November 8, 2007

Rehabilitation Required

Russia's Human Rights Obligation to Provide Evidence-based Drug Dependence Treatment

I. Summary and Recommendations
Methods
II. Background
Illicit Drug Use and Drug Policy in Russia..
Over-incarceration of Drug Users
Harm Reduction Programs
Russia's Drug Dependence Treatment System...
The Soviet Alcohol and Drug Dependence Treatment System...
Changes in early 1990s
Russia's Contemporary Drug Dependence Treatment System...
III. Drug Dependence Treatment Best Practices
Basic Principles of Effective Drug Dependence Treatment
Drug Dependence is a Chronic and Relapsing Disease..
Treatment Must be Readily Available..
Retention of Patients in Treatment for Adequate Period of Time is Critical
Treatment Plans Must be Tailored to Individual Patients' Needs
Treatment Must Attend to Multiple Needs of the Patient
Elements of the Effective Treatment System...
Open Access Services
Detoxification Treatment
Rehabilitation and Relapse Prevention..
Maintenance Therapy with Methadone or Buprenorphine..
Aftercare Stage..
IV. Findings: Human Rights and Drug Dependence Treatment
The Right to Health..
Scope of the Right to Health..
The Availability Requirement
Detoxification Services
Methadone or Buprenorphine Maintenance Therapy
Rehabilitation Services
The Accessibility Requirement
Physical Accessibility
Drug User Registration..
Pre-admission Paperwork
Distrust of Drug Dependence Treatment Services
Economic Accessibility and Non-discrimination..
Information Accessibility
The Acceptability Requirement
The Quality and Scientific and Medical Appropriateness Requirement
Failure to Facilitate Patient Retention..
Counseling on HIV/AIDS and Other Health Conditions
Conditions at Narcological clinics
Principle of Non-discrimination and Restrictions on the Rights of Drug Users
V. Detailed Recommendations
To the Russian Government
Regarding availability of treatment
Regarding accessibility of treatment
Regarding scientific and medical appropriateness and quality of treatment
Regarding acceptability of treatment and discrimination against drug users
Other
To the International Community
Acknowledgements
Appendix: Drug Dependence Treatment Best Practices