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Rehabilitation Required: Russia’s Human Rights Obligation to Provide Evidence-based Drug Dependence Treatment

Rehabilitation Required

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

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I. Summary

Key Recommendations to the Government of Russia

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

November 2007 Volume 19, No. 7(D)