Challenges in Providing Drug User Treatment Services in Russia: Providers' Views

Abstract

The estimated number of opiate users in Russia is 2,000,000 and heroin consumption is continuing to increase. The Russian government is discussing the initiation of compulsory treatment to bring illegal drug users to the treatment services. At the same time, there is no access to the evidence-based treatment for opiate addiction such as methadone and buprenorphine maintenance programs. Qualitative interviews were conducted with drug user treatment service providers (N = 35) in Barnaul, Volgograd, and Yekaterinburg, Russia, in 2003–2004 to examine their views on drug user treatment services in Russia. The framework approach was used in data collection and analysis. Study participants identified major challenges in service provision for drug using population, including lack of resources, rehabilitation programs, and social support. It also depicted ambivalent attitudes toward compulsory treatment and clients' registration. The Russian drug user treatment system desperately needs resources allocation to provide quality care and diversify in its services in order to achieve long-term recovery. At this stage, it seems unreasonable to initiate compulsory treatment as is advocated by some government officials.

Keywords:

• drug user treatment services
• attitudes
• service providers
• compulsory treatment
• Russia
• structural factors
• structural barriers
• treatment coercion

Acknowledgments

We are grateful to the UK Department for International Development for the support provided for this study. We thank research teams in each city for their assistance and hospitality: Svetlana Zonova, Marija and Igor Kanarskij, Olga Oboskalova, Valerij Gafarov, Darija Omelchenko, Nikolaj Krasukov, Irina Shevtsova, and Yekaterina Nechaeva. We would also like to thank Evgenija Koshkina, Sergej Tsarev, and Andrej Karpets for their expertise and help in providing useful background information about Russian drug user treatment system.

Notes

¹ The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused Editor's note.

² There is a need to distinguish between treatment registration, confidentiality, and anonymity in terms of dimensions, processes, implications, and outcomes for the treatment constituency; patient, provider, and program. Editor's note.