Treatment response by primary drug of abuse: Does methamphetamine make a difference?
doi:10.1016/j.jsat.2006.06.007
Bill Luchansky Ph.D., Antoinette Krupski Ph.D. and Kenneth Stark M.B.A
Abstract
The purposes of this study were to examine the outcomes of a sample of patients receiving publicly funded substance abuse treatment in Washington State and to compare the outcomes of those using methamphetamine (MA) with patients using other drugs of abuse. All data for this study came from administrative systems in Washington State, and the outcomes included completion of and readmission to treatment, employment, and various forms of criminal justice involvement. Treatment records were linked to outcome data using both deterministic and probabilistic matching techniques. Patients were tracked for 1 year following their discharge, and analyses were performed separately on a study population of adults and a study population of youth. For both adults and youth, the results showed that across outcomes, there were few differences between MA users and users of other hard drugs, whereas there were consistent differences between MA users and users of alcohol and marijuana. Alcohol and marijuana users tended to have more positive outcomes than the other groups. Future research should focus on more detailed analyses of the type of treatment received by patients, particularly for MA users.
Showing posts with label treatment. Show all posts
Showing posts with label treatment. Show all posts
Wednesday, December 20, 2006
Tuesday, December 19, 2006
Needle Exchange and Drug Treatment More Effective HIV Prevention
By Yale School of Medicine
Dec 18, 2006, 07:00
(HealthNewsDigest.com).. New Haven, Conn.- For injection drug users, the
most productive and cost-effective approach to managing the spread of HIV is
expanding syringe exchange and drug treatment, as well as promoting
antiretroviral treatment for those already infected with HIV, according to a
new study by researchers at Yale School of Medicine.
Published in the January issue of American Journal of Public Health, the
authors, led by Yale Public Health professor Robert Heimer, found that the
Centers for Disease Control and Prevention's (CDC) new approach of promoting
HIV testing, "Advancing HIV Prevention," may not be best for injection drug
users.
Heimer, professor in the Department of Epidemiology and Public Health at
Yale School of Medicine, said the CDC policy is based on the presumption
that the HIV epidemic can be curtailed in great part by promoting HIV
testing and that more resources should go to expanded testing of high-risk
populations. However, the results reported in this study revealed that
testing was already widespread for urban injectors.
Heimer and co-authors analyzed interviews conducted with 1,543 injection
drug users in five cities, including New Haven and Hartford, CT,
Springfield, MA, Chicago, IL, and Oakland, CA. Access to sterile syringes
through syringe exchanges or at pharmacies with a prescription was not
available in all cities. Injection drug users who participated in the study
were asked if they had been tested for HIV and if they had ever been told
they were HIV positive. From this, the research team estimated what
percentage had never been tested and what percentage did not know their
status.
Ninety-three percent of injectors had been tested, and of those currently in
need of testing, 90 percent were tested in the past three years and 70
percent within the past year. Less than three percent were infected with HIV
without their knowledge. Women and syringe-exchange participants were more
likely to have been tested at least once, and in the recent past. The team
estimated the number of undetected infections among urban injection drug
users in the United States to be fewer than 40,000.
"Our results highlight the need for shifting prevention dollars for urban
injection drug users," said Heimer, who is also an associate professor of
pharmacology at Yale. "It is more important to expend scant resources on
effective primary and secondary preventive programs including access to
clean syringes and helping users get into treatment for their addiction."
Heimer emphasized needle exchange programs, substitution therapy like
methadone and buprenorphine, and engaging those injection drug users already
infected with HIV in supportive anti-retroviral therapy. He said these
approaches have been shown to decrease the incidence of new infections at
rates sufficient to save money.
"When it comes to urban injection drug users, money will be wasted on
low-impact, low-yield counseling and testing programs," said Heimer.
"Prevention programs should not be compelled to generalize and accept a
single approach to preventing disease transmission. Injection drug users
should not be lumped in with other high risk groups. Instead, tailored
programs designed with their unique needs in mind will yield better
outcomes."
Since the study was conducted, Heimer and his colleagues have been working
to immunize injection drug users against hepatitis B, as well as developing
other interventions designed to reduce HIV infections in drug using
populations.
Other authors on the study were Lauretta Grau, Erin Curtin, Kaveh Khoshnood
and Merrill Singer.
Citation: American Journal of Public Health, Vol. 97, No. 1 (January 2007)
By Yale School of Medicine
Dec 18, 2006, 07:00
(HealthNewsDigest.com).. New Haven, Conn.- For injection drug users, the
most productive and cost-effective approach to managing the spread of HIV is
expanding syringe exchange and drug treatment, as well as promoting
antiretroviral treatment for those already infected with HIV, according to a
new study by researchers at Yale School of Medicine.
Published in the January issue of American Journal of Public Health, the
authors, led by Yale Public Health professor Robert Heimer, found that the
Centers for Disease Control and Prevention's (CDC) new approach of promoting
HIV testing, "Advancing HIV Prevention," may not be best for injection drug
users.
Heimer, professor in the Department of Epidemiology and Public Health at
Yale School of Medicine, said the CDC policy is based on the presumption
that the HIV epidemic can be curtailed in great part by promoting HIV
testing and that more resources should go to expanded testing of high-risk
populations. However, the results reported in this study revealed that
testing was already widespread for urban injectors.
Heimer and co-authors analyzed interviews conducted with 1,543 injection
drug users in five cities, including New Haven and Hartford, CT,
Springfield, MA, Chicago, IL, and Oakland, CA. Access to sterile syringes
through syringe exchanges or at pharmacies with a prescription was not
available in all cities. Injection drug users who participated in the study
were asked if they had been tested for HIV and if they had ever been told
they were HIV positive. From this, the research team estimated what
percentage had never been tested and what percentage did not know their
status.
Ninety-three percent of injectors had been tested, and of those currently in
need of testing, 90 percent were tested in the past three years and 70
percent within the past year. Less than three percent were infected with HIV
without their knowledge. Women and syringe-exchange participants were more
likely to have been tested at least once, and in the recent past. The team
estimated the number of undetected infections among urban injection drug
users in the United States to be fewer than 40,000.
"Our results highlight the need for shifting prevention dollars for urban
injection drug users," said Heimer, who is also an associate professor of
pharmacology at Yale. "It is more important to expend scant resources on
effective primary and secondary preventive programs including access to
clean syringes and helping users get into treatment for their addiction."
Heimer emphasized needle exchange programs, substitution therapy like
methadone and buprenorphine, and engaging those injection drug users already
infected with HIV in supportive anti-retroviral therapy. He said these
approaches have been shown to decrease the incidence of new infections at
rates sufficient to save money.
"When it comes to urban injection drug users, money will be wasted on
low-impact, low-yield counseling and testing programs," said Heimer.
"Prevention programs should not be compelled to generalize and accept a
single approach to preventing disease transmission. Injection drug users
should not be lumped in with other high risk groups. Instead, tailored
programs designed with their unique needs in mind will yield better
outcomes."
Since the study was conducted, Heimer and his colleagues have been working
to immunize injection drug users against hepatitis B, as well as developing
other interventions designed to reduce HIV infections in drug using
populations.
Other authors on the study were Lauretta Grau, Erin Curtin, Kaveh Khoshnood
and Merrill Singer.
Citation: American Journal of Public Health, Vol. 97, No. 1 (January 2007)
Check these out...
Methamphetamine.org: new and integrated approach to dealing with methamphetamine from UCLA.
Prototypes.org: integrated approach to providing services to women
Methamphetamine.org: new and integrated approach to dealing with methamphetamine from UCLA.
Prototypes.org: integrated approach to providing services to women
Monday, December 18, 2006
Huntsman makes tackling meth epidemic a top priority
Deseret Morning News, Friday, December 15, 2006
By Dennis Romboy
Gov. Jon Huntsman Jr. and his wife have made friends with the people in their neighborhood, including some hooked on methamphetamine.
A residential treatment center called House of Hope is a couple of doors down from the Governor's Mansion on South Temple. Their neighbors are moms who are trying to fight meth addiction, said Mike Mower, the governor's spokesman.
The Huntsmans visited women in the house and Mary Kaye Huntsman had them over for a tea party.
"The governor realizes the insidious nature of meth use and its disproportionate use among young women, often young mothers," Mower said.
To turn that tide, Huntsman's proposed state budget includes $5.1 million a year (half from Medicaid) to place 600 more women in treatment programs, giving priority to those involved with the Utah Division of Child and Family Services.
read the rest...
read the rest...
Women, Meth, and Children
by Terri Hurst, MSW
Women are often overlooked when it comes to treatment for meth use, especially women with children. Women usually enter treatment through the criminal justice system and by that time, CPS (Child Protective Services) has intervened.
Women who are not allowed access to their children while in treatment have a greater likelihood of relapse and are not as successful in completing treatment. It is also important for children to remain connected to their mother, unless severe abuse has taken place. Just because a mom uses meth, it does not make her a "bad" mother.
With the prevalence of ice in Hawaii, many women have lost their children due to harsh laws that are not focused on keeping families together. This goes against the Hawaiian principle of "ohana" or family and the importance of family within the Hawaiian culture. While ice use is inter-generational in the islands, it is even more important that children of meth users see that their parents can recover from drug use and that parents teach their children about ice so that they can stop the cycle of use. Women's Way, which is located on the island of Oahu, is a residential treatment program run by the Salvation Army - Family Treatment Services. Women's Way is the only subtance abuse treatment program on the islands that works with women and children. The program targets women who are pregnant and using or who have children between the ages of 0 - 3 years of age. For more information, call: (808) 732-2802 x 39
In Utah, where meth rates are also extremely high for both men and women, there are two programs that work specifically with women and children. The Volunteers of America, Center for Women and Children works with women who have children aged 10 years and younger. The Program Director stated that "meth is the number one problem we see." For more information call: (801) 261-9177
Also, Valley Mental Health offers the Cottonwood Family Treatment Center, which is a residential treatment program geared specifically for meth use among women with children. For more information call: (801) 263-7225
by Terri Hurst, MSW
Women are often overlooked when it comes to treatment for meth use, especially women with children. Women usually enter treatment through the criminal justice system and by that time, CPS (Child Protective Services) has intervened.
Women who are not allowed access to their children while in treatment have a greater likelihood of relapse and are not as successful in completing treatment. It is also important for children to remain connected to their mother, unless severe abuse has taken place. Just because a mom uses meth, it does not make her a "bad" mother.
With the prevalence of ice in Hawaii, many women have lost their children due to harsh laws that are not focused on keeping families together. This goes against the Hawaiian principle of "ohana" or family and the importance of family within the Hawaiian culture. While ice use is inter-generational in the islands, it is even more important that children of meth users see that their parents can recover from drug use and that parents teach their children about ice so that they can stop the cycle of use. Women's Way, which is located on the island of Oahu, is a residential treatment program run by the Salvation Army - Family Treatment Services. Women's Way is the only subtance abuse treatment program on the islands that works with women and children. The program targets women who are pregnant and using or who have children between the ages of 0 - 3 years of age. For more information, call: (808) 732-2802 x 39
In Utah, where meth rates are also extremely high for both men and women, there are two programs that work specifically with women and children. The Volunteers of America, Center for Women and Children works with women who have children aged 10 years and younger. The Program Director stated that "meth is the number one problem we see." For more information call: (801) 261-9177
Also, Valley Mental Health offers the Cottonwood Family Treatment Center, which is a residential treatment program geared specifically for meth use among women with children. For more information call: (801) 263-7225
Satan's son?
Montana Meth Project advertising does one thing well - it inspires creative writing.
Thanks to the aggressive, slick, and lurid advertising campaign mounted by the Montana Meth Project high school students are thoroughly versed in the purportedly inevitable consequences of meth use: a disgusting, rotting mouth; cheap sex in dirty bathrooms; scabs and oozing wounds; and crime.
Evidence of the campaign's success to scare kids straight was printed in the Billings Gazette in the form of a letter from "crystal" penned by a local high school student.
"I have very serious long-term affects. Signs that you have been hanging with me could be rotten teeth, nasty oozing scabs and a disgusting odor coming from your body. I can be injected through your mouth, nose or veins."
What appears to be a creative writing project probably in response to yet another "horrors of meth" news story is family values-inspired drug porn. Meth provides, like marijuna, heroin, and crack before it, the chance for Americans to indulge their need to be voyuers and peer into the world of the nasty "other." This time around, we feed our desires with scenes of sweet young kids being turned into thieves and whores by methamphetamine.
All of the kids featured in the Montana Meth Project video and print ads are actors. They get paid to portray drug users. The women who are all too often exposed on drug and law enforcement websites, however, are real. Their lives are summed up by mug shots, which are arrayed in chronological order typically progressing from a shot of a pretty blonde who becomes, over the course of ten years and ten busts, a haggy old crone with no teeth because she couldn't kick the habit.
In the act of laying out a woman's life in her mug shots and summing it all up to drug use is a convenient, and apparently legal, way of stripping drug users of their humanity and privacy. Like the portrayals of young users in the Montana Meth Project ads, they become part of a public peep show and the poster children of the drug warriors.
What the Montana Meth Project ads and the mug shots don't do is talk about the many reasons people turn to drugs, and they certainly don't address the realities of our world where the pressure to perform and produce and stay skinny and take care of the kids can be overwhelming.
A better use of our ad space and air time would be to engage young people in an honest conversation about turning complex problems, like methamphetamine use, into lurid stereotypes and why we find it so hard find the humanity in others.
Montana Meth Project advertising does one thing well - it inspires creative writing.
Thanks to the aggressive, slick, and lurid advertising campaign mounted by the Montana Meth Project high school students are thoroughly versed in the purportedly inevitable consequences of meth use: a disgusting, rotting mouth; cheap sex in dirty bathrooms; scabs and oozing wounds; and crime.
Evidence of the campaign's success to scare kids straight was printed in the Billings Gazette in the form of a letter from "crystal" penned by a local high school student.
"I have very serious long-term affects. Signs that you have been hanging with me could be rotten teeth, nasty oozing scabs and a disgusting odor coming from your body. I can be injected through your mouth, nose or veins."
What appears to be a creative writing project probably in response to yet another "horrors of meth" news story is family values-inspired drug porn. Meth provides, like marijuna, heroin, and crack before it, the chance for Americans to indulge their need to be voyuers and peer into the world of the nasty "other." This time around, we feed our desires with scenes of sweet young kids being turned into thieves and whores by methamphetamine.
All of the kids featured in the Montana Meth Project video and print ads are actors. They get paid to portray drug users. The women who are all too often exposed on drug and law enforcement websites, however, are real. Their lives are summed up by mug shots, which are arrayed in chronological order typically progressing from a shot of a pretty blonde who becomes, over the course of ten years and ten busts, a haggy old crone with no teeth because she couldn't kick the habit.
In the act of laying out a woman's life in her mug shots and summing it all up to drug use is a convenient, and apparently legal, way of stripping drug users of their humanity and privacy. Like the portrayals of young users in the Montana Meth Project ads, they become part of a public peep show and the poster children of the drug warriors.
What the Montana Meth Project ads and the mug shots don't do is talk about the many reasons people turn to drugs, and they certainly don't address the realities of our world where the pressure to perform and produce and stay skinny and take care of the kids can be overwhelming.
A better use of our ad space and air time would be to engage young people in an honest conversation about turning complex problems, like methamphetamine use, into lurid stereotypes and why we find it so hard find the humanity in others.
Friday, December 15, 2006
African American Safety Counts Group
John Cottrell
Since March 2006, HRP has been holding a Safety Counts Group specifically for African American substance users. What started out as a small group of 3 attendees, has blossomed into an engaging experience for all participants ranging from 9 to 12 participants each week. How did this happen?
Coming on earlier in the year as a health educator to run this group, personally, I was a bit nervous about being able to get people to attend……more specifically BLACK people to attend. I started with asking the people that I knew to make referrals: Sarah McClellan with the Northern Utah Coalition, Ernest Timmons from the Calvary Baptist Church, Janine Hansen from Project Reality, and others. I only hoped that we would have a few people. Outreach workers from HRP passed out flyers at the Weigand Center, Road Home, and Pioneer Park. I only hoped that we were covering our bases.
I have to say that I was pleasantly surprised. On the first day, we had 6 people attend. All seemed enthusiastic, they participated well in the group as we discussed ways to prevent getting HIV and hepatitis. And I do believe the $10 cash incentive helped, too!! After that initial group, though, the numbers dwindled to 2 or 3 each week. I got worried. So I asked the members if they knew people who might benefit from this type of class specifically for African Americans. Current members were only eager to bring more people. Since then, our numbers have grown.
It’s not so much that our numbers have grown or that each class is dynamic with each participant sharing their personal stories and triumphs. An interesting piece to this entire scenario is WHO the members are. This group was designed for African American drug users. Those that are attending happen to be all men. Interesting. And the average age of the group is 50 years of age. Also interesting. Where did these guys come from? Why do they keep coming? What are they getting from this group (besides some cash and an occasional clothing voucher)? And where are the women? These are the questions I have asked myself. It got me thinking about this particular demographic which is statistically and historically difficult to engage in services sometimes. When we look at HIV prevention in Utah, for example, this group is one that is not directly targeted. Perhaps HRP has fallen on to something here. Maybe we’re getting some of those “hard-to-reach” individuals.
The guys that have been coming, especially the new ones, are all brought by current group members. Some have said that they didn’t know they would get an incentive for attending. Some just heard that “there is a great class you should attend.” As mentioned, the classes are informative and definitely lively. We share knowledge with one another. I provide information about HIV and hepatitis, but we go further than that. We set goals to change their thinking or behavior about their drug use. We seek ways to increase their self esteem. We encourage one another. I think this is what the group does and the reasons why the guys keep coming back. It is an atmosphere where these gentlemen can speak their minds openly and honestly. They are among friends and peers. One of my mottos in the group is “stay aware, be conscious.” This relates to the knowledge they already possess. Be sure to bring that knowledge to the surface and use it.
We’ll see how things continue with this group. Will the same members keep attending? Will there continue to be new members? We’ll see.
John Cottrell
Since March 2006, HRP has been holding a Safety Counts Group specifically for African American substance users. What started out as a small group of 3 attendees, has blossomed into an engaging experience for all participants ranging from 9 to 12 participants each week. How did this happen?
Coming on earlier in the year as a health educator to run this group, personally, I was a bit nervous about being able to get people to attend……more specifically BLACK people to attend. I started with asking the people that I knew to make referrals: Sarah McClellan with the Northern Utah Coalition, Ernest Timmons from the Calvary Baptist Church, Janine Hansen from Project Reality, and others. I only hoped that we would have a few people. Outreach workers from HRP passed out flyers at the Weigand Center, Road Home, and Pioneer Park. I only hoped that we were covering our bases.
I have to say that I was pleasantly surprised. On the first day, we had 6 people attend. All seemed enthusiastic, they participated well in the group as we discussed ways to prevent getting HIV and hepatitis. And I do believe the $10 cash incentive helped, too!! After that initial group, though, the numbers dwindled to 2 or 3 each week. I got worried. So I asked the members if they knew people who might benefit from this type of class specifically for African Americans. Current members were only eager to bring more people. Since then, our numbers have grown.
It’s not so much that our numbers have grown or that each class is dynamic with each participant sharing their personal stories and triumphs. An interesting piece to this entire scenario is WHO the members are. This group was designed for African American drug users. Those that are attending happen to be all men. Interesting. And the average age of the group is 50 years of age. Also interesting. Where did these guys come from? Why do they keep coming? What are they getting from this group (besides some cash and an occasional clothing voucher)? And where are the women? These are the questions I have asked myself. It got me thinking about this particular demographic which is statistically and historically difficult to engage in services sometimes. When we look at HIV prevention in Utah, for example, this group is one that is not directly targeted. Perhaps HRP has fallen on to something here. Maybe we’re getting some of those “hard-to-reach” individuals.
The guys that have been coming, especially the new ones, are all brought by current group members. Some have said that they didn’t know they would get an incentive for attending. Some just heard that “there is a great class you should attend.” As mentioned, the classes are informative and definitely lively. We share knowledge with one another. I provide information about HIV and hepatitis, but we go further than that. We set goals to change their thinking or behavior about their drug use. We seek ways to increase their self esteem. We encourage one another. I think this is what the group does and the reasons why the guys keep coming back. It is an atmosphere where these gentlemen can speak their minds openly and honestly. They are among friends and peers. One of my mottos in the group is “stay aware, be conscious.” This relates to the knowledge they already possess. Be sure to bring that knowledge to the surface and use it.
We’ll see how things continue with this group. Will the same members keep attending? Will there continue to be new members? We’ll see.
Thursday, December 14, 2006
Treatment v. incarceration
by Wyndimarie Anderson
Harm Reduction Project
You hear this debate all the time. The truth is for some people it can feel like one and the same for many reason and the recent tragedy in Russia reminds me that we have to make sure our treatment centers do not become prison like (again)….
In Moscow this week, 46 women were killed in a fire in a drug treatment facility.
Apparently, the 44 patients and 2 staff were trapped between the fire and a locked gate which led to their deaths.
Locked gates in a drug treatment facility? From everything I have been able to read so far this was not a facility housing inmates from the criminal justice system. Why were there locked gates? And why didn’t the staff have the keys to open the gates?
Our work to educate people about the need for health care and drug treatment includes making sure that the programs and facilities offered are not substandard or just one step removed from jail. We don’t need steel bars to treat a drug addict. We need treatment. And we need access to that treatment.
(Yes, we need a lot more, but for the sake of this posting I’ll stay focused on that)
Here is a comment from the Russian Harm Reduction Network calling for an investigation into the fire: http://www.healthdev.org/viewmsg.aspx?msgid=9E66ED94-2DD4-4D97-AFFA-5CC7B380CA3F
The Russian Harm Reduction Network (RHRN) and the International Treatment Preparedness Coalition / Region of Eastern Europe and Central Asia (ITCPru) express deep condolences to the families of people who died in the fire in the drug treatment hospital #17 in Moscow, as well as to those who were injured during the fire and to the hospital personnel.
On December 09, 2006 the Office of the Procecutor General of the Russian Federation announced initiation of criminal cases under two articles: malicious destruction of property and disregard of fire safety resulting in death. While we support the need for a just an unbiased investigation into this tragedy, our collective expertise as activists and professionals working in the areas of drugs and HIV/AIDS shows that the problem is as systemic as it is individual. RHRN and ITCPru assert that the cause of the tragedy is rooted in the inhumane and ineffective organisation of drug treatment in Russia, and is not merely due to the negligence of separate individuals.
"Conditions within drug treatment facilities in Russia remind more of prisons than hospitals," - says Vitaly Djuma, the Executive Director of the Russian Harm Reduction Network, which unites providers of harm reduction services to drug users from all over Russia.
"In the rest of the modern world this approach to treatment was banned decades ago. Cells, bars, insensitive personnel, indifference to the lives of their patients - all these add up to cause of the tragedy. The problem is not of a just one particular hospital, this is the problem of the whole system."
Specialists and activists agree that whatever the results of the investigation, we shouldn't blame selected individuals be them patients or personnel of the hospital. We especially denounce placing the blame on a woman in severe pain and suffering, for breaking the fire. The distribution of discriminative and speculative disinformation in press before the end of the investigation is yet one more part of the systemic problem that creates general public antipathy towards the victims.
"Blaming separate individuals means closing one's eyes on the fact that the whole system of drug treatment in Russia is absolutely ineffective, inhumane and discredited, - says Gregory Vergus of the International Treatment Preparedness Coalition, an association which unites HIV activists from around the world, including those from Newly Independent States and the Baltics.
"What is called 'narcological assistance' in this country in fact isn't assistance at all.
Join the Harm Reduction Project in signing this petition asking for a full investigation of what happened to the clinic in Russia. Treating addicts like throw aways or criminals cannot go unnoticed in any part of world… the deaths of these 44 women do matter.
by Wyndimarie Anderson
Harm Reduction Project
You hear this debate all the time. The truth is for some people it can feel like one and the same for many reason and the recent tragedy in Russia reminds me that we have to make sure our treatment centers do not become prison like (again)….
In Moscow this week, 46 women were killed in a fire in a drug treatment facility.
Apparently, the 44 patients and 2 staff were trapped between the fire and a locked gate which led to their deaths.
Locked gates in a drug treatment facility? From everything I have been able to read so far this was not a facility housing inmates from the criminal justice system. Why were there locked gates? And why didn’t the staff have the keys to open the gates?
Our work to educate people about the need for health care and drug treatment includes making sure that the programs and facilities offered are not substandard or just one step removed from jail. We don’t need steel bars to treat a drug addict. We need treatment. And we need access to that treatment.
(Yes, we need a lot more, but for the sake of this posting I’ll stay focused on that)
Here is a comment from the Russian Harm Reduction Network calling for an investigation into the fire: http://www.healthdev.org/viewmsg.aspx?msgid=9E66ED94-2DD4-4D97-AFFA-5CC7B380CA3F
The Russian Harm Reduction Network (RHRN) and the International Treatment Preparedness Coalition / Region of Eastern Europe and Central Asia (ITCPru) express deep condolences to the families of people who died in the fire in the drug treatment hospital #17 in Moscow, as well as to those who were injured during the fire and to the hospital personnel.
On December 09, 2006 the Office of the Procecutor General of the Russian Federation announced initiation of criminal cases under two articles: malicious destruction of property and disregard of fire safety resulting in death. While we support the need for a just an unbiased investigation into this tragedy, our collective expertise as activists and professionals working in the areas of drugs and HIV/AIDS shows that the problem is as systemic as it is individual. RHRN and ITCPru assert that the cause of the tragedy is rooted in the inhumane and ineffective organisation of drug treatment in Russia, and is not merely due to the negligence of separate individuals.
"Conditions within drug treatment facilities in Russia remind more of prisons than hospitals," - says Vitaly Djuma, the Executive Director of the Russian Harm Reduction Network, which unites providers of harm reduction services to drug users from all over Russia.
"In the rest of the modern world this approach to treatment was banned decades ago. Cells, bars, insensitive personnel, indifference to the lives of their patients - all these add up to cause of the tragedy. The problem is not of a just one particular hospital, this is the problem of the whole system."
Specialists and activists agree that whatever the results of the investigation, we shouldn't blame selected individuals be them patients or personnel of the hospital. We especially denounce placing the blame on a woman in severe pain and suffering, for breaking the fire. The distribution of discriminative and speculative disinformation in press before the end of the investigation is yet one more part of the systemic problem that creates general public antipathy towards the victims.
"Blaming separate individuals means closing one's eyes on the fact that the whole system of drug treatment in Russia is absolutely ineffective, inhumane and discredited, - says Gregory Vergus of the International Treatment Preparedness Coalition, an association which unites HIV activists from around the world, including those from Newly Independent States and the Baltics.
"What is called 'narcological assistance' in this country in fact isn't assistance at all.
Join the Harm Reduction Project in signing this petition asking for a full investigation of what happened to the clinic in Russia. Treating addicts like throw aways or criminals cannot go unnoticed in any part of world… the deaths of these 44 women do matter.
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