The draft Concept for Reform of the Russian Drug Addiction Service was examined at the first meeting of the working group of the Russian Social Chamber on anti-narcotics policy and reform of the system of treatment of addicts. The head of the group, Oleg Zykov, said the system in Russia is in crisis, not least because the network of rehab centres is inadequate, as are conditions for addicts to return to work and social interaction. The legal basis for the treatment of addicts is also inadequate. The free treatment provided in state-run institutions is relatively ineffective, and few addicts use them, because once registered at them, the addicts are deprived of some of their rights. This repressive model, according to Zykov, will not reduce the number of drug addicts and alcoholics, so a different approach is needed, using psychological rehabilitation. The main thing is to inculcate in the addict a sustainable motivation to quit the use of alcohol or drugs.

A number of experts, including Zykov, recommend ending the practice of deprivation of rights when addicts ask for help. Another expert, from the “Ozone” organisation, Evgeniya Tsymbala, said that only those who have repeatedly lapsed back into addiction, or who represent a danger to other people because of their mental state, should have their freedom limited at all. The drafters of the new approach also recommend a broad programme of treatment rather than punishment. In this method, the court can decide how long they should be treated for, and order regular checks on their substance abuse, rather than locking them up. A range of opinions were expressed by experts on treatment of substance abuse. Some, such as Sergei Belogurov, thought that the best ideas stood no chance while most Russian doctors still thought that the only treatment was drying out, or “cold-turkey”, and detoxification.  He suggested that it would be best to separate two issues: dealing with the dependence and detoxification. The latter could be done in state organisations, while NGOs might be best able to deal with the addiction, at the request of the state authorities. Doctors needed to have updated training in dealing with addiction, and an information campaign should inform the public about motivation and how to deal with addictive behaviours. Belogurov also mentioned the need to involve families of addicts. All the ideas put forward will be studied further. For texts of the documents presented and to send your own recommendations, please e-mail:nan@nan.ru

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