Hope Where There Is None

For more than eight years, Moscow, Russia was my home.

As cliche as it is, I learned more about myself in that time than I ever thought possible, met amazing people along the way, and discovered a place that had been mythological in my post-Cold War imagination. As a child of the ’80s, Russians were ‘the enemy’. At moments during my stay there, they took on that persona to a tee. However, that was the exception, and I loved my life in Moscow and wouldn’t trade any of the time I spent there. So many individuals welcomed me as the ‘silly American’, and I miss the daily interaction with them despite the difficulties inherent in contemporary Russian life.

Perhaps that’s why it pains me to hear of how little things have changed in the five years since I left. Russia has the dubious distinction of being one of the few remaining countries in which the HIV epidemic continues to expand. What’s more, it has occupied one of the worst of all statistics as the country with the fastest growing epidemic in the history of the global pandemic. That is not an accolade any country should aspire to and most governments would take action to remedy it quickly.

That hasn’t been the case in Russia. In fact, the opposite holds true.

Primarily fueled by the sharing of unclean injecting equipment and compounded by one of worst tuberculosis epidemics in the world, the Ministry of Health has maintained its hostility towards ‘Western’ or ‘foreign’ evidence-based practices and prevention methods which could save a generation of young Russians and prevent the further spread of HIV. Many small-scale local-level projects were funded not by domestic sources by but international agencies such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Distributing clean paraphernalia and informational materials on safer sex and drug use, providing counseling and social support services to those who had no where else to turn, and delivering training seminars to local-level healthcare professionals to introduce international experiences and human rights-based approaches have helped immensely. Yet, as obvious as it might be, Russia is huge and reaching every corner without governmental support is impossible. Furthermore, as the funding from international sources has dried up, many of those local-level initiatives have had to close and left a gaping hole for those least accepted and cared for in Russian society.

It’s quite simply heartbreaking.

Much of our news in the West focuses on the Russian elections. However, there are many other unheard stories, both of unimaginable determination and heroism, as well as of tragedy and despair. The Andrey Rylkov Foundation has made it their mission to work towards a humane and just approach to drug use and fight for the rights of those who most need it, and listen to and respond to those most ignored. Engaging with drug users, they provide harm reduction services in and around Moscow. They also work to highlight the extreme positions of the Russian government towards drug treatment and harm reduction strategies which have been proven to help prevent HIV. Spend 20 minutes from your day and watch this video about what they do and why.

Is there hope? There must be. Is failure an option? Not really. Life in Russia is not easy. But, working with individuals who are considered social outcasts, undesirable, and many perceive the best solution is to simply ‘let them die’ is unimaginably difficult. But, it’s well-worth the struggle if it improves the conditions for even a few individuals at a time.

So, as insignificant as it may be, I just want to thank Anya and all those who continue to do this type of work. Keep fighting the good fight!

‘And I am the Drug Policy Alliance’…

I’m often quite happy to miss the ‘news’ on main stream television, particularly when I read of interviews and exchanges such as the recent ‘debate‘ between Fox News and the Drug Policy Alliance.

The Alliance has just released a rather poignant video highlighting the need for a rational, evidence-based and research-informed approach to drug policy. Rather than focusing our efforts and resources on criminalisation and incarceration, we should re-focus our attention on a human-rights based approach to drug use and policy. I fully embrace this approach, which is not at all surprising given what I do for a living.

A smattering of viciousness and derogatory language from Mr O’Reilly and his co-host Megyn Kelly highlight their inability to understand the issues at stake and how damaging and unhelpful the so-called ‘War on Drugs’ has been and remains.

Thus, the message in the Drug Policy Alliance’s latest video was completely and utterly lost on them. In addition, their segments (three, that I could find) were not based on intelligent debate, but on rhetoric and unsubstantiated claims, many of which are simply false.

Drugs have been legal and regulated in several countries to varying degrees for many years now. I spend about 25% of my time in the Netherlands these days, and there is very little in the way of ‘drug-related crime’. In fact, within the last year or so, I was told by Dutch that the state was forced to close prison facilities because they did not have enough prisoners to fill them. That is, prisons were sitting empty rather than bursting to capacity such as those in the US. Think about that for a moment.

John Stossel, also from Fox News, quite rightly made the point to Mr O’Reilly that prohibition drives the behaviour underground. Indeed. The prohibition of drugs has worked much the same way as the prohibition of alcohol—people will find ways around the law and will go to great lengths to hide it from the authorities.

The real shame in driving behaviours underground is that even if an individual does wish to seek help for dependency or any other medical and/or social issues, they are less likely to do so if they believe they run the risk of incarceration or any sort of reprimand. Thus, any programme designed to reduce drug- or substance-related harm, such as needle-exchange programmes, are less likely to reach them. In an age of HIV, this represents a tremendous shortcoming and travesty.

I support and applaud the Drug Policy Alliance in their efforts to advocate for a human-rights based approach to drug use. And I fully support an end to the War on Drugs.