Marseille 2007
| Abstract #190 - Attitudes of drug users towards opiate substitution therapy in Russia. | ||||
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Session: 6.22: Posters A (Poster) on Monday in Chaired by Authors: Presenting Author: Dr Mauro Guarinieri - Open Society Institute, Hungary |
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| Additional Authors: Dr Vladimir Mendelevich, | ||||
| Aim: In Russia, opiate substitution therapy is forbidden by law. This is despite the fact that nearly 6 million Russians reportedly experienced with opiates; roughly 500 thousand with symptoms of addiction are registered as patients in state drug clinics. The effectiveness of current treatments of opioid addiction, evaluated by the rate of yearly remissions, is very low (it does not exceed 15%). Moreover, contaminated needles are still the prevailing mode of HIV spread in Russia. In 2006, members of Medical Psychology Department of Kazan State Medical University conducted a study of attitudes toward the potential introduction of substitution therapy in Russia. A total of 808 people took part in the anonymous survey, including both blue-collar and white-collar workers, pupils, college students, and retirees. Law enforcement workers, narcologists (drug addiction specialists), people suffering from drug addiction and their parents or families participated as a special group of respondents. The survey demonstrated that 29.5% of respondents voted in favor of substitution therapy and 42.8% voted against. Supporters outnumbered opponents only among narcologsts (44% in favor, 38.7% opposed). All other groups of respondents actively opposed the idea of substitution therapy, including drug addicts themselves (34% for; 50% against) and their parents (5.3% for; 42.1% against). Views of drug users living with HIV, however, differed from the attitudes of all other groups, including HIV-negative addicts. Drug users with HIV supported substitution therapy most emphatically: 55% were in favor, while 17% opposed, and 23% were undecided. This outcome demonstrates that people, diagnosed with both drug addiction and HIV, are interested in the emergence of a therapy that would help them sustain in HIV treatment programs and adhere to ARV regimens. At the same time, antagonists of substitution therapy in this subgroup used the same justification as other opponents: It will not be possible to regulate the dose that the drug user administers and it will encourage drug addicts to abandon drug treatment - 41% each. For comparison, HIV-negative users expressed these arguments in only 20% and 40% of cases, respectively. Especially worthy of attention is the argument it will not be possible to regulate the dose that the drug user administers, which was given by HIV-positive users at almost twice the frequency than among the rest of respondents. Moreover, drug users with HIV were nearly five times as likely to see substitution therapy as an immoral action 27%, versus 6.3% among the rest of the respondents and 10% among HIV-negative drug users. | ||||
| Results / Comments: Injecting drug users are not active supporters of substitution therapy in Russia. Only when sufferers are diagnosed with both drug addiction and HIV do patients begin to more actively support the idea of substitution therapy as a means of adherence to ARV. These results allow for reorientation of the process of advocacy for substitution therapy from the group of narcologists to injecting drug users and especially those living with HIV. | ||||
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