undergo drug treatment and rehabilitation, empower courts to issue drug treatment orders to people who commit drug-related administrative offenses (such as non-medical use of narcotic drugs or possession of insignificant amounts of narcotic drugs) or to DDP who commit minor crimes (such as theft or the possession of significant amounts of drugs for personal use), introduce administrative punishment of up to 30 days of imprisonment for evasion of court-imposed drug treatment or rehabilitation, and require drug treatment and rehabilitation organizations to report to police those patients who do not fulfill court-imposed treatment or rehabilitation orders."

Golichenko, Mikhail, and Sandra Ka Hon Chu. “Human rights in patient care: drug treatment and punishment in Russia.” Public health reviews vol. 39 12. 1 Jun. 2018, doi:10.1186/s40985-018-0088-5
https://www.ncbi.nlm.nih.gov/p...

2. Failure of Russian Drug "Treatment"

"Analysis of court statistics demonstrates that the 2013–2014 amendments have not led to the expected outcome of “motivating” PWUD to undergo drug treatment or rehabilitation. Only about 2% of people convicted for drug administrative offenses chose to undergo treatment rather than punishment (about 1500 out of more than 70,000) [32] and only about 1% of 48,557 people who were involuntarily ordered to undergo drug dependence treatment remained drug-free within a year or more after treatment. Publically available judgments indicate that people have either simply not shown up for their appointments with narcologists or failed to visit narcologists after diagnostics (after which narcologists report truant patients to the police) [33]. Despite this obvious ineffectiveness, narcologists continue to express strong support for this system of “social pressure.” In June 2017, the Ministry of Health of the Russian Federation sponsored a large conference of narcologists. The conference’s final resolution included recommendations to health institutions in Russia to form a system of social pressure for people who use psychoactive substances, including a mechanism of legal “motivation” for treatment and rehabilitation as an alternative to administrative and criminal liability for people committing drug crimes. The same conference endorsed a bill to be introduced to the Federal Parliament in order to expand the coercive treatment measures of 2013–2014 to “problem alcohol users” [34]."

Golichenko, Mikhail, and Sandra Ka Hon Chu. “Human rights in patient care: drug treatment and punishment in Russia.” Public health reviews vol. 39 12. 1 Jun. 2018, doi:10.1186/s40985-018-0088-5
https://www.ncbi.nlm.nih.gov/p...

3. Russian Drug Treatment and Human Rights Abuses

"As noted above, human rights organizations and UN bodies have documented human rights violations against PWUD in Russia, including the absence of drug dependence treatment for people living with HIV and tuberculosis [56], the use of unscientific methods and the drug user registry in drug dependence treatment [57], and the prohibition on OST [57, 58]. Moreover, the UN Committee on Economic, Social and Cultural Rights (CESCR) has urged Russia to apply a human rights-based approach to PWUD so that they do not forfeit their right to health [59, 60], while the UN Human Rights Committee has recommended that Russia provide effective drug dependence treatment to people in police custody [61] and the UN Committee on the Elimination of Discrimination against Women has recommended that Russia provide drug-dependent women access to OST [62]. As of September 2017, there were also at least five applications pending before the European Court of Human Rights concerning the human rights of PWUD.3

"However, human rights violations arising from punitive drug policy are not limited to PWUD. Arguably, narcologists’ human rights are also infringed when Russian drug laws criminally prohibit evidence-based drug dependence treatment such as OST, thus subjecting narcologists who are willing to provide OST to their patients to life imprisonment for drug trafficking. Narcologists are also prohibited from openly supporting harm reduction activities, such as needle and syringe programs, because such support can lead to administrative or criminal sanctions for violations of drug propaganda laws [63, 64]. According to a former Chief Narcologist, Nikolay Ivanets, Russian narcologists would never speak in favor of OST because of the risks of prosecution [65]. Russian narcologists are pulled in two directions, representing polarized sets of obligations. On the one hand, they have responsibilities as doctors, acting in the best interest of their patients, which ostensibly includes employing the most effective, evidence-based treatment methods. On the other hand, narcologists are prohibited from providing or promoting such methods of treatment and care, such as OST and harm reduction programs, under the threat of criminal and administrative sanctions."

Golichenko, Mikhail, and Sandra Ka Hon Chu. “Human rights in patient care: drug treatment and punishment in Russia.” Public health reviews vol. 39 12. 1 Jun. 2018, doi:10.1186/s40985-018-0088-5
https://www.ncbi.nlm.nih.gov/p...

4. Prevalence of Injection Drug Use-Related HIV in Russia

"Russia has the largest population of injecting drug users (IDUs) in the world — an estimated 1·8 million people. More than a third have HIV; in some regions, the proportion is nearer to three-quarters. Astonishingly, an estimated 90% of Russian IDUs have hepatitis C, and most patients co-infected with HIV and tuberculosis in Russia are drug-dependent."

Talha Burki, "Russia’s drug policy fuels infectious disease epidemics," The Lancet, Vol. 12, April 2012, p. 275.
http://en.rylkov-fond.org/wp-c...

5. Russia's Burgeoning HIV Epidemic

"The latest information, obtained directly by us from the Ministry, covers the year ending 2017, and reports the number of newly registered PLHIV [People Living with HIV] has increased by 105,844. Clearly, this is not an exact measure of incidence, but it gives an indication that numbers continue to rise unabated. Reasons for the absence of progress in Russia are numerous and include insufficient access to sterile injecting equipment, unavailability of opioid substitution therapy, and a shortage of treatment in populations where it is most needed, namely people who inject drugs and their partners, sex workers, and men who have sex with men."

"Russia's burgeoning HIV epidemic," The Lancet, Editorial, Volume 393, Volume 10172, P612, Feb 16, 2019. DOI:https://doi.org/10.1016...
https://www.thelancet.com/...

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