Harm Reduction in Moscow: Successes and Challenges

 

By Ivan Varentsov

“We began outreach at 7:30pm. As always, it was cold and windy in the outreach area. Right away, a guy came up smiling and asked for alcohol swabs and a pack of insulin syringes. Those who came later weren’t so modest. Everybody wanted ointments, but we had little of them. Once they asked me for condoms and lamented that we didn’t have Contex – we only had something called “Love”. Anyway, they took those. Three people asked about naloxone with two of them telling us how it had helped them save people from overdoses – three people saved at once. They asked for our contact details to get some consultations on treatment, including for HIV. One girl talked to Max for a long time telling him about her tribulations with treatment and drug clinics; he gave her some advice. Overall we had about 15 people approach us this time. In general, in spite of the foul weather outreach work went well…”     

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This is a description of a regular workday of the Harm Reduction Moscow project’s outreach team. The project is implemented by the Andrey Rylkov Foundation. The goal of this project is to help people using injectable drugs – who for various reasons are not ready to quit immediately- reduce all kinds of harmful consequences of drug use such as overdoses or vein problems. It helps them obtain necessary health and social support to impact the spread of infectious diseases such as hepatitis C and HIV infection. Our outreach teams work practically every day in various areas of the city. Our services are in great demand – just in the period between July 1 and December 31, 2013, 938 requests for services were registered. However, the project can cover only a small part of those who need its services in a mega-city. And unfortunately there are few such projects in Russia. They are usually implemented by non-governmental and non-profit organizations (NGOS), while the government does not support them at all.

The Andrey Rylkov Foundation for Health and Social Justice (or ARF) was established in June 2009. Its mission is to promote and develop humane drug policy based on tolerance, protection of health, dignity and human rights. The Foundation’s activities rely on voluntary support from representatives of the drug users’ community in the implementation of its projects. Through their involvement the Foundation builds the PUD community’s capacity to engage in advocacy and service provision.

Aside from direct services for people who use drugs, advocacy for access to Opioid Substitution Therapy (OST) in Russia is another key direction for the Foundation. While substitution therapy is one of today’s most widespread and effective methods of addressing opioid dependency, as well as HIV prevention among injecting drug users, Russia does not implement substitution therapy programs. This is because of a legal ban, conservative drug policy in the country, and the lack of support for substitution therapy from drug treatment specialists and law enforcement agencies.

As part of its advocacy, the Foundation engages in strategic litigation at the domestic and international levels, and aims to change the current legislation and practices. As a recent success, the EU Court of Human Rights has communicated with the Russian authorities about the complaints made by three Russian citizens using injectable opiate drugs, in relation to the denial of substitution therapy with methadone and buprenorphine. Two of the complaints (by Irina Teplinskaya from Kaliningrad and Ivan Anoshkin from Togliatti) were prepared and submitted to the ECHR with support from the Andrey Rylkov Foundation. The Russian government must respond to the ECHR’s questions about this case by September 22, 2014, after which Russia’s objections will be sent to the complainants for review and a date for a court hearing will be assigned.

Recently, the Foundation began to develop the work of street lawyers as a new direction. Many participants of the harm reduction projects face various legal problems for which they need help.  The goal of the Street Lawyers Project is to enable outreach workers, social workers, and PUD volunteers of the Foundation to provide legal support to the participants of the harm reduction project independently, without support from professional lawyers, with regard to rights protection, including by representing them in courts, state and healthcare facilities, etc.

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The slogan of the IDPC campaign, “Support. Don’t Punish” campaign is very close to our organization, and we understand it well. Not only do we work with drug users on the streets of Moscow on a daily basis, but also for many of us, drug users are our friends and colleagues – and they are us. In our work and life, we constantly face problems related to the criminalization of drug use, as well as the stigma and discrimination directed at drug users. These problems could be avoided if the Russian drug policy was based on a humanitarian approach rather than on repression.

 

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