Use of Methadone to Curb Rising Injection Drug Use, Spread of HIV in Russia Examined at Conference
July 22, 2008
Faced with a "steady increase" in injection drug use that is cited as the leading cause of the spread of HIV/AIDS in Russia, a meeting of physicians and specialists was held in the country in February to discuss the use of methadone in treating injection drug users, which number between three million and six million in Russia, the New York Times reports. Although injection drug use is "widely linked" to the country's HIV/AIDS epidemic, "the issue of methadone treatment is all but taboo" in Russia, according to the Times.
According to the Times, some Russian specialists, along with current and former IDUs, "have begun to challenge the official line." Evgeny Krupitsky, head of a laboratory that conducts research on drug addiction at St. Petersburg State Pavlov Medical University, said, "Scientific arguments, evidence-based data, are not convincing" opponents of methadone. Russian methodology regarding opiate addiction "is not evidence-based," but relies on "subjective opinions of major leaders in the field," Krupitsky added. Although not all IDUs would benefit from methadone treatment, more than 60% in Russia would, Krupitsky said. The Times reports that many researchers on both sides of the methadone debate agree that only a small fraction of heroin users in Russia seek treatment at detoxification centers and that most who do -- some say more than 90% -- relapse into drug use shortly after leaving.
At the clinics, physicians encourage immediate abstinence from drug use rather than the gradual process that methadone substitution therapy entails. Patients also receive sedatives and painkillers to cope with withdrawal symptoms. Many are allowed to leave after one or two months with the expectation that they will remain drug-free; however, few do so, the Times reports.
Consequently, methadone supporters or other opiate substitution therapies say that if properly administered by medical professionals, the treatment can end IDUs' dependence on drugs, acting as a surrogate to ease withdrawal symptoms while decreasing the risk of overdose (Schwirtz, New York Times, 7/22).
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.