Intended for healthcare professionals

Rapid response to:


Russia declares “total war” on the country’s drug problem

BMJ 2011; 343 doi: (Published 04 July 2011) Cite this as: BMJ 2011;343:d4194

Rapid Response:

It is not a war, it is not even problem solving

The news item described the words really pronounced in Moscow, but
missed the content and the context.

Russia is in a big trouble with misuse of drugs. But it is not that
simple. Russian drug control agency is very ineffective. They prefer to
struggle in the court with the home owners, who got one (literally) wild
poppy seed in their garden and to control drug stores. When we look at
their successes from what they reported, we find out, e.g., that yesterday
they reported as about great success the confiscation of 120 g of grass
and other substances. It is the imitation of the "war" and misuse of state
resources. The major object of their efforts - the drug addicts, who are
pressed and robbed everywhere.

The same with codeine and desomorphine produced from it. The tablets
and syrups containing codeine were sold as prescription only drugs till
2005. Then Ministry of health put the codeine containing drugs on the OTC
drug list. Soon these drugs became the best sellers of the Russian market.
Literally, one combination drug was the second in the list of best sellers
of Russian drugs. The total volume of trade of the codeine containing
drugs is enormous. The company, which sells five different drugs of this type, and profits
hugely from this trade is allegedly connected to the Russian minister of
health's family [;].
This spring, when the media campaign was launched against the liberal trade of codeine containing drugs, health minister Golikova kept the pause and then promised to take these drugs from the OTC list in 12 months.

Usually the "war on drugs" is led by informed government and the "army" of the interested society and medical specialists, who provide the weaponry - the evidence based interventions. The most dramatic is the plan to compulsorily screen all school and university students by blood and urinalysis. The government appointed medical adviser in narcology, E.A. Briun MD,
insisted that he developed the tests which makes possible to detect the
one time consumption of the drug many months before test
Only the critique by human rights activists and the evidence based medicine society prevented the speedy introduction of the program. Now it is modified as a voluntary screening. But, of course, it is proposed as voluntary in the presumption, that everybody who rejects testing is
supposedly a drug user. The questions about the false positives and
necessity to test the program efficiency before it is implemented are just
ignored by the Government.

Russian Government succeeds to get the federal law barring the use of
the substitution therapy for drug addicts. More, the idea of substitution
therapy is pictured as a diversion of the perverse West against Russia.

More, the harm reduction programs are closed around the country. Minister
T. Golikova explicitly said that the introduction of the harm reduction
programs is encouraging the drug misused and led to the spread of HIV
in Russia. On 7 July the Speaker of the Russian parliament's low chamber "Duma" B.
Gryzlov at the official meeting said that for drug users the alternative
to a prison term may be enforced treatment

If the war is a lie, crime and corruption, then Russia really is in
the war.

Competing interests: No competing interests

21 July 2011
Vasiliy V. Vlassov
Society for Evidence Based Medicine, Russia