Repressive measures and discriminatory attitudes towards PWID are the main reasons efforts to curb the epidemic have not been successful. Police in some countries arrest PWID who access harm reduction services and confiscate drugs and syringes or extract bribes for the possession of syringes or needles. One study showed that in Russia, 60.5% of PWID were arrested for needle possession or had drugs planted on them by the police and were subsequently arrested.
The people affected by the policies
As someone who has dedicated my life to this field, I have seen first-hand the effects on PWID. There is a very common theme among my patients, that include history of drug abuse, many treatment episodes, incarcerations for drug trafficking, which often results in becoming HIV positive. These are the people who are suffering the most from limited access to real treatment and increasingly I am seeing Russian citizens appealing to human rights courts to fight for their rights for treatment access.
Irina, is one of those people, who has been a patient of mine. Irina is an activist for drug reform and openly speaks out about the lack of access to any OST in Russia. She was born into a high-rank family in Russia and started to use illegal opioids at a very early age. By the time she was 17 years old, she was diagnosed with an opioid addiction. Irina is now 45 years old and for the past 30 years has suffered from drug addiction. She had multiple unsuccessful attempts to treat her drug addiction in different clinics, spent 16 years in prison, lived on the streets for two years and acquired Hepatitis C, HIV and Tuberculosis. Her life, along with millions of other PWID, could have been very different if she had access to harm reduction services and received OST.
The evidence doesn’t lie
Opioid dependence is a chronic and relapsing condition, and with over 40 years of research and clinical practice, the scientific community has determined that it can be effectively treated with a combination of medications and services. OST is a treatment using methadone and buprenorphine which are opioid substitutes that are internationally recognized and recommended essential medicines. In countries where OST is widely available, 40–50% of drug users receive treatment.