Sovereign Rules and Rearrangements: Banning Methadone in Occupied Crimea

ABSTRACT

In 2014, Russian authorities in occupied Crimea shut down all medication-assisted treatment (MAT) programs for patients with opioid use disorder. These closures dramatically enacted a new political order. As the sovereign occupiers in Crimea advanced new constellations of citizenship and statehood, so the very concept of “right to health” was re-tooled. Social imaginations of drug use helped single out MAT patients as a population whose “right to health,” protected by the state, would be artificially restricted. Here, I argue that such acts of medical disenfranchisement should be understood as contemporary acts of statecraft.

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KEYWORDS:

• Russia
• Ukraine
• medicalization
• right to health
• sovereignty
• substance use

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

1. The national status of Crimea has shifted several times over the past century. Originally part of the Russian Soviet Socialist Republic within the USSR, Crimea was not a part of Ukraine until 1954, when it was “gifted” to the Ukrainian Soviet Socialist Republic by Krushchev in celebration of the 300th anniversary of Pereyaslav, when Cossack leaders joined forces with Russia’s Tsarist military forces in their uprising against the Polish-Lithuanian Commonwealth (Reid 1997).

2. Beginning in 1991, Crimea existed as an autonomous region within Ukraine, retaining its status as a nearly exclusively Russian-speaking population with close historical ties to the Russian Orthodox Church and Russian cultural identity. Russian political rhetoric tends to frame Crimea as a fundamentally Russian place, drawing lines of distinction not between Russia and Ukraine, as world maps might have us imagine, but between a historically imagined “Russian world” and everywhere else. Historian Serhii Plokhy has described this contemporary model of Russian identity as on “which stresses the indivisibility of the Russian nation, closely associated with the Russian language and culture, [and which] poses a fundamental challenge to the Ukrainian nation-building project” (Plokhy 2017:350).

3. Original Russian: Чем дольше будит функционировать программы ЗПТ в Крыму, тем дольше эти люди смогуть нормально жить. Они не говорять о политике. Они не просять многого. Они просто хотят жить.

Translation by author: The longer MAT programs in Crimea operate, the longer these people will be able to live a normal life. They are not talking politics. They are not asking for much. They simply want to live.

Additional information

Funding

The research presented in this article was supported by the Wenner-Gren Foundation, IREX (International Research & Exchanges Board) with funds provided by the United States Department of State through the Title VIII Program, and the Department of Anthropology at the University of Washington. None of these organizations are responsible for the views expressed herein. Completion of this research has been facilitated in part by the infrastructure and resources provided by the Lifespan/Tufts/Brown Center for AIDS research, an NIH funded program, grant number [P30-AI-42853], from the National Institutes of Health, Center for AIDS Research. This work was also supported by grants from the National Institute on Drug Abuse [award Number T32 DA013911] and the National Institute of Mental Health [award Number T32-MH078788].

Notes on contributors

Jennifer J. Carroll

Jennifer J. Carroll is assistant professor of Anthropology at Elon University and adjunct assistant professor of Medicine at Brown University. Her first book, Narkomania: The Addiction Imaginary at Peace and at War, is being published by Cornell University Press.