Russia’s chief public health official has told Russian reporters that methadone substitution therapy will not made available in the near future, despite growing pressure from the international public health community.
In an interview with TASS news agency, Russia’s Chief Sanitary Doctor Gennady Onischenko, said Russia is not ready for legalisation of medical applications of narcotic drugs.
In his opinion, the main problem is that "if the right of free-of-charge distribution of methadone will be given to NGOs, it will not be always possible to control exact observance of legislation. Even if this practice will be implemented in [state] clinics, there are chances that the medical personnel will plunder the drug. Besides it is impossible to exclude that addicts will trade in surpluses of methadone.”
Russian attitudes to methadone substitution therapy were strongly criticised two weeks ago when 49 leading drug treatment and HIV researchers and other experts from around the world issued a letter of concern over a highly influential anti-methadone article published in the Russian Medical Newspaper (Meditsinskaya Gazeta) in March 2006.
The Russian article was republished in the journal Issues in Narcology, and distributed widely to drug treatment professionals across Eastern Europe and the former Soviet Union. The memo was signed by important figures in Russian medicine and government, including V. N. Krasnov, Chair of the Russian Society of Psychiatrists, N. N. Ivanets, Director of the National Center on Addictions, and A. S. Kononets, Deputy Director of the Department of Corrections of the Russian Ministry of Justice.
The Russian article assembled numerous inaccuracies, misstatements of fact and even references to non-existent scientific studies in order to attack the use of methadone as a substitution therapy. These included:
- The claim that susbtitution therapy is contrary to the 1961 UN Convention on Narcotic Drugs. In fact the convention does not address methadone substitution therapy because it was not used at the time; methadone’s only use in 1961 was as a painkiller.
- The claim that methadone substitution therapy is ineffective, creates a new body of drug addicts and causes harmful long-term side effects. No references are provided by the Russian authors to support these claims, and methadone substitution is widely endorsed by governments in Europe and North America as an effective treatment.
- Advocates of methadone substitution therapy are advancing the economic interests of methadone manufacturers. This is perhaps the most absurd claim in the Russian article; in fact, methadone costs pennies to produce and is a generic product manufactured by many companies.
- The claim that recent WHO guidance on substitution therapy runs counter to all previous UN conventions and decisions. In fact, the 2004 position paper was endorsed by UNODC, the drug control body of the UN, and reflected policies already practiced throughout the European Union, China, India, the United Statese, Canada and Australia.
Signatories of the protest letter included Doctors of the World, the European Opiate Addiction Treatment Association, the French Harm Reduction Association, the Italian Red Cross, National Treatment Agency for Substance Misuse (UK), and the Royal College of General Practitioners (UK), as well as Dr. Jim Yong Kim, Dr. Robert Newman, Dr. Allen Rosenfield, and Dr. Alex Wodak, among others. The letter was sent to Russian health officials on May 12 and widely distributed during the 1st Eastern European and Central Asian AIDS Conference held in Moscow from May 14 to 17, 2006.