Andrey Rylkov Foundation’s website shut down in Russia

Here is an article from our friends at Harm Reduction International, writing about a truly appalling situation (another one) to emerge from Russia -affecting our dear friends and peer activists at Andrey Rylkov Foundation.  This courageous HIV/AIDS, drug and human rights organisation has consistently raised their head above the parapet (in a country where it can be literally be beaten off), and given people much needed health and harm reduction information in a climate of fear and intimidation.  One can only imagine what that must be like, to work every day knowing that you could be arrested, imprisoned, fitted up on a trumped up charge (which has happened repeatedly to other HIV and human rights activists) while thousands upon thousands of people are desperate for the sterile syringes that you give out, and the HIV information you impart. Last World AIDS day, December 1st 2011, ARF were instrumental in supporting us at BP (and INPUD) to coordinate the global Russian embassy protest, an attempt to shame Russian officials about their inaction and lack of response to the HIV catastrophe unfolding in their country. We are deeply concerned at this latest attempt by the Russian government to silence anyone or any organisations that discuss methadone in what is an ” ongoing assault on HIV prevention” taking things to the “next level by moving to silence public health advocates whose only infraction has been to spread life-saving information online and to criticize the government for its own failures.” We will keep you posted of developments. Catch ARF on facebook, and join to keep up to date with what is looking to be a highly charged time in Russian life and politics.

 

 

 

Authors:  

Vladimir Putin wrote a recent column praising the potential for “internet-based democracy”. But the Russian government adopts rules allowing for websites to be shut down on a

Vladimir Putin

Vladimir Putin's iron grip on power continues to circumvent free speech in Russia, as yet again, HIV & drug organisations like ARF are targeted.

whim, and has used those rules to close down HIV prevention sites.

He talked about free medical care being one of the priorities of Russian citizens. But that care denied to millions of Russian people.

While Prime Minister Putin spoke glowingly of digital democracy, his anti-drugs agency is censoring websites for writing about WHO essential medicine.

“[It’s over] methadone, plain and simple” said Anya Sarang, President of the Andrey Rylkov Foundation, which had its website shut down over the weekend.

The government’s anti-drugs agency, FSKN Moscow Department demanded that the Andrey Rylkov Foundation’s service provider block their website, utilizing new rules adopted last year. The notification states it was due to “placement of materials which propagandize (advertise) the use of drugs, information about distribution, purchasing of drugs and inciting the use of drugs”

What the Foundation was doing was spreading the word about basic HIV prevention measures and commenting on the Russian government’s policies.

Amidst pro-democracy protests, the Russian authorities have taken what is an ongoing assault on HIV prevention to the next level by moving to silence public health advocates whose only infraction has been to spread life-saving information online and to criticize the government for its own failures.

Russia is home to one of the biggest populations of injecting drug users, and one of the fastest growing HIV epidemics in the world. It is estimated that there are just under two million injecting drug users in Russia. In some regions, more than 80 percent of people living with HIV in the country contracted the virus through injecting with contaminated equipment.

According to the World Health Organization, methadone is an essential medicine, for treating heroin dependence and for preventing HIV transmission by reducing the practice of injecting. Multiple scientific studies back this up.

But the Russian government’s ‘zero tolerance’ approach to illicit drugs is well known and has resulted in the outright denial of methadone (or ‘opioid substitution therapy’). It is illegal in Russia.

The net result of these policies is a massive increase in the number of people living with HIV in the country over the last decade.

According to UNAIDS, “In Eastern Europe and Central Asia, there was a 250% increase in the number of people living with HIV from 2001 to 2010. The Russian Federation and Ukraine account for almost 90% of the Eastern Europe and Central Asia region’s epidemic. Injecting drug use remains the leading cause of HIV infection in this region”.

“People all over the world take this medication for granted” says Sarang, “but here in Russia it’s central to our struggle against HIV and it’s banned. Now, even our speaking about it seems to be banned.”

This is not the first time Russia has attempted to censor civil society voices for public health. At the UN General Assembly talk on HIV last March the Russian delegation tried to stop a Ukrainian drug user from speaking about HIV prevention. Fortunately, others were not happy with such censorship and the effort failed.

“The right to information is essential to realizing the right to health,” said Agnes Callamard, Executive Director of ARTICLE 19, in a statement. “A government agency such as Federal Drug Control Service should not have the ability to ban websites at the whim of a bureaucrat. This is particularly so when considering the impact of censoring discussions relating to drug addiction or HIV/AIDS.”

For years, human rights advocates like the Andrey Rylkov Foundation have argued that Russia’s colossal failure to provide vital services is a breach of its obligation under international law to respect, protect and fulfill the right to health. The government’s latest crackdown against public health activists has turned the matter into an issue of freedom of expression.

Mr. Putin says that democracy needs “efficient channels for dialogue… communication and feedback,” while the government’s actions silence people fighting to raise issues the government is refusing to face. This silences the spread of information. It silences the democratic process.

Source of publication: http://www.huffingtonpost.com

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Dec 1st Russian Embassy Protest -Be there!

The Red ribbon is a symbol for solidarity with...

WORLD AIDS DAY

On Dec 1st, 2011, World Aids day, people in 8 countries around the world will descend on Russian Embassies -To protest at the criminal treatment of people who use drugs – in the biggest catastrophe in the history of HIV in recent times. (See below for where and when).

In Russia today, we are bearing witness to one of the biggest, avoidable catastrophes in the history of HIV – the lack of response to the epidemic in Russia. We must point directly to the specific responsibility that Russian medical and public health officials bear for creating and sustaining this disastrous situation. Of particular concern are Russia’s, brutalising drug policies and its recently revised Total War on Drugs, which has resulted in further pushing people who use drugs into hiding, prison, and enforced detention, and severely compromising efforts from the international community to revert the trajectory of HIV/AIDS. The world is approaching a crossroads; a strong and decisive downward trajectory in the epidemic is possible in all countries -but it will only happen if the people who are most vulnerable to infection are supported and their human rights realised. Governments have legal obligations to act. Indeed, the implementation of harm reduction measures is consistant with and required by states obligations under international human rights law. 1,2.

Injecting drugs with contaminated equipment is driving Russia’s HIV epidemic, now the fastest growing in the world and it is reflected in the numbers; as many as 80% of new infections are occurring amongst people who inject drugs (PWID), in a total HIV positive population of approx 1million. With this in mind, recent projections forecast an additional 5 million people could become infected with HIV in the near future, unless Russia transforms the way it is dealing with its HIV pandemic.6

Russian authorities have repeatedly come in for fierce international criticism over their policy towards the treatment of drug dependence, which relies almost completely on the promotion of abstinence to the exclusion of harm reduction.  Russian officials claim, incorrectly, that the effectiveness of opiate substitution therapy (such as providing methadone and buprenorphine) has not been adequately demonstrated, and as such it is prohibited by law. Yet, despite the addition in 2005 of these two drugs to WHO’s list of essential medicines, and multiple position papers by international experts calling for substitution treatment as a critical element in the response to HIV (IOM, 2006; UNODC, UNAIDS, and WHO, 2005), methadone or buprenorphine remain prohibited by law in Russia and promotion of its use – punishable by a jail sentence.
Compare this legitimate injection kit obtained...

Sterile needles and syringes are proven ways to prevent the spread of HIV

With over 30,000 people dying from drug overdoses every year, numbers that can be shown to markedly reduce with the implementation of OST, and 150 becoming infected with HIV each day (2/3rds of which are injecting drug users), also evidenced to drastically reduce with the roll out of Needle and Syringe Programmes (NSP), it is upon everyone who cares about humanity, to demand an immediate transformational shift in Russia’s approach to HIV prevention and its treatment of drug users.  Access to NSP and OST is in itself, a human right;  UN Ruman Rights Monitors have specifically stated harm reduction interventions as necessary for states to comply with the right to health. 5)

Consistent evidence from around the world shows that treatment for opiate dependence works most effectively when the exclusive goal of abstinence is widened to foster multiple outcomes – including reduction in use of illicit opiates, exposures to blood-borne infections such as HIV and hepatitis, reduction in drug overdoses, better management of existing health problems etc. Evidence has repeatedly shown the clear benefits to the individual and society as a whole when drug dependence is viewed as a public health issue, as opposed to a criminal one. Evidence also shows OST, combined with a range of harm reduction measures such NSP, leads to a drastic reduction in the spread of new HIV infections in countries across the globe; none of this more clearly demonstrated today, than in Netherlands, a world leader in harm reduction where in 2010, only ONE injecting drug user contracted HIV. In the UK, another country that has harm reduction at the centre of its HIV prevention strategy, prevalence of HIV amongst drug injectors is at 1.5%, this against a Russian HIV prevalence backdrop of 30-35%. The evidence on harm reduction has been in for years. Why does Russia continue to turn its back?
The Russian government‘s estimated annual expenditure related to drug law enforcement) equal approx 100 million US  dollars. 7. This amount does not include the money spent on detention and imprisonment. In stark comparison, only 20 million US dollars was allocated to HIV and hepatitis B and C  prevention combined, among all population groups in 2011. By 2013, amounts spent will be three times less. Considering the context and tendencies in the development of the HIV epidemic in Russia, clearly such policies are not leading to any positive results. No money at all is allocated towards HIV prevention among the injecting drug using population.6Such punitive and torturous approaches to tackling drug use are not only fuelling the HIV epidemic in the region, but also the stigma, hate and ignorance of drugs, and of people who use drugs.  The insistence by both the Russian government and medical profession to treat drug users as criminals that need imprisonment at worst, and at best – enforced detention, has meant harm-reduction programs, including needle exchange, are officially accused of propagandizing drug use and activists have been arrested, harrassed and imprisoned for promoting harm reduction measures. Demonstrators who have protested and spoken out against the Russian response to HIV/AIDS are also regularly arrested and detained, including HIV positive people calling for access to ARV’s (drugs to treat HIV) and an end to treatment interruption fuelling drug resistant strains of HIV.This World Aids Day, December 1st 2011, we will echo the urgent voices of Russian drug users who are living and dying in the grip of an HIV and TB pandemic with almost no recourse or chance to engage in or promote an effective response.  . We will gather at Russian embassies around the world to demand Russia to change it current course towards death and disease. We want to see inappropriately aggressive, state sponsored hostility to drug users replaced by enlightened, scientifically driven attitudes and more equitable societal responses” 3 We demand our own countries to apply pressure wherever and whenever they can, voicing publicly our concerns about human rights abuses in the Russian response to drug use and HIV.
Sound, evidenced based and cost effective harm reduction solutions stand at the forefront of what has been shown to effectively prevent HIV infection in the drug using community. The personal narratives of people who use drugs and their allies on the front line of human right struggles must be recognised and remain a key part of today’s growing evidence base. People who use drugs must be seen as central players in the search for solutions rather than being framed and targeted as the problem.
Nothing About Us Without Us  www.inpud.net
Dec 1st at Russian Embassies in London, Stockholm, Berlin, Bucharest, New York, Sydney/Canberra, Spain (?), and Toronto. Dec 1st
 for times and locations follow updates at http://russianembassyprotest.wordpress.com or (add your email/website)

1) UNIDCP Flexibility of Treaty positions as regards harm redcution approaches, decision 74/10 Geneva UN 2002 ,
2) UNODC World Drug Report Vienna 2009
3) Lancet July 2010 HIV in people who use Drugs
4) The right to the highest attainable standard of health; Article 12, comment 14  International Covenent on  Economic, Cultural and Social Rights 2000
5) Barrett D et al;  Harm Reduction and Human Rights, the Global response to drug related HIV Epidemics. London, HRI, 2009
6) News Release, Oct 7th 2011, Risk of HIV Hitting Catastrophic Levels; from the Canadian HIV/AIDS Legal Network; Eurasian Harm Reduction Network; Harm Reduction International;
7) Articles 228-233 of the Russian Criminal Code

Krokodil- Home made heroin of the very worst kind

Viktor Ivanov, the head of Russia's Drug Contr...

Viktor Ivanov, the head of Russia’s Drug Control Agency

 

 

I am reprinting here an Independent article from June on what is perhaps one of the most disturbing issues to confront the drug using community in years. Home made heroin – desomorphine (also called Krokodil because of what it does to the skin) is becoming more and more common in Russia, affecting the poorest heroin users and having the most horrendous effects on the body. The Russian government continues to look the other way, refusing to provide methadone or subutex or humane and evidenced based treatments. Their lame attempt at banning one of the ingredients (over the counter sales of codeine)will do little to circumvent what is fast becoming an epidemic of home made drugs of dire quality. Please read this article and check out our videos down the right hand side of the page on the effects of desomorphine.Note: desomorphine was apparently invented in the USA in 1923 as a pharmaceutical preparation and was used in Switzerland under the trade name Permonid (strong opiate, fast onset, short duration). Krokodil and desomorphine as home made in Russia, seems more to pertain to the extremely hazardous way it is made, using ingrdients as mentioned below – and not in the sterile pharmy environment that desomorphine could in fact be made, without all the added human health problems associated with it. Worrying, Krokodil, the ‘home made’ desomorphine, has recently spread to Germany. Unless someone makes Russia listen soon and implement harm reduction such as OST, Needle exchange, etc -we are going to see this death and destruction of lives continue to spread further than Russia.

Krokodil: The drug that eats junkies  (Click link for the original Independant article June 22nd 2011)

A home-made heroin substitute is having a horrific effect on thousands of Russia’s drug addicts

By Shaun Walker

Oleg glances furtively around him and, confident that nobody is watching, slips inside the entrance to a decaying Soviet-era block of flats, where Sasha is waiting for him. Ensconced in the dingy kitchen of one of the apartments, they empty the contents of a blue carrier bag that Oleg has brought with him – painkillers, iodine, lighter fluid, industrial cleaning oil, and an array of vials, syringes, and cooking implements.

Half an hour later, after much boiling, distilling, mixing and shaking, what remains is a caramel-coloured gunge held in the end of a syringe, and the acrid smell of burnt iodine in the air. Sasha fixes a dirty needle to the syringe and looks for a vein in his bruised forearm. After some time, he finds a suitable place, and hands the syringe to Oleg, telling him to inject the fluid. He closes his eyes, and takes the hit.

Russia has more heroin users than any other country in the world – up to two million, according to unofficial estimates. For most, their lot is a life of crime, stints in prison, probable contraction of HIV and hepatitis C, and an early death. As efforts to stem the flow of Afghan heroin into Russia bring some limited success, and the street price of the drug goes up, for those addicts who can’t afford their next hit, an even more terrifying spectre has raised its head.

(See video on vod pod – bottom right column)

The home-made drug that Oleg and Sasha inject is known as krokodil, or “crocodile”. It is desomorphine, a synthetic opiate many times more powerful than heroin that is created from a complex chain of mixing and chemical reactions, which the addicts perform from memory several times a day. While heroin costs from £20 to £60 per dose, desomorphine can be “cooked” from codeine-based headache pills that cost £2 per pack, and other household ingredients available cheaply from the markets.

It is a drug for the poor, and its effects are horrific. It was given its reptilian name because its poisonous ingredients quickly turn the skin scaly. Worse follows. Oleg and Sasha have not been using for long, but Oleg has rotting sores on the back of his neck.

“If you miss the vein, that’s an abscess straight away,” says Sasha. Essentially, they are injecting poison directly into their flesh. One of their friends, in a neighbouring apartment block, is further down the line.

“She won’t go to hospital, she just keeps injecting. Her flesh is falling off and she can hardly move anymore,” says Sasha. Photographs of late-stage krokodil addicts are disturbing in the extreme. Flesh goes grey and peels away to leave bones exposed. People literally rot to death.

Russian heroin addicts first discovered how to make krokodil around four years ago, and there has been a steady rise in consumption, with a sudden peak in recent months. “Over the past five years, sales of codeine-based tablets have grown by dozens of times,” says Viktor Ivanov, the head of Russia’s Drug Control Agency. “It’s pretty obvious that it’s not because everyone has suddenly developed headaches.”

Heroin addiction kills 30,000 people per year in Russia – a third of global deaths from the drug – but now there is the added problem of krokodil. Mr Ivanov recalled a recent visit to a drug-treatment centre in Western Siberia. “They told me that two years ago almost all their drug users used heroin,” said the drugs tsar. “Now, more than half of them are on desomorphine.”

He estimates that overall, around 5 per cent of Russian drug users are on krokodil and other home-made drugs, which works out at about 100,000 people. It’s a huge, hidden epidemic – worse in the really isolated parts of Russia where supplies of heroin are patchy – but palpable even in cities such as Tver.

It has a population of half a million, and is a couple of hours by train from Moscow, en route to St Petersburg. Its city centre, sat on the River Volga, is lined with pretty, Tsarist-era buildings, but the suburbs are miserable. People sit on cracked wooden benches in a weed-infested “park”, gulping cans of Jaguar, an alcoholic energy drink. In the background, there are rows of crumbling apartment blocks. The shops and restaurants of Moscow are a world away; for a treat, people take the bus to the McDonald’s by the train station.

 

In the city’s main drug treatment centre, Artyom Yegorov talks of the devastation that krokodil is causing. “Desomorphine causes the strongest levels of addiction, and is the hardest to cure,” says the young doctor, sitting in a treatment room in the scruffy clinic, below a picture of Hugh Laurie as Dr House.

“With heroin withdrawal, the main symptoms last for five to 10 days. After that there is still a big danger of relapse but the physical pain will be gone. With krokodil, the pain can last up to a month, and it’s unbearable. They have to be injected with extremely strong tranquilisers just to keep them from passing out from the pain.”

Dr Yegorov says krokodil users are instantly identifiable because of their smell. “It’s that smell of iodine that infuses all their clothes,” he says. “There’s no way to wash it out, all you can do is burn the clothes. Any flat that has been used as a krokodil cooking house is best forgotten about as a place to live. You’ll never get that smell out of the flat.”

Addicts in Tver say they never have any problems buying the key ingredient for krokodil – codeine pills, which are sold without prescription. “Once I was trying to buy four packs, and the woman told me they could only sell two to any one person,” recalls one, with a laugh. “So I bought two packs, then came back five minutes later and bought another two. Other than that, they never refuse to sell it to us, even though they know what we’re going to do with it.” The solution, to many, is obvious: ban the sale of codeine tablets, or at least make them prescription-only. But despite the authorities being aware of the problem for well over a year, nothing has been done.

President Dmitry Medvedev has called for websites which explain how to make krokodil to be closed down, but he has not ordered the banning of the pills. Last month, a spokesman for the ministry of health said that there were plans to make codeine-based tablets available only on prescription, but that it was impossible to introduce the measure quickly. Opponents claim lobbying by pharmaceutical companies has caused the inaction.

“A year ago we said that we need to introduce prescriptions,” says Mr Ivanov. “These tablets don’t cost much but the profit margins are high. Some pharmacies make up to 25 per cent of their profits from the sale of these tablets. It’s not in the interests of pharmaceutical companies or pharmacies themselves to stop this, so the government needs to use its power to regulate their sale.”

In addition to krokodil, there are reports of drug users injecting other artificial mixes, and the latest street drug is tropicamide. Used as eye drops by ophthalmologists to dilate the pupils during eye examinations, Dr Yegorov says patients have no trouble getting hold of capsules of it for about £2 per vial. Injected, the drug has severe psychiatric effects and brings on suicidal feelings.

“Addicts are being sold drugs by normal Russian women working in pharmacies, who know exactly what they’ll be used for,” said Yevgeny Roizman, an anti-drugs activist who was one of the first to talk publicly about the krokodil issue earlier this year. “Selling them to boys the same age as their own sons. Russians are killing Russians.”

Zhenya, quietly spoken and wearing dark glasses, agrees to tell his story while I sit in the back of his car in a lay-by on the outskirts of Tver. He managed to kick the habit, after spending weeks at a detox clinic ,experiencing horrendous withdrawal symptoms that included seizures, a 40-degree temperature and vomiting. He lost 14 teeth after his gums rotted away, and contracted hepatitis C.

But his fate is essentially a miraculous escape – after all, he’s still alive. Zhenya is from a small town outside Tver, and was a heroin addict for a decade before he moved onto krokodil a year ago. Of the ten friends he started injecting heroin with a decade ago, seven are dead.

Unlike heroin, where the hit can last for several hours, a krokodil high only lasts between 90 minutes and two hours, says Zhenya. Given that the “cooking” process takes at least half an hour, being a krokodil addict is basically a full-time job.

“I remember one day, we cooked for three days straight,” says one of Zhenya’s friends. “You don’t sleep much when you’re on krokodil, as you need to wake up every couple of hours for another hit. At the time we were cooking it at our place, and loads of people came round and pitched in. For three days we just kept on making it. By the end, we all staggered out yellow, exhausted and stinking of iodine.”

In Tver, most krokodil users inject the drug only when they run out of money for heroin. As soon as they earn or steal enough, they go back to heroin. In other more isolated regions of Russia, where heroin is more expensive and people are poorer, the problem is worse. People become full-time krokodil addicts, giving them a life expectancy of less than a year.

Zhenya says every single addict he knows in his town has moved from heroin to krokodil, because it’s cheaper and easier to get hold of. “You can feel how disgusting it is when you’re doing it,” he recalls. “You’re dreaming of heroin, of something that feels clean and not like poison. But you can’t afford it, so you keep doing the krokodil. Until you die.”

Some of the names in this story have been changed

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