either. Very often the tier 2 advisers
are so busy that they can’t get put
through.
There have been cases where
employees have had to break their
remit and inform a caller about
naloxone. The sense of relief is
palpable in the caller’s voice when
they discover that an overdose does
not have to end in fatality and that
they are not totally powerless in the
chaos round about them.
The problem is that FRANK and
Know The Score discourage this and
have ended people’s contracts for
mentioning naloxone and refusing
not to give information. KTS and
FRANK are run by Serco and neither
Scottish Government nor PHE have
briefed the employees. Most tier 1
employees do not appear to know
what naloxone is either, and face
being sacked if they do research and
provide information on it.
No one from PHE or Scottish
Government has responded to any of
my emails asking for a remit to be
given to FRANK or KTS on naloxone. I
telephoned DAN [Welsh helpline] last
night also and mentioned several
times that my partner will not
engage with any services and I was
worried about her overdosing. They
tried to signpost me to a service and I
kept saying she wouldn’t go and that
I was really worried about her over-
dosing. After five minutes I asked
why they hadn’t mentioned naloxone
– ‘I’m not medically trained’ was the
answer.
Neither the Scottish Government
nor PHE have got back to me, and
the only response I have had was a
verbal assurance from someone that
they would bring this up with Serco
at their next meeting.
Name and address supplied
losing BalanCe
I get
DDN
every month as I am very
interested in all recovery from
addiction issues. However, I am
becoming increasingly dismayed by
the increasing amount of articles,
letters and overall focus on harm
reduction. I believe there is a place in
DDN
and in the recovery world for
harm reduction issues and articles,
but not at the expense of balancing
this with abstinence issues and
articles. A year or so ago it was the
same – then there was an abundance
of articles about abstinence/recovery
for a while, and now
DDN
seems to
have swung back to harm reduction.
Can you and your editorial team
please try and find some balance in
this? I believe
DDN
was at its best
between the swings when there was
a more equal balance of articles
about both of these issues.
Alex McKinlay, by email
December 2015 |
drinkanddrugsnews
| 17
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letters may be edited for space or clarity.
‘The sense of relief
is palpable in the
caller’s voice when
they discover that
an overdose does
not have to end in
fatality and that
they are not
totally powerless.’
LAST WEEK I ASKED VIKTOR HOW HE WAS
, as his health seemed to be
deteriorating. He relapsed again despite a desperate attempt to undergo drug
treatment at Russia’s most renowned drug treatment clinic, the National
Research Center for Drug Dependence. He had started using ‘khanka’, which
contains opium, aged 16 years, and then tried a number of other drugs, but he
always went back to injecting opioids.
For the next few years he was in and out of prison, and then in about 2004 he
found out that he was HIV and HCV positive. Prison was followed by several
attempts at detoxification, as this was the only drug treatment available, but
each time he relapsed.
Last October the Russian government’s health committee held a meeting to
discuss the rapidly growing HIV epidemic. The minister of health said that, at the
current pace, the epidemic would grow 250 per cent by 2020 and any control
would be lost completely – and suggested that HIV treatment coverage should be
significantly expanded to include more people from vulnerable populations,
including people who use drugs.
Authorities in Russia are aware that sharing contaminated injecting
equipment remains the main driver of the epidemic. Despite this, Russian
officials continue with their dogmatic approach to harm reduction and maintain
a criminal ban on OST.
The Russian government argues that the legal ban on OST is to promote the
right to health; the legal ban is mandatory for all, so there is no discrimination of
any kind. The arguments that they present to the European Court of Human
Rights (ECHR) are based on the notion that the low level of retention in
abstinence-based treatment, which is the only method of treatment available in
Russia, has nothing to do with the treatment’s low effectiveness, and that people
return to drug use because of their lack of motivation to stay abstinent.
According to the government, the introduction of OST will further demotivate
people who use drugs from abstinence. Taking this one step further, the
authorities insist that the awful health and legal risks people who use drugs face
should scare and ‘motivate’ them into abstinence – in spite of there being no
scientific evidence to support such an argument.
The ECHR hearings will take place sometime in 2016. Meanwhile, because of the
government’s stubborn resistance to OST, thousands of people who inject drugs
contract HIV every year. The current denial of access to OST in Russia is not unlike
the denial of access to antiretroviral therapy (ARVT) in South Africa at one time,
when myths and ignoring clear evidence led to millions of unnecessary deaths.
Mikhail Golichenko is at the Canadian HIV/AIDS Legal Network; Chris Ford is at
International Doctors for Healthier Drug Policies (IDHDP)
Russian drug policies are fuelling the escalating
HIV epidemic, says
Chris Ford
with input from
Mikhail Golichenko
From our Foreign Correspondent
Zero tolerance, zero cure
