The excesses of the global war on drugs are often so brutal as to seem like parody: think of Singapore’s macabre antidrug illustrations for children, or the recent news that Iran had executed all the men in a single village in the name of drug control. Latest in the ominous, believe-it-or-not category was watching Russia host a side event on science at the UN General Assembly Special Session on the world drug problem in New York on April 20. To informed observers, this was akin to watching climate change denialists host a look at global warming.
Russia has been among the nations most committed to denying scientific evidence on effective drug dependence treatment. The country has banned methadone and buprenorphine, widely researched medicines that the World Health Organization deems essential in the treatment of dependence on heroin and other opiates. Russian “narcology” — the sub-discipline of psychiatry charged with treating drug dependence — has instead promoted such approaches as “coding,” where patients are hypnotized and told that they will fatally poison themselves if they use alcohol or drugs, or induction of comas in drug-dependent patients followed by administration of electroconvulsive shock. St. Petersburg scientists piloted an approach — adapted and practiced in China — that involves drilling holes in the skull and destroying portions of the brain thought to be associated with craving. This “neurosurgery” is irreversible, and has raised the same ethical questions as lobotomies performed on mentally ill patients in the Europe and the United States in the 1930s and 1940s.
After listening to renowned scientists present on key principles of drug dependence treatment at the UN, the representative of the Russian Ministry of Health informed attendees that prescription of methadone “did not apply to us” since the country did not believe in replacing one drug with another. She did not mention that back at home, Russia has aggressively challenged scientists whose inquiries or findings deviated from this party line. Researchers seeking to distribute information about methadone have been threatened with investigations by the prosecutor’s office, and websites containing information about the medicine have been shut down by the Federal Drug Control Service.
Russian law punishes the presence of even trace amounts of opioid alkaloids or poppy straw — such as those found in poppy seeds, for example — as if the entire batch is illegal, and recently used that law to charge an importer of baking supplies with drug dealing. When Dr. Olga Zelenina, a respected scientist and head of the lab at the Penza Agricultural Institute, confirmed that poppy seeds indeed can contain trace amounts of opium, she was arrested by a masked, armed squad of drug control officers and charged with “aiding and abetting attempted drug trafficking.” Moscow has been more supportive of a study finding that parsley seeds contained mind-altering properties, with the federal consumer protection agency banning them in 2011.
Russia has ignored concern from international addiction experts and its own public health specialists about how the refusal to adopt health measures accepted across the world are increasing HIV infections and deaths. So, what is the country really up to when it seeks to sponsor a session on science at a major international meeting on drugs? Or when Russian diplomats — as reported by negotiators at the Commission on Narcotic Drugs in March — seek to replace any reference to “evidence-based approaches” in UN documents with the phrase “scientific approaches” instead? This appeal to science appears to a move to close international space to the voices of nongovernmental organizations that are already being silenced at home.
Human rights defenders in Russia have indeed produced careful documentation of the effects of Russian drug policy, and the results are ugly. Several patients denied methadone treatment are now suing the Russian government in the European Court of Human Rights. Other Russian groups — forced by law to declare themselves “foreign agents” if they receive financial support from abroad, but nonetheless continuing their work to counter official government narratives — have documented abuses, deprivation of medical treatment, and other abuses in drug treatment institutions, prisons and police detention facilities. This is evidence that Russian officials, who urged attendees at a recent Moscow AIDS conference to pursue “approaches that would not counter Russia’s ideology,” would prefer to exclude from the public record.
As for the UN Office on Drugs and Crime, the agency that approved side event requests at the UN Special Session, and was listed as the focal point for Russia’s session — it is difficult to imagine what they are thinking. The agency is headed by a Russian diplomat, so this may have been understood as an offer that could not be refused.
Side events, by definition, are marginal. But in the UN system, which operates by consensus, the views of any one country at Special Session of the General Assembly can drive the entire discussion to a lowest common denominator. Russian negotiators successfully removed any mention of methadone or buprenorphine from the official outcome document adopted on the first day of the Special Session, and were among the countries that inserted the phrase “in accordance with national legislation” to provide themselves an exemption from norms recommended by the global consensus.
As the world turns to thoughts of the next UN debate on drugs in 2019, UN staff and representatives of all nations should be clear that the Russian account of science does not meet international standards. As for the Russian event on science and drug dependence at this UNGASS — I wish it had been listed under “tragicomedy” in the program.