Mass Deaths in Crimea as Russia Bans Methadone

Soon one year will have passed since Russia’s annexation of Crimea. I remember it well: March 16, 2014. What happened next caused a lot of distress for everyone in Crimea. Life was upended, from the invalidation of our passports to the loss of land rights to the introduction of a new currency. But for people who use drugs, the annexation and its aftermath unfolded like a nightmare. Under Russian rule, the life-saving treatments of methadone and buprenorphine were abruptly taken away.

Opiate substitution treatment, in which people who are drug-dependent are given daily medicine to aid in their recovery, is used in many countries. It’s part of a broader strategy to prevent the spread of HIV and other health and social harms associated with illegal drug use. In Russia, however, substitution treatment is banned by federal law. So when Russia annexed Crimea, 800 people were suddenly cut off from their treatment. For patients, the loss of this support was devastating to the delicate balance of medicine and communal support that makes treatment possible.

Substitution treatment is not just about taking a pill. It engenders a whole new way of life. Besides access to medical and social support services, it gives people new friends and families. People in Crimea came to the treatment sites to get together, play chess, have picnics, and celebrate birthdays. They came to date and get married. Basically, to live life as most people do.

Once these centers were closed, a small group of patients were able to move to Ukraine and resume treatment thanks to support from the International HIV/AIDS Alliance. This wasn’t an option for the majority of patients, however, who were unable to move because of family, disability, or work. These people were stuck in Crimea with two choices: they could cope without any treatment at all, or utilize one of Russia’s so-called rehabilitation centers, which are ineffective to the point of being useless.

For many of those who tried to cope on their own, the end of substitution treatments meant the end of their lives. Andrey was one of those lost. A 50-year-old man who had no close family of his own, the treatment center was his home and his family. After the substitution treatment program was shut down, Andrey could not cope with the realities of life without it. Soon after, he committed suicide.

For a patient named Anton, seeking support at the Russian treatment centers proved no better. Having suffered through horrible abstinence-based treatment, he escaped the clinic and soon started using street drugs again. He died of an overdose.

I knew that both of these men might die as a result of their treatments being cut off, which is why I included them in the short film I created. You can view it above. Both of these deaths are emblematic of the havoc wrought by Russia’s termination of the treatment so many in Crimea rely on for survival.

In January, UN Special Envoy Michel Kazatchkine announced that approximately 80 to 100 people had died in Crimea since the drug treatment programs closed. That’s nearly one out of every ten patients.

Each of those deaths reverberates far and wide. Drug addiction is rarely confined to a single individual. It affects large numbers of people: family members, friends, acquaintances, colleagues. In this way, far more than 800 people have been affected by Russia’s decision to shut down the centers. For those in Crimea who were on the path to a better life, the future suddenly looks grim.

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This is a travesty. Why can't the UN force Russia to reinstate the Crimea's program. If Russia cut off necessary medication to people who were not addicts there would be world wide outrage.

The most vulnerable face the brutal brunt of the power seekers - that is the history of civilisation. There needs to be global outrage about this despicable situation.

This is absolutely abhorrent. Wherever Russia steps in, it's like time starts flowing backwards. I have no clue what i would do without the substitution treatment, or without some sensible alternative. I'm ten years on methadone, living absolutely normal life for the majority of those years which probably wouldn't be the case without the substitution. This is horrible situation and it must be hell to live through it.

Thanks for posting. We know Russia is a political bully but who would have ever thought of such collateral damage as this? Tragic to think of the senseless hurt that came out of Russia's hunger for power.

Russia is a "political bully?" The biggest bully on Earth is the USA. Russia has been and always will be one of the most "Bullied" nations of the USA list of victims.

Whether the US or Russia are political bullies, or who is the bigger bully is irrelevant to this discussion. This discussion is focused on the removal of treatment options.

I'm sure it was excruciatingly painful for a lot of people, but the two examples given showed "indirect" mortality and the 80-100 figure wasn't substantiated. Sounds more like harm reduction "propaganda" than actual, factual reporting.

Just like the UN started prohibition and enforced it everywhere, now IT'S TIME FOR THE UN TO BRING PROIHIBITION TO A QUICK END IN EVRY COUNTRY OF THE WORLD: of course there will be someone who could be harmed by free drugs, there already are many people who are, i.e. alcoholics and smokers, as IS TRUE AND NOT A CLICHE' THAT ALCOHOL AND TOBACCO ARE TOTALLY TWO DRUGS LIKE OTHERS, but most people will get the oppostite result and will stay away from drugs, if you provide people the due education, or will use it wisely. As long as the statistics are made by the death/disease/arrests toll numbers, we really don't know how many people actually uses drugs safely, as they don't need help and so they don't fit the statistics. END THE DRUG WAR NOW UN - DON'T LET OTHERS LIVES GET LOST IN A DENIAL OF LIFE STRATEGY! Time to change is this

UN PLEASE END THE DRUG WAR NOW IN EVERY COUNTRY, just like you started and enforced long ago. There will be someone harmed by free drugs, of course, but the majority will stay away from drugs (as legalizing will come with a proper education to be provided us all) or will use drugs wisely. Many already do, but we don't know, as the statistics are made by the numbers of death/disease/arrests toll, and so those who live a healthy and productive life on drugs usually don't get in the numbers. TIME TO END A PRIMITIVE INQUISITION-ISH GLOBAL GENOCIDE! Many solutions are available. A Prayer of Light for Crimean MMT people, with all of my heart. God bless

I am sorry for those who died but I applaud the Russian and Crimean authorities who banned the use of the drug Methadone and all of its companion drugs . I live here in the United States I know this drug and the reasons it was suggested and manufactured to treat Heroin and other chemical substance addictions but Methadone is also villainous just as heroin is . It as heroin or other criminal acting supportive drug must be criminalizes .

Russian situation, number of addicts, number of HIV positive and other infection, number of people who always back to drug are result of lack of Methadone. Crocodile drug is found only because desperate addicts tried to stop withdrawal symptoms on any cost. Why Switzerland no Crocodile, because patients there get completely safe and non toxic opiate medications. Hundreds of thousands people die in world every day because they don't want to start Substitution Treatment and think they will abandon heroin without them, and that never happen and they die, or constantly back to drug. Most of patients on Methadone are people who 10 times failed with other treatments. If only country where no Methadone have 10 times worse situation then worse country with Methadone Treatment than they should serve as example of fail. China sentenced drug lords and addicts to death, many years without effect. First positive effect they saw with Methadone. After that they opened few thousands of clinics and situation is far better than before. Repression and torture is not solution, situation become only worse. But China is smart and they don't want to sacrifice own people as Russia. I saw picture where police communist give dosage of Methadone to addict with smiley on face, Why? Because they are practical, they very fast recognize what is better for own people and don't allow anybody to tell them Start with Methadone or Stop with Methadone. They start pilot project and after that no one civilized and human can't ignore positive results. And they didn't allow prejudice to decide. Problem is because last few years some pharmacists gone to far from original Methadone patent to save cost and new Methadone is far less effective with more side effect.Now I see some small number of pharmaceutical companies start again to advertised their Methadone mixture as original because they recognize that patients couldn't success to live with weaker and inferior Methadone mixtures and Russia use bad Methadone as example and explain how Methadone is not effective and make more problems than help.. But I think that WHO should be involved to publish guidelines and organize production on Methadone on old way.

I think victims must be treated and then find measures to prevent further occurrences.

While a drug free existence is the preferable option, buprenorphine and methadone save lives and improve their quality. This is based on solid scientific evidence. The research was of course conducted with well set up clinics that supplied controls and psychosocial rehab, and we're not just the shameful methadone mills one still sees.
As for Russian psychiatry, let's remember the old Soviet ways of controlling dissidents through its many leaders .and not a few of its practitioners. Just as the FSB is the child of the KGB, current mental health policy in Russia bears a resemblance to its parent in the Soviet Union.
The Soros foundation did much to reverse this but apparently old attitudes linger.

I would say that it is their way of gencide,who is going to fuss over a few druggies so very sorry ,but that country is known as bullies

It makes me wanna cry, as what a better treatment - call it call Cold Turkey. How did China deal with its drug addicts when the Communist came to pass, much more human, however, keep in mind who was selling the drugs.

subutex is a newer medicine that is expencive but i think that the people who were cut off should have had access to subutex or bupinorphine.

Why are there so much negativity towards Russia? This fund supports drug use and drug addition (may I remind you that cannabis is a drug). So, first of all you need to criticise those people and groups who promote light and heavy drug use, who promote bloody and long revolutions which lead to deaths and poverty (Ukraine).

So should alcohol, tobacco and caffeine be illegal and outlawed? I mean you can become addicted to all three and they are all drugs...

I feel very bad for these people and there families. As someone who has been on Methadone for 2.5 years I understand what it would be like to have it taken away. It inhumane. Methadone has allowed me to get my life back. I not have a full time job learning to be an electrician and a great relationship with my family. Putin should be publicly hung.

The problem with methadone and subutex is virtually all of its users continue using it for life. They stay drug addicts but their dealer is now the state. It is not a solution.

We must move past this method of continuing addiction and rehabilitate these individuals so that they can return to a normal life free of drug dependency.

Russia should try a trial Methadone on Heroin Addicts. I watch on you tube the problem in your country caused from Afghanistan Opium production. Some Addicts clear the body on Opiate ,and others don't! It is worth a try!

I live next to Fargo ND and there is a lot of Heroin here and Fentanal.

subutex, Most patients don't like Russian State policy
Melonis Kaopu MD When it does not involve the Medical community with out state politics.

Let oral Methadone treatment in. the government are not Medical certified !!

It's shame what happen in Russia and how they treat addicts. That's genocide, no other words. Pure genocide. They ignore all medical facts about addiction and treatments and put own personal and sick ideology on first place. There are many evidence that condition of patients depend from decisions of health works and choice of treatments but in Russia health workers don't care. Europe and USA are not aware of devastating influence of Russian ministry of Health on orthodox countries on Western Balkan where many politicians are ready to lie in Russian favor and listen Russian proposition.Because of that Harm Reduction Program and Substitution Treatment Quality there is completely destroyed and EU not react when victims of Russian lobby are pro NATO and EU supporters.Something must be done and we need to be united in fight against Russian influence in Europe completely. Objective need to be zero Russian influence in Europe because they spread dead, poverty, autocracy, cult of Putin and put human rights on last place. Serbia example have affair with Substitution Treatment quality only because Russian lobby try to spread false image about Substitute treatment and Harm Reduction and they have help from Serbian allies. Not all but there are politicians who share their opinion and hide real picture from EU.

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