Ibogaine update

Well readers, I have a treat for you!

Ten years ago David Graham Scott (whom we have written about and written with on this website) screened a very personal documentary on channel

Documentary filmmaker David Graham Scott on his journey to rid himself of heroin and methadone addiction. David during the dream phase of the Ibogaine drug. Copyright david gillanders_photography 2003 Not to be reproduced, printed or published without prior consent from David Gillanders. m_ + 44 (0)7974 920 189 e_ david@davidgillanders.com

Documentary filmmaker David Graham Scott on his journey to rid himself of heroin and methadone addiction. Above: David during the dream phase of the Ibogaine drug in the film Detox or Die. Copyright 

4, about his own experience as a person struggling to finally quit using methadone -by using ibogaine. The film Detox or Die has since been viewed many, many thousands of times on the web and at film festivals and conferences. It is a really interesting, personal and thoughtful film about his attempt to embrace the spirit of Iboga, by using a guide, who stayed with him throughout the entire two day ordeal, something he filmed entirely.

Well, my treat for you in David’s follow up film made 10 years later. David not only talks about his own experience of staying drug free since then but he looks at Ibogaine in other treatment settings -one persons actual DIY treatment to cure their heroin addiction, another couple of guys who embarked on a ‘journey with ‘a guide’ whom they paid a couple of thousand pounds, someone who bailed halfway through the treatment, as well as talking to some other dependent drug users about kicking their habit and their hopes for ibogaine working for them.

Portrait of filmmaker David Graham Scott today

Portrait of filmmaker David Graham Scott today

It is a classic piece of work, expertly made by a pro, we are dead proud of him here at BP and happily I can provide you with the link to watch not just Detox or Die but the more recent Iboga Nites -which came out in 2013. David has already won numerous awards for the film and it should spark interest and debate for some time to come. Well worth a watch for anyone remotely interested in detoxing or the subject of drugs.

This comes from David’s website detailing information on the film Iboga Nites

“The psychedelic plant root hails from Africa where it has been used in religious ceremonies through countless generations. A burgeoning movement in the west has promoted iboga as a quick fix route to painless withdrawal.

Now David wants to find out how truly effective iboga is. In a Dutch suburb several addicts embark on the long night of psychedelic detox under the watchful eye of an experienced Iboga practitioner. One client collapses and ends up on life-support, the provider is jailed and David starts to question the safety of iboga treatment.

 The film culminates with a nerve-wracking iboga session in London where the director himself administers the treatment. How does the filmmaker weigh up the ethics of involving himself so deeply in this controversial detox option and what will be his final resolve on the efficacy of it?”

IBOGA NIGHTS from David Graham Scott on Vimeo.

Good Practice Guide for Employing People who Use Drugs

Good practice guide for employing people who use drugs  – An indispensable toolkit (click link)

PWUD (People Who Use Drugs) have insights and expertise that can help inform the planning, delivery and review of harm reduction and HIV services. When we involve PWUD in the design and delivery of services, our work becomes more relevant, targeted and accessible. Working in partnership with PWUD helps our services to reach and connect with other PWUD more effectively, and to understand and meet their needs. A really powerful way of involving PWUD is to employ them as staff.

Employing PWUD sends out a clear message that they are valued partners and are welcome at all levels of service delivery. It also has a very practical set of benefits, helping services to better understand the needs and lived experience of PWUD. PWUD have the right to be employed. Policies that routinely exclude PWUD from the workplace are discriminatory.

When drug use is a problem (and when it is not)

Drug use is complex, and debate on the rights and wrongs of it can become easily polarised. In this context, the medical (disease) model of drug use tends to dominate. This emphasises the problems of dependence as an inevitable consequence of using heroin and other drugs. As a result, the response to drug use is often described as a treatment or cure for a medical illness. The medical model also dominates many 12-step programmes, such as Narcotics Anonymous (NA). It also influences the way many health professionals, academics, politicians and members of the public understand drug use. They share a belief that PWUD quickly lose the ability to control their drug use, and make conscious, autonomous or rational decisions about it. However, the United Nations Office on Drugs and Crime (UNODC) acknowledged in the World drug report 2014 that only 10% of PWUD will experience problems arising from their drug use.

This implies that many people’s experience of drug use can be non-problematic and often pleasurable. Similarly, some of our staff will have experiences with drugs that are non-problematic and recreational. Although in the alcohol field the concept of controlled drinking is now widely accepted, for many years the possibility of non-dependent and controlled heroin use has been largely ignored, despite evidence that such patterns exist.

This research demonstrates that some people are able to use heroin in a non-dependent or controlled manner. Studies of people using cocaine have also shown well-established patterns and strategies for self-control. These studies highlight the importance of the social context in which drugs are used and its impact on an individual’s experience of drugs and their effects.

We learn from these studies about the importance of context when trying to understand drug use patterns, and question the value of framing drug use as an individual failing or illness. (text taken from the guide itself. To receive a copy of the guide click the link at the top of this page)

Also read:

International HIV/AIDS Alliance (2010), Good Practice Guide. HIV and drug use: community responses to injecting drug use and HIV. Available at: www.aidsalliance.org/assets/000/000/383/454-G ood-practice-guide-HIV-and-druguse_original.pdf?1405520 726

This guide has been developed by the International HIV/AIDS Alliance (the Alliance) as part of the CAHR project, supported by the Netherlands’ Ministry of Foreign Affairs. The International HIV/AIDS Alliance in Ukraine (Alliance Ukraine) led this work, supported by the programme “Building a sustainable system of comprehensive services on HIV prevention, treatment, care and support for MARPs and PLWH in Ukraine”, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

 

Be Wary of the New Stylee Drug Rip Off

Something to spread among our community friends -a new style of rip off affecting drug users on the internet.

If your gonna do it - pass it on in the safest way possible.

If your gonna do it -be careful out there!

The other day while helping out on the Release Drugs Helpline (Release has THE BEST team of assembled minds to solely eat, sleep, think, create and research ‘drug use by the common dude’ -in ALL its incredible shapes and sizes. A knowledge that is only attainable by a  ferocious interest and total  immersion in the ‘Good the Bad and the Ugliest of every corner of the biggest dark room of synthetic and organic drug use and its role in our society today. We can’t advertise about it too much because we don’t have the resources to do the work that we know is out there and will flood our way should people find out we exist.

Anyway, I was answering a call on the helpline, which covers every kind of drug related call from worried mums and partners, to drug tests at work, to bullying or coercion to detox etc, from staff at methadone clinics,  to ‘what drug is this’ to ‘help I think I am in a mess -am I?’ and everything in between, before and after, when I got an interesting call.

For info on the RELEASE Helpline -click here

A very worried guy started telling me this story. He said his boss was a recreational drug user, who was using too much of everything and was spiralling out of control a bit. One night, his boss and a few other workmates were at his house (the phone guy) when the boss says ‘Hey, lets order some drugs on the internet -I know where and what to ask for’.

Everyone was drunk so agreed without thinking too much about it. The boss needed to use his employees computer right there, and his email -and sent off an order using – FIRST WARNING SIGN – a Moneygram money order – for mephedrone. It was to the USA.

48 hours later, the phone guy (the employee) starts getting emails -loads of them -and then phone calls -constantly. The people on the end of the phone said to him “I know what you did -those drugs are illegal. We are in Ghana and our company have intercepted your illegal shipment of drugs -destined for you in the UK. We want you to send $2000 immediately by way of a Moneygram order to a bank account we will name shortly – OR we will contact British Police and tell them everything and send them the drugs for your prosecution.

The poor employee was completely freaking out -his saw his entire ‘straight’ life crumbling around him in a mess of lies and police raids. He had not told his wife and was trying to hide everything. His boss had no real sympathy and told him to ignore it.

Unfortunately, the dude had to hang up fast as his wife came home and he didn’t ring back. However, he did say that the phone calls had stopped during the last 24 hours and so had the emails. So I am hoping things went quiet and the shitfuckers with the rather clever scam, went elsewhere.

In any case, our advice would have been to ignore it completely. A complete chancers scam, one should just call their bluff, maybe get ready with a story to tell your wife or boss if an email goes around from them with your order on it (which is probably not likely -but possible) -and say you were just curious but didn’t do anything -etc. I am sure you could think of something decent to explain your out of character behaviour.

Of course one must be very careful re buying internet drugs – always do your research -always read between the lines re-reviews, only buy via recent recommendation from a previous purchaser. And don’t inject anything you get through the internet re research chemicals. By the look of the very odd occurrences that happen to people who overdose on cathinones, (it looks like no other kind of overdose -and closer to poisonings from chemical gases or nervous system toxicity like chemical weapons exposure etc. Very disturbing so tread super careful with chemistry and what you dont expect… Google ‘frozen addicts’ on our website and see what one small mistake in the lab -one wrong molecule -can create in the average heroin user.

click this link to see it -its unmissable.

 

New York City; Drug Use in the Belly of the Beast

Here is a story from an incredible activist from back in the day called Peter VanDerKloot. Peter actually fought to keep open one of NYC’s main methadone clinics from closing, by agreeing to put his entire face (and his boyish all-American good looks) onto a FULL PAGE advert in a NYC newspaper, telling people that methadone had saved his life and was saving the lives of hundreds of others and that it just must not be closed down! It wasn’t, and Pete went on to do some fabulous work in the field and, though I don’t know where he is now, we are lucky to have had a few articles from him. Here is one. From issue 2.

 

Pic by photographer L. Bobbe 1970's NYC

When the Black Poppy crew asked me to do a column on the dope scene in the States, it got me thinking about all that’s changed in my time as a dopefiend here in the Belly of the Beast. It’s hard to believe it’s been 15 years since Ron and Nancy Reagan cranked up the heat on the War on [Some] Drugs and sold folks on the idea that invasion of ones home by a SWAT team was something that all Americans had a right to expect. Not that this was the first time our fearless leaders had declared war on a molecule. We’ve been through plenty of chemical warfare in this country, from turn of the century campaigns against cocaine-crazed Black men visually raping Southern belles with  their dilated pupils, to drives in the 70s to save pot-head teenage boys from the shame of Dolly Parton-esque breast growth. All along though, it’s been us dopefiends who’ve made up most of the casualties. Hell, we started the century able to buy pure heroin via mail order and now we end it unable to buy dried decorative poppies in the florist’s.

 

Still, the last two decades have been rougher yet. The powers that be seem to have decided that the solution to unemployment in our post-industrial

https://vimeo.com/106919970

The typical sort of NYC_heroin-baggies_ From Graham MacIndoe’s collection, see more in his photographic book, wraps he collected throughout his using days. Fascinating!

economy is to imprison half the population and hire the other half to guard them. At the rate we’re going, we’ll meet that goal soon – as it is, nearly 1% of our adult male population is currently behind bars.  No other Western democracy comes close, and when you factor in the effects of spiraling mandatory drug testing, increased police powers, and ever-decreasing privacy, you can bet that that lead will remain unchallenged – even if our right to call ourselves a “democracy” does not.
Here in my hometown of New York City, the dogs have really been loosed on us. The tanks are filled with public beer drinkers and subway fare-beaters, and you can catch a six month bit just for looking cross-eyed at a cop. And yet when it comes down to copping and getting off, the War on Drugs hasn’t made much headway.economy is to imprison half the population and hire the other half to guard them. At the rate we’re going, we’ll meet that goal soon – as it is, nearly 1% of our adult male population is currently behind bars.  No other Western democracy comes close, and when you factor in the effects of spiraling mandatory drug testing, increased police powers, and ever-decreasing privacy, you can bet that that lead will remain unchallenged – even if our right to call ourselves a “democracy” does not.

 

When I first got turned on to heroin, New York was still the dope capital of the world, and “Alphabet City” was still the capital of New York dope neighborhoods. In the days before the real estate interests moved in and the area was declared an extension of the “East Village” and hence suitable for yuppie inhabitation, the streets belonged to us, and you best believe we made the most of it. Block after block of abandoned buildings and vacant lots were commandeered by major dealing organizations. The streets echoed with the cries of the steerers touting the brand names of different bags: “Red Tape!… Seven-Up…ET!!”  We’d line up to cop in queues stretching around the corner, kept in place by enforcers with golf-clubs in their fists or pistols in their waistbands who’d order us to have our money ready and fanned out just so — reminding us not to linger post-purchase with chants of  “Cop and bop!” Street traffic was heavy too, as the narrow streets were choked with cars with out of state plates down either to supply the driver’s habit or to run a few bundles back for resale.

For the rest of this excellent article, click here.

Dealer’s Discuss

Articles from BP’s back catalogue….

Here’s a chat with a few of the people doing the biz, day in and day out, they haggle and hassle (and we cough up and complain)…But by and large, dealer’s are just like us, most are just trying to keep their own habits going without resorting to ‘other methods’. Can’t blame them. Dealer’s don’t sit out the front of schools tempting kiddies, they rarely want to sell to a newbie. In today’s world of prohibition and drug habits, dealing to keep your own head above water, is a way of managing day to day. It is the result of drug laws that leave all our drugs to the influences of the black-market. Some dealer’s are a nightmare, some violent, some a complete rip-off. BP says; if you are going to deal drugs -have compassion, take pride, do your best to give a clean product and treat your customers with respect. It shouldn’t have to get down and dirty. See our ‘Dealers Certificate’ and sign up to it. Let’s make the best of it and treat each other well; we are all struggling out there.

 

Martin (does heroin & crack):

“I wouldn’t call myself a dealer personally, and this very important to me; whether it’s the profiteering aspect or the pushy aspect, to me it makes a difference. I feel I am providing a service – most of my clients are middle class,  I see them twice a day, the same faces; My employers you could call business men or drug dealers, but again, its supply and demand. We don’t push drugs onto other people, we don’t go looking for new converts.

I guess I do it out of choice – it suits my lifestyle,  I’m paid a salary – I see the guy at the end of the day and get paid up. It doesn’t work on a commission basis like some setups. I use drugs myself so naturally it keeps my habit looked after. I look at it as a proper job, one has to be professional, it entails a hell of a lot from you and the law aspect is also on your mind. Yet sometimes one reaps the benefits and hits the highs, and meets some amazing people along the way. The myth of the user / dealer’s relationship is complex – discovering all the layers within each customer as you get to see them day after day in all manner of situations…It can be tough job.”

To see the rest of the article click here….

How to build support: influencing politicians /policymakers

Hi again, For all you activists out there, check out this really terrific piece of work from some really interesting collaborators  – and all their materials are available for others to use. Really useful stuff on how to explain the issues affecting people with multiple needs  so that politicians and policymakers can understand the issues and the people better and thus, should be more able and willing to really listen.

Thanks to Opportunity Nottingham and Voices from the Frontline:

Voices from the Frontline is an “exciting new project to bring the voices of people with multiple needs and those who support them to the heart of the policy debate.” Click here for more info. I love their thinking! Opportunity Nottingham exist to help people fighting at least three of the following: Reoffending, substance misuse, homelessness and mental ill health. “In achieving our primary goal of helping people we are also going to change the way the existing system of support works.” Bloody fantastic! I love this new way people are starting to think regarding issues of homelessness and incarceration, mental health problems and drug use etc; we have developed certain tools of empowerment -now we need to cross that divide, find out how we can make politicians really, but really understand our issues. Places where we can find the common ground, the language; As they say in the notes of what came out of their collaboration, “We need to move away from defensive practice.  Services can help people raise their voice, but they’re not really listening if they’re only defending their own position”. So true, so  true. Visit these sites my friends, for some really useful tips.

Bye for now – and thanks to the people working so hard to develop these amazing organisations and work towards changing the minds of some of the stubbonist in society – the politicians and policymakers!!

Here is the piece below…

How to build support: frontline tips for influencing politicians and policymakers

See entire article on the website by clicking here: 

Last Wednesday, a number of participants in Voices from the Frontline traveled to the Multiple Needs Summit in London. Over the last few months, all of them have been involved in a conversation about what the next government should do to improve support for people with multiple needs.

A big part of this conversation has been about how to explain the issues affecting them so that politicians and policymakers can understand and will listen. For that reason, we held a joint workshop with Opportunity Nottingham (an organisation improving services for people with complex needs in the city) to explore this.

One thing was clear: there’s a huge amount of knowledge out there about how to put the case across. Here are some of the best tips that people had.

  1. Get the right people in the room, and you’ll get the right answers. Go into a room feeling confident. Get people to listen to what you say (even if they roll their eyes.)
  2. Bring people together and get them to talk about a real case study. Then they’ll realise that languages are different, and there are other worlds they very rarely think about.
  3. Beware of ‘innovation fatigue’. For instance, someone explaining Fulfilling Lives (a major programme to help local areas improve how they work with complex needs) met with people saying “you’re just another person coming to my meetings – we’ll never see you again”.
  4. Sometimes the bad news and bad stereotypes that exist can make it really difficult. It can help to capitalise on them, though. “If I don’t address those stereotypes, we haven’t had a conversation.”
  5. The higher people are up, the less they know about what’s happening down below. Build relationships based on helping them see what’s happening. How do you bring things that don’t work to their attention?
  6. We need to move away from defensive practice.  Services can help people raise their voice, but they’re not really listening if they’re only defending their own position.
  7. Be a critical friend.  Or, as one person put it, “don’t throw a strop.”
  8. Finally, don’t assume a divide between policy people and lived experience.  There can be more overlap in their knowledge and interests than we sometimes assume.

(Should you be interested, you can read all the notes from the workshop here.)

If you want to think about how your own organisation could do more to influence decision-makers, Opportunity Nottingham have produced a brilliant handout summarising some of the things they’ve learned. Feel free to share it with others who you think might find it helpful.

Making Every Adult Matter

Making Every Adult Matter (MEAM) is a coalition of four national charities – Clinks, DrugScope, Homeless Link and Mind – formed to influence policy and services for adults facing multiple needs and exclusions. Together the charities represent over 1600 frontline organisations working in the criminal justice, drug and alcohol treatment, homelessness and mental health sectors.

For more information, click here.

And for the conference called

MultipleNeeds Summit 27th April 2015

MultipleNeeds Summit 27th April 2015

MEAM Coalition

@MEAMcoalition

Making Every Adult Matter (MEAM) – A coalition of     and  dedicated to tackling multiple needs and exclusions.

Thanks for the chance for credited reprinting everyone. BP xx

 

 

 

 

 

 

 

The History of Drug User Activism in Australia; by an Aussie Activist Superstar

Dont Miss this!!! If you want to find out the story of drug user activism in Australia by a woman who was not only there but integral to the very essence of active drug users doin’ it for themselves, setting limits in the sky and rockin right up to parliament house itself to get the job done – then you cannot miss this production!! From WHACK; Victorias Drug User Magazine; Annie Madden, the firebrand of an Aussie cog in the Aussie activist wheel, was asked to write about he years of experience and knowledge around the evolution of the Australian drug user history movement – and it is compulsory reading my friends! The History of Drug User Activism in Australia by AIVL’s Chief Exec and Superwoman incarnate, Annie Madden – get out your reading specs, sit back with your favourite tipple, and IV the contents of this fabulous issue….

Please click this link for the easy to read online magazine, which you can print out.

http://hrvic.org.au/docs/historyofIDUactivism/index.html

A Word About Ms Annie Madden…

Annie Madden, Chief Exec, AIVL Australia; Australia's Own Superstar Activist!

Annie Madden, Chief Exec, AIVL Australia; Australia’s Own Superstar Activist!

Australian Injecting & Illicit Drug Users League (AIVL)

Annie Madden is currently the Executive Officer of the Australian Injecting & Illicit Drug Users League (AIVL) which is the national peak body representing state and territory drug user organisations and illicit drug users at the national level. Prior to her current role, Annie was the Co-ordinator of the NSW Users & AIDS Association (NUAA) for six years. She has an honours degree in Social and Political Sciences. She is on numerous national, Commonwealth Government and research committees including the recently appointed Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis C and regularly takes extremely effective roles in global United Nation and WHO reviews, committees, global guidance publications and drug related recommendations. She has been working in the areas of illicit drug use, HIV/AIDS and hepatitis for over 14 years, has been an injecting drug user for over 18 years and on methadone for many years also. Annie is one of the world’s most inspiring women user activists who has worked tirelessly day in and day out to challenge the discrimination and human rights violations occurring to people who use drugs. And not just in Australia where she works at the top of her game, going head to head with politicians and Charity heads, doctors and do-gooders, parents and always her peers – drug users, but around the world, wherever she gets the chance to fight against ignorance and discrimination, for women who use drugs, for all of us, of any colour. Annie Madden is a woman we should all be proud of, especially, as drug users, we are lucky enough to have her on our side. Coz she is a truly kind and caring person, humble, hard working, smart and emphatic. Thanks for all you’ve done Annie Madden, and all your future will bring. We send you thanks, light and love.

Your friends at BP and around the world, those who know you, love you, and those who haven’t yet had the pleasure, thank you.

Succinct Explanation about the Many Misconceptions About ‘Addiction’

Check out another neatly defined, succinct and straightforward explanation of the roots of ‘addiction’ and just how society became laden with so many misconceptions about drug dependence or ‘addiction’. Dr Cart Hart has a new book out called High Price. Just 20 minutes long, this is a very useful listen for people wanting to know a bit of history around how we came to view ‘out of control drug addicts’ as the norm. He also mentions his fascinating research delivered over a few years around crack and crack users, which challenged many of our most deeply ingrained ideas about crack users. Get your facts up to date and have a listen..

Thanks to Vox.com for the article and video, though I think it originally appeared on TedsTalk.

Carl Hart is a neuroscientist and drug addiction expert at Columbia University. In a recent TEDMED talk, Hart spoke about drug addiction and the many misconceptions surrounding the topic — and how those misconceptions can mislead drug policy.

Hart went into neuroscience to cure the drug addiction he blamed for causing crime and poverty in his old Miami neighborhood. But when he began to work on the issue, he learned that his assumptions were wrong.

About 80 to 90 percent of the people who use illegal drugs don’t turn out addicts, Hart explained. As an example, Hart pointed to the three previous presidents, all of whom used drugs when they were younger. “Their drug use did not result in an inevitable downward spiral leading to debauchery and addiction,” Hart said. “And the experience of these men is the rule, not the exception.”

THE FINDINGS SHOW THE PROBLEMS ARE MUCH MORE COMPLICATED THAN SOME BELIEVE

As Hart explained, many of the current assumptions about drug addiction are based on old animal experiments from the 1960s and 1970s. In these tests, animals were put in a cage with a lever that they could pull for a shot of a drug. Researchers found the animals would pull the lever until they died from an overdose.

Hart said these animals were never presented with an alternative, though. In other experiments, animals were given another option: a mate or a sweet treat. At that point, the animals began choosing the non-drug alternative, and they didn’t take the drug until they died.

Hart followed up on these experiments with human participants in 2000 and 2012. His lab recruited meth and crack cocaine addicts, and the addicts were given the option to choose between a small amount of money or their drug of choice. When the money option was $5, they chose the money about half the time. When the money option was $20, they chose the money about eight out of 10 times.

The results, of course, don’t diminish the real problems of crime, poverty, and drug addiction in some of America’s communities. But the findings show the problems are much more complicated than some, including a younger Hart, believe.

 

Check out the useful flip cards and the rest of the article here.  Listen to Dr Carl Hart give a clear account of the many misconceptions around drug use and where they sprang from. 

 

Life Goes on In Crimea, (unless your on methadone…)

Life Goes On in Russia’s Crimea

Here are the final 2 blogs in the series of 4, from Igor Kuzmenko’s personal blogs of Crimea, in particular, life for those who once lived under Ukraine law and received Opiate Substitution Treatment (OST) such as methadone only to lose their new found stability after the region’s Referendum when the majority voted to go back to Russian governance. This effectively closed the doors for good on OST leaving over 800 people in shock and despair. So what is a person withdrawing from treatment supposed to do? What would you do if your access to methadone or buprenorphine was cut off almost overnight…? Igor gives us a frighteningly honest account of what happened to the OST community in Crimea..Here is part 3 and part 4.

NOTE: Part one and two are a bit further down this blog and the whole series has been reprinted here courtesy of INPUD’s blog and you can also read them in Russian at ENPUD’s website /blog. Thanks to Igor for a fascinating insight into Crimea for the drug using community, and INPUD for reprinting.

 

RIP Crimean OST Program, 2006

small_igor (1)

Igor Kuzmenko

Part 3

Meanwhile life in the Crimea went on. As spring approached, people continued to go to work, and students proceeded to attend their studies. Very few inhabitants of the Crimea understood that 806 people of the region’s  population, were literally on the way out.

 

Death From Abstinence

As I  wrote previously, the first patient in Simferopol died around the beginning of April. He was about 50, was seriously ill and couldn’t move at all. Everything was good with him before the March events; the doctor wrote a prescription for him so he could get liquid methadone and he continued to use Opiate Substitution Therapy without leaving the apartment. But after March 16, everything changed and the prescription form of OST was suspended in Crimea. It goes without saying that any coroner wouldn’t determine a cause of death as ‘death from abstinency’. But something tells me that if he continued to have the opportunity to receive methadone, he would be still alive.

 

 But after March 16, everything changed and the prescription form of OST was suspended in Crimea.

 

Bupe Not Methadone

Actually,  there were not so many people receiving OST on a prescription basis in the Crimea. And there were a few reasons for that. First,  the prescription form is possible only for those people who receive buprenorphine in Ukraine. There are cities where all clients of the buprenorphine program constantly receive it using a prescription. But everything is much more difficult when dealing with methadone.

ukrainianmethadone

The medicine used in a Ukrainian methadone OST program – known as ‘Metadict’ and ‘Metadole’ – are both made in Germany or Canada. Both of them are in the form of tablets, not syrup. They come in blister packs of 10 tablets: 25 mg each, (total 250mg)  or in bottles of 500 mg. But it is impossible to get it using a prescription because according to the laws of Ukraine a single prescription dose of any narcotic substance mustn’t exceed 112 mg. The blister packs are not allowed to be cut up or tablets prescribed separately from the packaging. There were individual cases when patients could receive a liquid methadone on prescription, but only on a commercial basis and it is very expensive.

 

Methadone Not Bupe

In the Crimea, it is different. Slightly more than 50 people out of 806 patients received buprenorphine, the others got methadone. About 10 people out of those 50 had the opportunity to receive buprenorphine on prescription though not on a constant basis. They got it occasionally – because of a business trip, illness or going on a holiday.

ukrainian-methadone-metadol

Ukrainian methadone; Metadol

 

There is also one more reason for prescriptions being shut down in the Crimea after “the referendum”. Doctors were afraid to write out prescriptions on both of these substances because they are actually illegal in Russia and so employees of drugstores in turn, were afraid to sell the medications and fill  these prescriptions.

 

May 20th – D Day

May 20 was the last day when people could use the OST program in the Crimea, so after that each of the 806 person’s who were prescribed had to make one’s own choices of what to do. There were only four options:

  1. String oneself up to stop using drugs forever
  2. Go to Russian local rehabilitation centers praised by numerous Russian “guests”;
  3. Continue using OST by moving to Ukraine;
  4. Go back to using “street” drugs.

According to my knowledge, no more than 20-30 people went to Russia for rehab. Many of them couldn’t undergo an entire “rehabilitation course” till the end and ran away. However, some stayed in rehab for the whole term. One OST client from Simferopol died in St. Petersburg during the rehabilitation process. He died of an overdose.

Slightly less than 60 people risked going to Ukraine. This option was, undoubtedly, the most realistic of all. For example, in many cases it was necessary to buy tickets at ones’ own expense to go to Russia, but in Ukraine both tickets, accommodation and food were paid for you.

 

Should I Stay or Should I Go?

Nevertheless, as you can see by the number of people who went to Ukraine, it didn’t become a mass phenomenon. Partly, this was due to mass media propaganda which colourfully described the various ‘atrocities’ of Ukrainians in relation to the inhabitants of the Crimea who risked leaving and facing the ‘mockeries’ of the Ukrainian border guards who were taking away passports on the border and other nonsense. The other reason that many of inhabitants of the Crimea never left for Ukraine, was they had neither friends, nor relatives there and simply couldn’t imagine where they were supposed to go.

Now many of the clients of OST who had gone to Ukraine, already found a job there, and all without exception found rented accommodation and received some financial support from the project MBF “Renaissance”.

 

“It turns out that more than 600 people started taking street drugs again.”

 

From those people with whom I was in contact no more than 10 people could finally stop taking drugs of any kind.    If you make simple arithmetic operation, it turns out the following:

806 (total number of clients in the Crimea OST program) minus 20 (number of those who undergone “rehabilitation” in Russia), minus 60 (left to Ukraine), minus 50 (suppose not 10, but 50 people stopped taking drugs) = 676.

About 30 already died out of that number of people. It turns out that more than 600 people started taking street drugs again. And many of them during many years of using the OST program found work, started a family and gave birth to children.  Now it’s all over.

 Igor Kuzmenko

Below is the final part of Igor Kuzmenko’s series on Crimea. Please feel free to add your thoughts and comments and let us know if you have a story to tell from your country.

 RIP Crimean OST Program, 2006

 

Igor Kuzmenko

Igor Kuzmenko

Part 4

How to reach those people who made decisions on the issues of Opiate Substitution Therapy (OST)  in the Crimea? Which words should be found to explain to them that situation where 800 drug users under constant medical and psychological control, employed and reintegrated, is much better than 800 people coming back to being criminalised in the drug trade? How could one explain what the blue sky is to the person born blind? How it is possible to explain to a mother, whose son quietly had been using OST for several years, stopped breaking the law, started a family and found a job, why he has died of an overdose during the rehabilitation? Who benefits from it?

“What we had been created for several years was destroyed in two and a half months.”

Probably, for those people who have nothing to do with OST and don’t have the slightest idea of what this therapy actually is, it is only a “change of the dealer” – earlier I bought drugs on the street and now I get them free of charge from the doctor. But actually OST is a difficult system in which the process of taking methadone or buprenorphine is only a small part of the whole process. OST is a complex of actions that allow the person to live a more or less productive life. Many elements of this scheme, such as the ART (Anti Retroviral Therapy*), anti-tubercular therapy, are strongly connected with OST. There is no point in pretending otherwise, many people started to use ART and to look after their health only after they visited the OST site.

 

Irina, a client from the OST program

Irina, a client from the OST program

Stability and the Street

What we had been created for several years was destroyed in two and a half months.

So, more than 600 former people from the OST programs have taken part in the illicit drug scene again since May. What do our people use to medicate themselves with now?

Lyrica. This beautiful and romantic word is actually the name for one of the biggest problems of the Crimean drug scene nowadays. Lyrica (active agent – Pregabalin). An antiepileptic and anticonvulsive medical product made by Pfizer Company. Many ex-OST patients are suffering from its over-use today. It has excellent medical qualities if you take it on prescription, but it causes terrible side effects and dependence for those people who try to combat withdrawal syndrome with its help. It is sold freely in any drugstore in the Crimea and costs not so much.

Only a total deficiency of any medical products in local drugstores is saving others from the serious consequences of pharmaceutical drug dependence in the Crimea.

“Now I hear from people who were full of vim and vigor, who had plans for the future just two months ago, that they want to die.”

Checks. “Checks” is how people name portions of raw opium from which it is possible to extract heroin, if you add acetic anhydride to it.

“Checks” existed in the Crimea as far back as I can remember. It is a good reliable way to quickly recover from withdrawal syndrome. You could get “checks” quite easily at any time. But after the OST programs were closed, hundreds of drug users suddenly entered the market (more than 200 people just in Simferopol! ) and devastated all the opium reserves in the Crimea. Moreover, new anti-narcotic structures represented by the Russian police (all police officers came to the Crimea from the Russian cities – Perm, Kazan, Moscow, there are not any local representatives in police) and by Federal Service on Control of the Drug trafficking (FDCS) – the nightmare of the Russian drug users. The increase in number of “checks” users led to a decrease in its supply and importing from Ukraine became a big problem.

By hearsay, so as not to suddenly miss an opportunity to increase profits, dealers began to add foreign substances to their product, it could be harmless substances or hard shit like home-made methadone. New police forces and new circumstances around buying drugs has led to the situation where purchasing “checks” poses a big problem now.

Heroin. I often hear from people in the Crimea that there is lot of cheap heroin here now. But I couldn’t find even one person who saw or tried that heroin. So I can draw a conclusion that there is not and there was not any heroin in the Crimea.

Krokodil. I assure you that if it wasn’t for a deficiency of medical products in drugstores, including codeine-containing ones, “krokodil” would now be problem No. 1 in the Crimea. But every cloud has a silver lining.  People just can’t find the substance that you should use to make this poison, and that’s why krokodil isn’t present in the Crimean drug scene.

“Well, this is how it goes.”

Well, this is how it goes.

Now I hear from people who were full of vim and vigor, who had plans for the future just two months ago that they want to die. Former patients aren’t able to go to work because they suffer from never-ending withdrawal syndrome. Their families suffer as much as they do.

I am an optimist.  My glass is always half full. But I can’t see anything optimistic in the future of those from the last OST programme in Crimea.

Well, who knows, maybe I’m mistaken.

Written by Igor Kuzmenko

*ART: Anti Retroviral Therapy is a medical treatment for HIV/AIDS

 

All 4 parts in the Crimean OST series has been written by Igor Kuzmenko and here’s a massive public thank you to him for his really honest and personal insights into what it has been like for our peers in the region, and answering many of our questions too, I’m sure. The blogs were translated from Russian into English by the very professional Daria Mighty, and we are indebted to her speed and accuracy, thank you Daria! (The Russian version is available atENPUD)
If you want to find out more about the drug using community and its issues in the region of Eurasia, or you are living in that part of the world, check out INPUD’s sister organisation on their website ENPUD (The Eurasian Network of People who Use Drugs). You can become a member, read other blogs from Igor and others and find out the news and views on drug issues and politics.

Another place that thinks its fine to kidnap users…

Just thought I would put in a story i saw on the BBC website today. It has left me cold and angry. I get so sick and tired of people who just think it is ok to come and take someone away, lock them up, beat them if necessary, maybe if your lucky your parents know where you are but you don’t get out until they let you…Guatemala, ok so it is having problems with a crack surge, but for Goddsake, this is a money making scam and a human rights violation. Why do we think its ok to just take a person who uses drugs, and think that there life is so worthless, that no one really cares enough to save them, that they actually need to be kidnapped, locked up and never let out. That it is ok to ‘treat’ them psychologically with any sort of unproven bullshit  for hours and days or months at a time. That they need to be made into slaves to work scrubbing floors or cleaning toilets…It is a disgrace and a scam and we need to keep the UN, who it says, said in 2012 that these places must be shut down (enforced treatment centres)…is there something the using community can do to speed this up? 

The rehab centres that lock up addicts against their will

A man behind bars

In Guatemala, behind barred and locked doors, thousands of drug addicts are offered treatment by Protestant churches. Christianity offers salvation for some but many are held against their will, and some are swept off the street by “hunting” parties.

“They grabbed me. They found me completely out of it on the streets, and they just grabbed me.”

Marcos is a big guy. With closely cropped hair, and a huge expanse of chest, he is not the kind of man to tackle lightly. But Marcos was accosted by a group of men in Guatemala City and forcibly taken to a private, Christian rehabilitation centre.

“I was there for about a month and a half, and nobody knew anything about me. People thought I was killed or something, because that’s what happens in Guatemala.”

“I saw terrible things in that rehab – the owner used to beat up the girls. He would tie up the guys and roll them up like a taco in a piece of carpet, and leave them there for hours,” he says.

Listen to Linda Pressly’s report from Guatemala City on Crossing Continents on BBC Radio 4 on Thursday at 11:00 BST – or find it soon after on BBC iPlayer

Marcos was freed when a friend came looking for him, and demanded his release. He doesn’t think enforced rehab is the right approach and says it did nothing to help him quit his alcohol and drug habit.

“People came out madder and more furious. Instead of being rehabilitated, you just went out to get high again.”

Marcos grew up in the United States – a refugee from Guatemala’s civil war in the 1980s – but was deported back to his parents’ homeland after serving a prison sentence. With family in California, the owner of the rehab centre saw Marcos as a money-making proposition – he tried, and failed, to get contact details for Marcos’ family to ask them for money for Marcos’ keep.

All that is behind him now – Marcos is clean, and is dedicated to mentoring young people.

As there is no residential, state provision for addicts in Guatemala, private rehabilitation facilities have filled the vacuum. There may be as many as 200 Christian centres in Guatemala, possibly holding 6,000 people, estimates Dr Kevin O’Neill, from the University of Toronto, who has made an anthropological study of the centres. It is not known how many of them practice the aggressive “hunting” Marcos experienced.

A rehab centre with metal bars on the outsideOne of the private rehabilitation centres that have sprung up in Guatemala City

O’Neill believes Guatemala is confronting a surge of addiction. Its strategic location in Central America means the majority of illicit narcotics moving from South America to the United States make landfall here. And the fallout is a growing local market for highly addictive drugs like crack cocaine.

“It’s increased the number of centres in the capital city. But it’s also changed the culture inside the centres – the internal dynamics have become much more aggressive, and much more discipline-driven because of the rise of crack cocaine,” he says.

The founder and director of the Rescatados del Abismo, Rescued from the Abyss, centre is Pablo Marroquin, a born-again Christian and former drug addict.

Pablo Marroquin at his rehab centre

“I’d been in other rehabilitation centres, but I wanted to make mine more personal. I put it in the hands of God – he’s the only one who can rescue us from drug addiction,” he says.

Marroquin lives on the ground floor of an unremarkable building in Guatemala City with his family, his budgerigars, and a pack of small, snappy dogs.

On the first floor, behind a locked, barred door, 54 addicts mill around. Many of them will not be allowed to leave for at least three months – but it could be years. Only the addicts’ families or the director himself sanction the release of those interned here.

It is a confined space for so many people – the size of a large, three-bedroom flat. Off a common area, there is a bathroom, a room stacked with roughly-constructed bunks for those with privileges -most inmates sleep on the floor – and a bedroom for the six women internees.

A man sits on the floor against the wall, eating out of a bowl

Currently, the smooth running of the centre is down to Carlos – an internee who has been into rehab more than 30 times to try to overcome his addiction to crack cocaine and alcohol. Carlos imposes discipline and punishment at Rescatados del Abismo.

“When people arrive they can be very violent, and the only way to respond to that is with violence. It makes me uncomfortable, but it’s extremely important to maintain discipline here,” he says.

CarlosCarlos, an internee himself, maintains order at Rescatados del Abismo

Forcing an internee to clean the floors or to work at night are other forms of punishment.

Internees are partly controlled by compulsory attendance at meetings. They spend seven hours a day telling and re-telling each other their stories, charting their descent into addiction. These meetings are the only “therapy”.

They are not structured, there is no psychologist or doctor involved, and no one is allowed to leave the room without permission. While listening to the testimony, the residents sit in shadow – the barred windows of the meeting room are covered with thick yellow corrugated plastic.

Freddie speaking to other internees

It is impossible to see the street from anywhere inside the centre.

“The vast majority, I would say 95% of the internees are here against their will,” says Carlos.

“Now he’s there, we have a bit more peace of mind – if he were in the street, anything could happen here in Guatemala”

Carlos Ruiz

Carlos Ruiz, brother of Victor, an internee

When desperate families call the centre asking for help with a substance-abusing loved one, he often accompanies the director to go and pick an addict up.

“It’s our role to bring them here, and that can mean using handcuffs like the police. Sometimes a family will say their son is very violent and has a knife or machete. In those cases we tie him up before bringing him here.”

Carlos believes this is legal in Guatemala. A ministerial accord of 2006 states that an addict can be interned when they are not in a fit state, but once they have recovered sufficiently, they must give consent. By all accounts, this rarely happens.

At the Ministry of Health, the regulation and co-ordination of the centres comes in the shape of just one man – Hector Hernandez has worked for the last 14 years to try to improve the centres and make them more humane. He has closed some, but he says forced detention has never been proven.

“Not even the attorney for the defence of human rights has been able to establish there are people detained against their will – there’s been no confirmation of any allegations made,” he says.

During the compulsory meetings at Rescatados del Abismo, Victor Ruiz reads his well-thumbed bible. An abuser of crack cocaine and alcohol, he has been here for three months. Victor believes only God and Jesus Christ will rescue him from addiction.

Victor Ruiz reading his bible

“I think I’ll be here for another five months, it all depends what my brothers decide,” he says.

Before he came to the centre, Victor was living on the streets. One day when the family could not find him anywhere, his older brother, Carlos Ruiz went to look for Victor at the morgue.

“I was looking at the photos of dead people to see if one of them was him. It’s really shocking. These things stay with you, it’s like you die a bit too,” he says.

After Victor was attacked in the street by someone with a machete, the family had him interned in Rescatados del Abismo.

“Now he’s there, we have a bit more peace of mind – if he were in the street, anything could happen here in Guatemala.”

The director of Rescatados del Abismo, Pablo Marroquin, has little patience with arguments about whether the regime he runs violates the rights of internees, especially when they are held involuntarily.

“What about families? What we do is give families peace, so their loved one doesn’t get himself into trouble. And so that he won’t kill them,” he counters.

Adverts for other rehab centresAdverts for other rehabilitation centres in Guatemala City, with the left one titled “Warriors of Christ”

There is no data about how successful the rehabilitation of addicts is in Guatemala. In 2012, the United Nations called on all member states to close compulsory drug detention and rehabilitation centres.

“There is no evidence that these centres represent a favourable or effective environment for the treatment of drug dependence,” declared the UN statement.

Many experts believe addicts can never be forced to change – they have to want to stop. And in Guatemala there are many Christian establishments that will only take addicts on a voluntary basis.

But Pablo Marroquin, clean now for 22 years, is a testament to his own approach to rehabilitation.

“I experienced God’s mercy – he rescued me. He brought me to a rehabilitation centre where I met myself, and I met God. And these days, I’m a happy man.”

Listen to Linda Pressly’s report from Guatemala City on Crossing Continents on BBC Radio 4 on Thursday at 11:00 BST – or find it soon

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