The 180-degree turn: FSIN allows for the possibility of substitution therapy for drug addicts

Absolutely unbelievable in the present context the statement was voiced by first Deputy head of the Federal penitentiary service Anatoly Rudy. According to him, replacement therapy will help to reduce the number of drug-dependent people, who are serving sentences for distribution and storage. Although this method of treatment ovoidnoj dependence is recognized throughout the world, in our country in recent years, the threat topic trying not to touch even psychiatrists and narcologists.

A cry from the heart of the Federal penitentiary service

The first Deputy head of the Federal service of execution of punishments said that I agree with the opinion about the need to reduce the number of citizens serving sentences in the articles about possession and sale of drugs, noting that the criminal-legal methods to do nothing. I might say things are terrible for a man in uniform, but I honestly think that should be introduced for those who became a drug addict, replacement therapy, to ensure that they did not steal, and received a dose officially free at the pharmacy, said Rudy at the special meeting of the Council on human rights under the President of the Russian Federation.

Thus, according to Rudy, will begin to break down the drug market, but behind bars would be less people receiving long sentences under article 228.1 (criminal code the Illegal manufacture, sale, or shipment of narcotic drugs) because they are just addicts and exchanged doses.

What is replacement therapy

Substitution maintenance therapy (SMT) is that the patient who uses heavy opioid drugs, primarily heroin, replacing them with a certain dose of methadone eliminates withdrawal.The addict will take it under medical supervision, regular blood tests and, ideally, they consumed a dose of methadone is gradually reduced until full repeal. Methadone is an opioid analgesic, it is also a drug and its overdose is dangerous. But in contrast to that of heroin, methadone is much longer (24-36 hours), almost does not cause euphoria, and addiction to it develops more slowly. In addition, this drug is ingested, and addicts no longer needed to inject drugs, infecting each other with HIV and other diseases.

The world health organization and UN office on drugs and crime officially recognize RRT is one of the most effective treatments for opioid dependence. Relevant programs exist in all developed countries, it involves more than a million patients. Accepted PTA only people with experience of opioid dependence and failed attempts to discontinue the drug other ways.

Own special way

In Russia the use of methadone and other opioid drugs in the treatment and rehabilitation of drug users is considered an absolute evil.Senior Russian officials insisting on the unproven effectiveness of insecurity and counterproductive this kind of addiction. But the methadone is on the list of illicit trafficking in narcotic drugs and psychotropic substances. In the former Soviet Union except Russia, PTA refused Turkmenistan and Uzbekistan. In Europe, only Turkey.

The last time the problem RRT is loudly discussed in 2015, when without usual medical care was drug-addicted inhabitant of the Crimea.The scandal has raised special envoy of the UN Secretary General on HIV/AIDS in Eastern Europe and Central Asia Michel Kazatchkine. In Ukraine, SMT with methadone and buprenorphine was legalized in 2006. But after crossing the Peninsula to Russia was closed by the SMT program, and received her addicts began to die. According kazachkine, the main causes of death suicide and drug overdose, to the use which addicts returned after the program is closed.

That OST in the Crimea should be immediately curtailed, the Russian authorities started talking immediately after the Crimean referendum. The health Ministry sounded timid proposals to extend the methadone program at the Peninsula doprovodu, but have not heard them.

Therapy for the poor

In the professional community relevant to RRT is controversial. As stated during the Crimean scandal, the chief narcologist of the country Yevgeny Bryun, RRT is therapy for the poor, for a full treatment of which Western countries do not want to spend money. According to him, the methadone is very toxic and destroys the liver and brain structure, causes dementia. Our medicine may make other treatment technologies more efficient.Detox after the use of methadone is much harder than heroin, Bruin said during the hearings.

According to the Moscow rehabilitation Yakov Marshak, he is not a fan of methadone, because it is not therapy, but rather a neutralization of the addict in relation to society. It is absolutely not a cure, methadone is the same harmful to the health of opiate drug, Marshak explained Mednovosti. But the PTA supports the addict in a more or less comfortable condition, so that it can tolerate and don’t look for any additional doses. It makes a person more socially acceptable, reduce the risk of criminal behavior.

In Russia, this topic is closed, and even the discussion of PTA is not encouraged, the law considers it as a promotion of drugs, told Mednovosti on condition of anonymity, one of the famous Russian narcologists. I have no personal experience of using the PTA, but there is a serious foreign studies, many documents of who, UN office on drugs and crime, which provides data on the indications, contraindications, mortality. And also evidence that OST is one of the most humane methods.

This topic is no longer relevant

Meanwhile, the proposal of the Federal penitentiary service late, at least for 10-15 years.And not only because during this time, thousands of people went to jail or died because of the repressive strategy of the Russian narcology. And because today changed the structure of drug use.

In those countries where methadone is allowed, according to conducted research there, he really played and continues to play a positive role. But overall this topic has faded away. Methadone is relevant only for heroin addiction. Today, the structure of drug use has changed, and come back to addiction is not those patients that 10-15 years ago, told Mednovosti head. the Department of medical psychology of the Kazan state medical University, Director of research Institute of mental health Professor Vladimir Mendelevich.

According to him, today prevails not already opioid, no heroin addiction. Place of hard drugs has taken spice, new psychoactive substances, amphetamines, ghb. The principle of substitution treatment are trying to apply in many areas of medicine (including Oncology), and not only for the treatment of opioid dependence, but while this option was not for cocaine nor amphetamines, and today have to choose other treatment, – the expert believes.

Irina Reznik