The International Network of People who Use Drugs (INPUD) condemns Russia’s denial of access to essential medicines in Crimea

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Methadone and buprenorphine, often referred to as opiate substitution treatment (OST), are classed by the World Health Organisation as ‘essential medicines’. Opiate substitution programmes increase adherence to antiretroviral therapies and contribute to decreasing incidence (new cases) of HIV amongst people who inject drugs. They reduce morbidity and mortality of people who use drugs, and increase quality of life for many. They are imperative harm reduction interventions.

People who use drugs in Ukraine have had access to harm reduction interventions, including OST, for around 10 years. Yet The Russian Federation opposes the provision of many harm reduction interventions, including OST, violating their citizens’ human rights to the highest attainable standard of health.  Opiate substitution is outlawed in Russia, and the spread of HIV in Russia has been primarily driven by a lack of harm reduction interventions, with very high HIV incidence amongst people who inject drugs.

Following Russia’s annexation from Ukraine of the Crimean peninsula in March 2014, methadone provision was rapidly halted. Seized methadone was burnt, with this destruction of medication televised. The provision of methadone officially ceased in May 2014, only two months after the annexation had taken place. This is despite the fact that coming off methadone safely can take considerable time, and can result in people recommencing use of other opiates.

Instead of being offered healthcare and service provision, people who use drugs in Crimea have been expected to endure opiate withdrawal and a lack of holistic healthcare. Since Russia’s annexation of Crimea, as many as 100 people who use drugs have died.

Since opiate tolerance can be reduced following periods of abstaining from heroin/opiate use, many have died from overdoses as a result of beginning to use heroin and other opiates due to the unavailability of methadone. Others have died by suicide, such is the desperate situation for people who use drugs in Crimea. INPUD is also concerned by the probability of increasing HIV and hepatitis C incidence that may result from people recommencing injecting drug use in a context where it is extremely difficult to acquire sterile injecting paraphernalia. Moreover, in addition to Russia’s denial of these essential services to people who use drugs in Crimea, the Donetsk and Luhansk areas of Eastern Ukraine have had healthcare provision, notably provision of antiretrovirals and OST, catastrophically impacted by ongoing warfare.

Background Note on Crimea  and  ‘Slow Death in Ukraine’  short film (English, PDF, 221 Kb)

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