Speaker 1: Hi, I'm Ethan Edelman, and this is Psychoactive, a production
Speaker 1: of I Heart Radio and Protozoa Pictures. Psychoactive is the
Speaker 1: show where we talk about all things drugs. But any
Speaker 1: of views expressed here do not represent those of I
Speaker 1: Heart Media, Protozoa Pictures, or their executives and employees. Indeed,
Speaker 1: as an inveterate contrarian, I can tell you they may
Speaker 1: not even represent my own. And nothing contained in this
Speaker 1: show should be used as medical advice or encouragement to
Speaker 1: use any type of drug. Hello, Psychoactive listeners. Today, I'm
Speaker 1: gonna be talking with Anya Sere. And Anya is perhaps
Speaker 1: the most well known and leading and longstanding activist for
Speaker 1: harm reduction in Russia, which is no easy job as
Speaker 1: you can imagine, as she's mostly been based in the
Speaker 1: Netherlands in recent years, where she is the chair of
Speaker 1: the Andre Rolka Foundation, which does harm reduction activity and
Speaker 1: activism in Russia. And yes, that has still been possible
Speaker 1: to some extent, but I thought that especially given what's
Speaker 1: going on in the world now with Russia's invasion of
Speaker 1: Ukraine and more and more attention and more and more
Speaker 1: consciousness among Americans and really the global audience to what's
Speaker 1: going on not just in Ukraine but in Russia. I
Speaker 1: thought would be interesting to have an episode specifically about
Speaker 1: drugs and drug policy and harm reduction and activism in
Speaker 1: Russia and maybe reflect a little bit about what you
Speaker 1: know insights that provides into Russia more generally. So, Anya,
Speaker 1: thank you so much for joining me on Psychoactive. You've
Speaker 1: done huge Thanks for inviting me and the It's a
Speaker 1: big owner for me. I'm really humble to be a
Speaker 1: guest on one of your great episodes. And you and
Speaker 1: I have not seen one another for quite some time,
Speaker 1: but you have been deeply involved in this now what
Speaker 1: for something like twenty years about trying to advance harm
Speaker 1: reduction policies and programs and thinking in in Russia. Years
Speaker 1: over twenty years now, So Russia, right, I mean, you know,
Speaker 1: if we go back historically, right, the Soviet Union kind
Speaker 1: of comes apart in the early nineteen nineties and there's
Speaker 1: a kind of wild and crazy period in the nineties
Speaker 1: where borders are open or as Yelson is the president,
Speaker 1: things are a bit chaotic. I think drug use, you know,
Speaker 1: it begins to increase significantly. You know, what was that
Speaker 1: period like back in the late nineties before Putin and
Speaker 1: especially looking at the drug situation back then as well.
Speaker 1: I was born in nineteen seventy too, so I was young,
Speaker 1: but I was like at the age when people start
Speaker 1: to experiment with drugs, and you are absolutely right. It
Speaker 1: was like something completely new and something too came to
Speaker 1: us quite massively and unexpectedly, and a lot of young
Speaker 1: people started to use drugs and started to use drugs
Speaker 1: by injection, and when they started to work with medicine
Speaker 1: san printiers, there was a huge concern about the future
Speaker 1: of HIV epidemic and Russia which did not start yet,
Speaker 1: but I was about to start. Because a lot of
Speaker 1: young people, inexperienced people, and people who did not have
Speaker 1: any information about drugs from there, you know, like parents
Speaker 1: or they did not see the previous generation using drugs,
Speaker 1: they started to use and they started to use in
Speaker 1: quite harmful ways. And was it mostly heroine and heroin
Speaker 1: coming from the Afghanistan? Was that the principle issue? Oh know,
Speaker 1: firstly it was a homemade heroin we called the hunk
Speaker 1: or churners. So it's like homemade opius and homemade stimulants.
Speaker 1: I don't know, maybe you've heard about Interrussian math vetamine
Speaker 1: also the kind of uh homemade product, and at first
Speaker 1: it was that so hunk and veined. They were, as
Speaker 1: far as I remember, like one of the first like
Speaker 1: most popular drugs. And then maybe several years later actually
Speaker 1: in the early nineties, the heroin like completely took up
Speaker 1: all the drugs scene, like city by city in Russia.
Speaker 1: But yes, a bit later. But even if you go
Speaker 1: back to the days when when Russia was occupying Afghanistan,
Speaker 1: was there already situations of heroin coming back into the
Speaker 1: country by Russian soldiers for example. Bringing it back to
Speaker 1: things like that, it was a fairly small scale until
Speaker 1: things really kind of opened up in the in the
Speaker 1: later nineties. I think it was quite small scale. There
Speaker 1: was no like a public health emergency. People did not
Speaker 1: hear much about that. I heard that there was some
Speaker 1: even like always like small scale always substitution program somewhere
Speaker 1: in Georgia, but it was not like a huge or
Speaker 1: visible problem before Now, I have to tell you, the
Speaker 1: only time I've ever been to your country, it was
Speaker 1: back in the spring of nineteen nineties six I think
Speaker 1: it was the annual Russian AIDS conference in St Petersburg,
Speaker 1: And I guess was that a period mean sort of
Speaker 1: a relative openness you think in those late nineties early
Speaker 1: two thousands, when the sort of more open discussion could
Speaker 1: happen even in kind of semi official gatherings. Yes, even
Speaker 1: you are absolutely right. Ninety six is probably when harm
Speaker 1: aduction started in Russian It started in Saint Pietsburg with
Speaker 1: the support of Medicine's Dumont. I think they set up
Speaker 1: the first harm aduction program in Russia that the still running.
Speaker 1: And uh again in the late nineties, like nineties ninety
Speaker 1: eight ninety nine, when I worked with Medicine San Frontiers
Speaker 1: who set up a huge national program for training of
Speaker 1: doctors and drug treatment specialists as doctors, there were huge
Speaker 1: hopes that the like all this training programs were done
Speaker 1: with the support of the Ministry of Health. I remember
Speaker 1: going to outreach in Moscow with the guy who was
Speaker 1: the chief consultant of the Ministry of Health on drug issues.
Speaker 1: So the scene was quite quite open and Russian specialist,
Speaker 1: the Russian doctors, especially drug treatment doctors and especially in
Speaker 1: factious disease doctors who are looking at the HIV epidemic,
Speaker 1: they will quite open to the idea of harmonduction, and
Speaker 1: I remember these conferences. They were always very interesting, Like
Speaker 1: the First AIDS conferences were amazing. You could meet people
Speaker 1: from all around the world talking about the experience and
Speaker 1: age prevention in their countries. The training that MSF set
Speaker 1: up for the regional doctors was great, and we learned
Speaker 1: so much from our colleagues from other countries. And there
Speaker 1: was a time of create of great aspirations and the
Speaker 1: time when we believe that it will be possible to
Speaker 1: really stop the AGS epidemic in people who use drugs,
Speaker 1: people who in jeb drugs in Vassia. Despite the huge
Speaker 1: scale of this group and the all so expectations that
Speaker 1: the donors will support the pilot programs of harm induction,
Speaker 1: but then they will be taken up by the state
Speaker 1: and they will be implemented all over Russia, scaled up
Speaker 1: to reach like sixty percent of people who who inject drugs,
Speaker 1: and every city is recommended by WHO organization and so
Speaker 1: on and so on and and a lot of people
Speaker 1: were released from prisons. I think it was about thirty
Speaker 1: thousand people that were released from prisons back then. Uh
Speaker 1: and it was like but unfortunately it is the last
Speaker 1: time the Russian drug policy changed to the pattern. For example,
Speaker 1: I remember, with the support of df IDA, there was
Speaker 1: a huge program planned to scale up harm reduction into
Speaker 1: Russian regions and the Ministry of Health was supporting it. Unfortunately,
Speaker 1: this program didn't happen due to the world uh in
Speaker 1: the rock when the funds were withdrawn. But there were great,
Speaker 1: you know, like preparations to scaling up harm reduction in
Speaker 1: a big way in Russia, which never happened because there
Speaker 1: were a well, huge boys to turn after two thousand eight,
Speaker 1: which we can talk about later, right, Well, we'll get
Speaker 1: to that, so just for our listeners, just uh, you know,
Speaker 1: and has mentioned a few organizations Mont San San Frontier,
Speaker 1: which was an organization of doctors working in war zones
Speaker 1: and otherwise trying to help with things, founded by Bernard Kushnair,
Speaker 1: the former French health minister and politician, and then the
Speaker 1: organization met Saint Dumont, which sort of spun off, you know,
Speaker 1: Doctors of the world that spun spun off from its
Speaker 1: frontier with the same leadership. Interestingly enough, I think there
Speaker 1: was some internal division there. And she also mentioned different
Speaker 1: which was basically the A I D. The International Aid
Speaker 1: Department of the British government, and so these were all
Speaker 1: quite involved. Now, even when putin comes in around roughly
Speaker 1: two thousand, right, for the first five or six years,
Speaker 1: I think things were fairly open. I mean there was
Speaker 1: even a kind of shift in the law where drug
Speaker 1: users were let out of prison. Just say a little
Speaker 1: more about that, you know, that continuing sort of open period. Right,
Speaker 1: there was a little shift in the law. I think
Speaker 1: it was around two thousand three, two thousand four, quite
Speaker 1: an achievement in the reform of the Criminal Code of
Speaker 1: Drush and Federation. Before the shift, it was possible to
Speaker 1: literally lock person up for i don't know, like ten
Speaker 1: years for just like something that was found in there.
Speaker 1: So it was really harsh, and any amount of drugs
Speaker 1: was considered a large amount of drugs. But after the
Speaker 1: reform it became a little better. So unfortunately in Vassia,
Speaker 1: the amount for which a person can be incarcerated is
Speaker 1: defined by the state and not by a judge, and
Speaker 1: so the state has to confirm this like table of amounts,
Speaker 1: and in two thousand three was probably the last drug
Speaker 1: policy reform was successful. When the amounts for example, if
Speaker 1: you talk about heroin, it was from zero point zero
Speaker 1: zero something a large amount. It came to half half Graham,
Speaker 1: so half gram of heroin before the half cram. A
Speaker 1: person was is not liable for criminal responsibility. But I
Speaker 1: think also it's important stand that I think, you know,
Speaker 1: as an activist, you know, I mean, my my attentions
Speaker 1: were always global, but the US is obviously my principal preoccupation.
Speaker 1: And one of the great humiliations of being an American
Speaker 1: was the fact that we had the highest incarceration rate
Speaker 1: in the world going back to roughly the late eighties,
Speaker 1: early nineties and continuing to today. But typically Russia was
Speaker 1: number two. Russia was the second, always, always after you guys,
Speaker 1: and I think that may still be the case. How
Speaker 1: do you explain this, like, you know, long standing commitment
Speaker 1: of Russia at the high levels of incarceration. I think
Speaker 1: it's just because it's like, you know, big land, big prisons,
Speaker 1: and in this economic transition time, and there was the
Speaker 1: equation like what to do with the large population, like
Speaker 1: people could not get jobs. People. I remember because I
Speaker 1: worked with this Doctor's Without Borders Medicine some frontiers, and
Speaker 1: we went around the Russian Siegies. I went to maybe well,
Speaker 1: I don't know, like not every Russian beaching, but like
Speaker 1: a lot of them. And they've seen some Russian cities
Speaker 1: and this cities were economically depressed, like people could not
Speaker 1: find the job, people couldn't like the onli like basically
Speaker 1: the only thing people were interested in those drugs all
Speaker 1: like drug Well not everywhere, of course people studied then,
Speaker 1: like there was still some groups that could live better.
Speaker 1: But like for the poor population, I think was just
Speaker 1: the Russian solution. Yeah, and prisons became so big. Prisons
Speaker 1: became like a big part of the response to the problem.
Speaker 1: But I have to say when you talk about the
Speaker 1: role of poverty, I mean lots of other countries have
Speaker 1: gone through terrible poverty without having anything like the incarceration
Speaker 1: rates that Russia the US have had. So has there
Speaker 1: been a racial ethnic dimensioned that was going on in Russia?
Speaker 1: Is it mostly about poverty? There's kind of comfort with
Speaker 1: putting people in jail and prison. What is that about
Speaker 1: in Russia? Well, it's difficult to say. There is a history.
Speaker 1: I mean, if you look at the yells some time,
Speaker 1: it was the first several years, less than ten years
Speaker 1: when we had the glassness, you know, historic when people
Speaker 1: started to be involved in the discussion. But before people
Speaker 1: were just silent and it was convenient to you know,
Speaker 1: build up a huge system, and of course it had
Speaker 1: to be filled in. There is always an ethnical aspect
Speaker 1: to the war on drugs I think the main marker
Speaker 1: for people to be locked up was, Yeah, it was
Speaker 1: the poverty. I mean, like the drug use associated with overtire.
Speaker 1: So it wasn't as if you had disproportioned numbers of
Speaker 1: checking it's going in, or disproportional numbers of people that
Speaker 1: come from you know, former Soviet republics and Central Age
Speaker 1: or something like that. It was basically about people, poor
Speaker 1: people who were using drugs, selling drugs involved in that
Speaker 1: world who were getting locked up, whereas you know, more
Speaker 1: affluent people using drugs generally avoided getting in trouble and
Speaker 1: a kind of real comfort with the police and government
Speaker 1: authorities who just throw the people away. I think there
Speaker 1: was definitely not lily an ethnic you know bias, and
Speaker 1: especially as you mentioned, people from the Central Asian especially
Speaker 1: from Tajikistan, Peakistan, but also Roman people were greatly affected
Speaker 1: by this bias. But in general, I think the main
Speaker 1: population that went to prison was just for people who
Speaker 1: who got addicted to drugs. And this time a lot
Speaker 1: of reports sort of go back to roughly two thousand
Speaker 1: six two thousand seven as a kind of moment when
Speaker 1: things really began to change, when when Putin seems to change,
Speaker 1: maybe partially in response to things that are happening with
Speaker 1: NATO in the West, but also with things that are
Speaker 1: happening domestically in Russia. I would say for us the
Speaker 1: turning point was was two thousand nine, because we remember
Speaker 1: it quite clearly, because in two thousand eight there was
Speaker 1: an interesting moment when the Russian Ministry of Health was
Speaker 1: presenting at the regional eighth conference was called ECOQ, the
Speaker 1: Eastern European Central Asian Aids Conference, which was goal sponsored
Speaker 1: by the Russian government and the United Nations Programs Program
Speaker 1: on AIDS, and she was speaking at the conference. There
Speaker 1: were many guests from the Global Fund to Fight its
Speaker 1: UH Tuberculuis and MILLARYA, which became the main donor for
Speaker 1: the harmonduction programs and other ADS programs in Russia by then,
Speaker 1: and I should say it was about eight harmorduction programs
Speaker 1: back then in Russia funded by the Global Fund, and
Speaker 1: she said that we will be able to pick up
Speaker 1: all these programs. We have the capacity, we have the resources,
Speaker 1: we have the money, and we will continue everything ourselves.
Speaker 1: Then a year later she talks of the Security Council
Speaker 1: before Dmitry mediated if I think he was the president
Speaker 1: back then, and putting the prime minister. Well, she talks
Speaker 1: before the government and she says that harm reduction contributes
Speaker 1: the Russian way, and we have our own way to
Speaker 1: deal with the AIDS problem and harmonduct and is not
Speaker 1: one of them, because harm reduction programs have proved in
Speaker 1: effective in the Russian context, and we will have to
Speaker 1: follow our own Russian way to deal with drugs and AIDS.
Speaker 1: And that wasn't two thousand nine. So that for us
Speaker 1: was the main kind of turning point when the official
Speaker 1: government of policy has completely changed. And if before like
Speaker 1: two thousand eight, two thousand nine, we had at least
Speaker 1: some hopes that it will be possible to do something
Speaker 1: and like really like prevent AIDS and HIV in Russia.
Speaker 1: Up to two thousand nine, we just realized that the
Speaker 1: government policy has changed and we will be living in
Speaker 1: much more challenging times. So just for our listeners to
Speaker 1: fill in a little context here, And when I mentioned
Speaker 1: the Global Fund, I mean that was the organization that's
Speaker 1: creating early two thousand's the Global fun to fight AIDS,
Speaker 1: tuberculous tuberculosis and malaria. Just something something that's just called
Speaker 1: the Global Fund, which is a sort of international financing
Speaker 1: and partnership organization funded by governments and some private foundations
Speaker 1: like the Gates Foundation, which is given out almost fifty
Speaker 1: billion dollars to fight AIDS to regulus the malaria over
Speaker 1: the last roughly twenty years. So there comes this point
Speaker 1: where the Russian government basically says we don't want your
Speaker 1: money and we don't want your ways. And that's roughly
Speaker 1: two thousand and nine. And yes, in two thousand and nine,
Speaker 1: days started to really like close up on the international
Speaker 1: partnerships and slowly slowly sending home all the donors, including
Speaker 1: the UN agency is the UN Office on Drugs and
Speaker 1: Crime has been shut down in Russia, and well UN
Speaker 1: Development program of course, so all the like major UN
Speaker 1: programs have been shut down. When I think about it,
Speaker 1: you know, it means though what you're saying, though, isn't
Speaker 1: that first decade of the two thousands you say they
Speaker 1: were roughly seventy eighty harmorduction programs up and going in Russia,
Speaker 1: and I have assumed many of them were doing needle exchange.
Speaker 1: And it was not just in big cities like Moscow
Speaker 1: and St. Petersburg, but in quite a number of other
Speaker 1: places in Russia. It was all over rushal like, Russia
Speaker 1: has eighty nine I think so called oblast or territories,
Speaker 1: and in every of these territories we had the harm
Speaker 1: aduction program pilot in a major city. Yeah. Uh so
Speaker 1: there were over eighty programs in some smaller cities as well.
Speaker 1: So we had like violence and bigger and smaller cities
Speaker 1: to see how they can reach out to people. And yes,
Speaker 1: they will needle exchange programs and needland citrange programs. Alboways.
Speaker 1: Substitution treatment has been always prohibited in Russia, and there
Speaker 1: is a provision into the Russian law that prohibits to
Speaker 1: provide all like any kind of prohibited or controlled substances
Speaker 1: to people with drug addiction. So apilways substitution treatment was not.
Speaker 1: It was like an issue for the international organizations and
Speaker 1: later for ourselves more like local grassroots Unity advocacy group
Speaker 1: to fight for substitution treatment but the Midlands each programs,
Speaker 1: outreach programs, um you know, access to HIV testing and
Speaker 1: later treatment, improved access they were available in Russia. So
Speaker 1: it was a period of relative openness, I guess. And
Speaker 1: in that way, no, I mean, I also presume that
Speaker 1: certain regions were much more sympathetic and open where others
Speaker 1: were much more grudging or repressive. That I mean, were
Speaker 1: there any standout regions back in the day that were
Speaker 1: particularly supportive of harm reduction in a more cutting edgeway. Yeah,
Speaker 1: I mean the world visions that were most supportive. And
Speaker 1: I remember, for example St. Petersburg from the very early times.
Speaker 1: They enjoyed the support of the city here, you know,
Speaker 1: the hospitals and the munistable budget and the local specialists
Speaker 1: and the local decision makers were much more open to
Speaker 1: the idea of harm reduction and scaling it up through
Speaker 1: the local medical system like health system, whereas for example,
Speaker 1: in Moscow where we worked, all harm aduction was prohibited
Speaker 1: by the former mayor, and he he issued an order
Speaker 1: prohibiting all the like health organizations in the city to
Speaker 1: participate in any kind of harm reduction Midland city inch programs,
Speaker 1: outreach and so on. So there was definitely a difference
Speaker 1: in approaches, but like most of the cities were convinced
Speaker 1: by the Ministry of Health and other partners like earlier
Speaker 1: in the history, that harm aduction is a good approach
Speaker 1: to the problem. And only the most conservative the city governments,
Speaker 1: like the Moscow the Mostcow city government, they really opposed
Speaker 1: harm reduction from the early days. So I actually have
Speaker 1: to ask you this question. So, I mean, you've been
Speaker 1: living in the Netherlands for a number of ers now
Speaker 1: but seven years, but you're still a Russian citizen, right
Speaker 1: and and you're still a family in Russia, and you're
Speaker 1: learning a foundation andre Ricco Foundation or you know, sharing
Speaker 1: it that that is active there. So in our us
Speaker 1: having this conversation now, it's seeming like increasingly repressive just
Speaker 1: this year and since the invasion. Do you have to
Speaker 1: worry about some of this stuff in your conversation with
Speaker 1: me right now? Uh? Not in the conversation. But we
Speaker 1: do have the worries about the security of our work.
Speaker 1: I mean, we had this worries before. And I should
Speaker 1: say that our organization is a for an agent organization.
Speaker 1: We were included in the least than two thousands sixteen
Speaker 1: I mean, this station was getting worse and worse year
Speaker 1: after year, and now after day after Russia started the
Speaker 1: war in Ukraine. The situation in Russia is becoming very
Speaker 1: very dark and we honestly don't know what will happen.
Speaker 1: We have of course, like discussed a lot all the
Speaker 1: security measures and like we have relocated several people from
Speaker 1: our organization al Radio to other countries, to Georgia, but
Speaker 1: most of the people are still in Moscow and we
Speaker 1: are still doing everyday outreach work and need land Syrange
Speaker 1: provision to our clients, the case management, the street lawyers program,
Speaker 1: the mental health program, so we're still doing the work.
Speaker 1: But we just like more and more prepared that this
Speaker 1: may not be maybe at some point even possible. But
Speaker 1: to be honest, like I told you about this station,
Speaker 1: but the most school government like years ago, but still
Speaker 1: we were we were the first who started new and
Speaker 1: Syrange program in Mosque, which despite all this concerns and
Speaker 1: we kind of trained ourselves to uh he had to
Speaker 1: work in very difficult conditions and like in this situation
Speaker 1: when maybe next year or even like next months, we'll
Speaker 1: have to suspend our activities and we've been able to
Speaker 1: continue our work since two thousand nine, every day with
Speaker 1: every day awareness that it may not be for a
Speaker 1: long time. And now we are very concerned what will
Speaker 1: happen in Russia, uh, because we are looking at the
Speaker 1: complete like probably a closure on the civil society here.
Speaker 1: And you probably know that a number of well all
Speaker 1: the international human rights organizations have been expelled in Dussages
Speaker 1: this week, including Human Rights Watch, Amnesty International and so on. Yes,
Speaker 1: it's not safe, definitely not a safe space for civil
Speaker 1: sides organization to do the harm induction work. And is
Speaker 1: it apart from Moscow at St. Petersburg, are there still
Speaker 1: some other pockets in the country where harmorduction programs and
Speaker 1: activism is still possible. There are some other organizations that
Speaker 1: are doing harmonduction. But I think now do to the
Speaker 1: financial and of course the political situation, uh, it will
Speaker 1: become more and more. Well, it's already too difficult, too difficult,
Speaker 1: and people are being really like exposed to a huge
Speaker 1: pressure on behalf of the government or all the Yeah,
Speaker 1: because I was reading about one program or one area,
Speaker 1: like I think in the city of kan in the
Speaker 1: Republican tatarstand which is I think, well, you know, republic
Speaker 1: has maybe one third Muslim, and that that was also
Speaker 1: a place at at harm aduction at least until recently
Speaker 1: or hopefully even until today. He's actually the Tarstan was
Speaker 1: one of these like territories where they plan to scale up,
Speaker 1: like when I was talking about the DEFT program. They
Speaker 1: Arstan was one of the friendly territories that were ready
Speaker 1: to support harmonduction financially, and that we're quite open to
Speaker 1: the idea, and where there were a huge number of
Speaker 1: great specialists who work in the a's or drug field
Speaker 1: and they were supporting harm aduction. But now I think
Speaker 1: all this activities have stopped. Yeah, there is no harm
Speaker 1: aduction program anymore. Just became too too dangerous, too young
Speaker 1: to continue this work. We'll be talking more after we
Speaker 1: hear this add You know, you mentioned before that there's
Speaker 1: no opioid substitution treatment, no method on now, no bupern orphine,
Speaker 1: and and that Russia is really I mean, it's been
Speaker 1: remarkable in its absolute indifference to the science, the evidence,
Speaker 1: the fact that this is the recommended treatment for heroin
Speaker 1: other opioid addiction by the World Health Organization and almost
Speaker 1: every other repeal organization around the world, and that even
Speaker 1: as you see method on maindance programs emerging in parts
Speaker 1: of Asia, you know, Vietnam, China, Indonesia, you name it,
Speaker 1: where which you couldn't have an imagine method on maintenance
Speaker 1: programs twenty years ago. You know, even as you see
Speaker 1: it popping up in even all all other countries that
Speaker 1: used to be part of the Soviet Union, Russia has
Speaker 1: this sort of fierce ideological opposition to it, right, and
Speaker 1: this I think they call it a narcological establishment. Narcology
Speaker 1: is which they call like the drug addiction expertise, me,
Speaker 1: can you just give us some more insight into this
Speaker 1: and why this crazy ideological crazy is in terms of
Speaker 1: opposing any method and buprenorphine, especially in the phase of
Speaker 1: rising opioid detection problems. Yeah, even it has always been
Speaker 1: a mystery for me and for anyone who tried to
Speaker 1: understand this issue. Why there is such a huge position
Speaker 1: to a simple public health intervention like the first line
Speaker 1: intervention for people with apioid or dependency or other problems
Speaker 1: related to aupioid use. So it is not clear why
Speaker 1: there is such a huge opposition. There is a theory though,
Speaker 1: that is a historical position and one of the fathers
Speaker 1: of Russian like founding fathers of their Russian archology. Academisian Bobaiyan,
Speaker 1: who was also a very prominent figure in the Russian
Speaker 1: psychiatry in the Erpsky Institute, the kind of homeland for
Speaker 1: their repressive psychiatry, the psychiatry that was used against the
Speaker 1: dissidents in the late seventies and ages. He was the
Speaker 1: first person who who started to deal with drug drug
Speaker 1: addiction and alcohol addiction problems, and he modeled these uh
Speaker 1: interventions on the basis of this repressive psychiatry kind of philosophy.
Speaker 1: He was also for a long time member of the
Speaker 1: International Narcotic Control Board. You know, Russia has been on
Speaker 1: the board for a long, long long time, and maybe
Speaker 1: also one of the reasons why the International Narcody Control
Speaker 1: Board became such a comparatively depressive organ in monitoring the
Speaker 1: implementation of the Conventions on drugs. So this is the
Speaker 1: same person, the same person who was in power very
Speaker 1: much on the international arena, but he was also in
Speaker 1: power in Russia, and he kind of conceptualized the whole
Speaker 1: like this, you know, mandatory labor and the labor camps
Speaker 1: for people who use drugs or people who are addicted
Speaker 1: or to drugs or alcohol. And he is the one
Speaker 1: who was very much opposed toward your substitution treatment. He
Speaker 1: thought that drugs could not be provided to people with addiction,
Speaker 1: that drug cannot be a solution to a drug problem.
Speaker 1: And this philosophy it became the kind of main belief
Speaker 1: of the of the Russian ideologists who worked in the
Speaker 1: drug treatment field. You know, like uhh, it almost seems
Speaker 1: like a closeye religious commitment. It was because you know,
Speaker 1: you can understand, like you know, China with the history
Speaker 1: of the opium wars, and they had this resistance, you know,
Speaker 1: not just the heroin, but obviously even a methodic maintenance.
Speaker 1: And then fifteen years ago whatever they make, you know,
Speaker 1: they turn around on this thing. And countries malais I said, Malaysian, Indonesia, Iran, right,
Speaker 1: you know, which has method on maintenance. And then you
Speaker 1: even see, I mean, as I when I was looking
Speaker 1: at the map just recently of the former Soviet public,
Speaker 1: it looks like essentially all of them, you know, except
Speaker 1: for uh maybe a Turkmenistan or something like that, but
Speaker 1: all of the other formers have had needle exchange and
Speaker 1: methodon with a few small exceptions, So it seems like
Speaker 1: this failure mentioning may have influenced things more broadly during
Speaker 1: the Soviet Union. It's only a Russia where it remains
Speaker 1: this almost article of faith. Would you meet people working
Speaker 1: in the Ministry of Health and others who are sort
Speaker 1: of embarrassed by this ideological opposition to methodon, yes, definitely. Well,
Speaker 1: I agree with you completely that it's rather like a
Speaker 1: symbolic symbolic belief or as you say, religious belief of
Speaker 1: the Russian specialists. And I think it was used from
Speaker 1: the very beginning as this kind of point that Russian
Speaker 1: narcology as it was called, is different from the Western
Speaker 1: narcology that is based on its own like I don't know, epistemology,
Speaker 1: and is based on its own Russian way. So it
Speaker 1: was from the very beginning like a very big, very
Speaker 1: big thing for the decision makers, and a lot of
Speaker 1: decision makers, including some people worked in the mystery of health,
Speaker 1: both on the sides of aids and on the sides
Speaker 1: of drugs, they tried to challenge that because they understood,
Speaker 1: understood perfectly well that it's a great tool to stop
Speaker 1: the ase or at least like slow down the as
Speaker 1: epidemic in this population, and also to provide help to
Speaker 1: people with obvio dependency. Of course, later it also became
Speaker 1: an issue when a lot of people already had HIV
Speaker 1: and they could not get access to enter a troviral
Speaker 1: medicines because they were considered not productive for the society
Speaker 1: and also because they could not be maintained without the
Speaker 1: substitution treatment. So there was all and of course also
Speaker 1: treatment of tuberculoise is substitution treatment could be a great
Speaker 1: key to like preventing the munstruct resistant to perculosis epidemic
Speaker 1: that we had in Russia. Uh So it was clear
Speaker 1: to everyone who worked in health that it would be
Speaker 1: a really like great solution to a lot of problems
Speaker 1: and be pool including great you know, medical specialists, accademissions
Speaker 1: and like uh you know, professors and even officials from
Speaker 1: the Ministry of Health. They were supporting substitution treatment, but
Speaker 1: there was always something that was opposing it, and this
Speaker 1: something was the conservative ideology. And whenever people pushed too far,
Speaker 1: they just lost their positions, and at some point it
Speaker 1: became just impossible for Russian professionals, and that probably in
Speaker 1: the midle thousands when it became completely impossible for the
Speaker 1: Russian professionals to talk about audio substitution treatment. Yeah, it's
Speaker 1: amazing because you know, I remember I looked, I took
Speaker 1: a look at your website for the Andrew Record Foundation, Uh,
Speaker 1: and there's almost nothing on it now. And my recollection was,
Speaker 1: you know, years ago there was a lot of interesting
Speaker 1: information about harm reduction and maybe stuff on method on
Speaker 1: and and your cases in the European Court of Human
Speaker 1: Rights and all that sort of stuff. But now I think,
Speaker 1: you know, it's it's it's almost such a defined there.
Speaker 1: And is it basically the point where even talking about
Speaker 1: method on maint and it's much less advocating for it
Speaker 1: is actually criminalized in Russianale, Yeah, talking about all all
Speaker 1: the illegal substances is a danger. And like the first time,
Speaker 1: our yeah, you're right, we had a great, great website
Speaker 1: and of course we put all the like regulations and
Speaker 1: all the normative guidance and all the like medical guidance
Speaker 1: on the website. And we also had the recommendation from w.
Speaker 1: Chow from the UN Committee on Economical, Social and Cultural
Speaker 1: Rights that recommended that Russia legalized perious substitution treatment back
Speaker 1: in two thousand eleven or two thousand twelve. And our
Speaker 1: website was first attacked by the Federal Drug Control Service
Speaker 1: back in two thousand and thirteen and it was just
Speaker 1: shut down without any illegal action by the Federal Drug
Speaker 1: Control Service. Then we challenged them in court and the
Speaker 1: side went back online and we have maintained it for
Speaker 1: another like long time. All we received a lot of
Speaker 1: administrative punishment and fines. One of the biggest fine was
Speaker 1: when we published information about harm reduction on UH newly
Speaker 1: psychoactive substances like the METHODRON harmonductional METHODRON. We published the
Speaker 1: information and we will find with like around ten thousand
Speaker 1: Europe for just like publishing the harmonuction information on the website.
Speaker 1: But the last attack was in twenty twenty when during
Speaker 1: the COVID pandemic, journalist published an article with our citations
Speaker 1: and about the very difficult situation economic collustiuation during the
Speaker 1: pandemic for people who use drugs, and we will attacked
Speaker 1: by the parliament member of the Russian Federation, and we
Speaker 1: just realized that it's too dangerous to have so much
Speaker 1: open information and we put our website to the bare minimum.
Speaker 1: We now only have the Contacts Center like basic information
Speaker 1: about the organization and donate button. Yeah, you know, I
Speaker 1: remember that that you guys in your allies were doing
Speaker 1: some very creative activism in the past. That reminded me
Speaker 1: of some of the stuff that act UP to the
Speaker 1: United States back in the eighties and nineties and early
Speaker 1: arts around around drugs and around eights and this sort
Speaker 1: of stuff. Letteral honeys know a few examples of some
Speaker 1: of your you know, more provocative and successful campaigns over
Speaker 1: the years. Well, I love to remember the name of
Speaker 1: the person Andre, the person who was our friend and hero.
Speaker 1: He's the one like who was the leader and probably
Speaker 1: like the initiator of this act UP inspired movement in Russia,
Speaker 1: the movement to include people who use drugs into the
Speaker 1: list of patients who can receive untrovital treatment. So in
Speaker 1: let's say two thousand three, two thousand four, it was
Speaker 1: two thousand five, it was still quite difficult for people
Speaker 1: who use drugs, and there was many it was always
Speaker 1: like eighty percent of all people with HIV in Russia,
Speaker 1: but they could not get access to the red ReViral
Speaker 1: treatment because they were considered like socially unreliable and so on.
Speaker 1: And Andre Rikov and some other other our friends have
Speaker 1: set up the Front AIDS movement, and that was the
Speaker 1: like very bright movement which the guys changed themselves to
Speaker 1: like the municipal buildings or to the Ministry of Health.
Speaker 1: There was a huge banner in Moscow and there was
Speaker 1: an action, you know when they came out to Saint
Speaker 1: Petsburgh with the coffins and also attracting attention to the
Speaker 1: tragedy of the AIDS, you know, of the ads that
Speaker 1: could be prevented. So it was quite inspired movement the
Speaker 1: Front AIDS in Russia. Andrekov died in two thousand and six.
Speaker 1: He was also an activist, drug user and the great,
Speaker 1: great inspiration for all of us um but he died
Speaker 1: and in two thousand nine when we started our organization,
Speaker 1: we decided to take his name and to continue his
Speaker 1: create like drug user activists. He was activism. He was
Speaker 1: a great inspiration. You know. Going back to these narcologists
Speaker 1: right in their anti method on saying, I mean my
Speaker 1: understanding is that they sometimes in place of methodon back
Speaker 1: some really bizarre forms of drugs what they call drug
Speaker 1: treatment al as sometimes it sounds to me more like torture.
Speaker 1: Can you just say a little more about that well,
Speaker 1: the drug treatment in Russia is really like um based
Speaker 1: on the very old protocols, and the drug treatment in
Speaker 1: Russia is organized in the way that the like the
Speaker 1: medical part of drug treatment is controlled by the states,
Speaker 1: so it's impossible to run a drug clinic if you're
Speaker 1: not a state institution. So we have a system of
Speaker 1: uh so called narcology drug treatment centers and drug treatment clinics,
Speaker 1: but they are all run by the states, so basically
Speaker 1: they work for the state. And there is a lot
Speaker 1: of more private or church or like religious groups based
Speaker 1: rehabilitation centers, and unfortunately both of the systems are not effective.
Speaker 1: So the state run system is based on well, as
Speaker 1: we all ready discussed, we don't have a methodon or
Speaker 1: orphan substitution treatment, so there is not really much that
Speaker 1: the system can offer. Uh So they use the taxification
Speaker 1: and sometimes they use yes, they do use like very
Speaker 1: old protocols and some medicines that been all radios but
Speaker 1: like how a paradol for example, that has been all
Speaker 1: radio like uh not used even in the psychiatry, but
Speaker 1: they use in the drug treatment protocol up to now.
Speaker 1: But they're also the most cruelty you probably came from
Speaker 1: the private rehabilitation center. I don't know if you remember
Speaker 1: or if you've heard the story of the City Without
Speaker 1: Drugs in Euclidian book. It was a popular group book
Speaker 1: is a b exceeds a big industrial city about three
Speaker 1: million people, I think in the bural in the euro mountains.
Speaker 1: Uh So, in the beginning of Siberia, so there was
Speaker 1: a group called City Without Drugs who started to fight
Speaker 1: with the Roman people with ethnic minorities and with people
Speaker 1: who used drugs, and they promised to clean up the
Speaker 1: city with their owns, with their own means, and they
Speaker 1: started to like kidnap people from their homes, sometimes prompted
Speaker 1: by their parents who did not know what to do,
Speaker 1: and people were kept on like in very tortuous conditions.
Speaker 1: They were beaten up, and they were chained to beds
Speaker 1: for like months without proper food, and it was considered
Speaker 1: quite normal. I would say, it's not anymore. But back then,
Speaker 1: in their earlier and mide A two thousand, it was
Speaker 1: considered quite a reasonable approach to solving the drug problem.
Speaker 1: And if you talk to like Russian people, they would say, yes,
Speaker 1: of course, it's quite extreme to beat up and torture people,
Speaker 1: and like chain them to bads, but you know it's
Speaker 1: uh junkies, and they first have to become humans. And
Speaker 1: to become humans, they have to go through all this
Speaker 1: like horrible, you know, all this horrible treatment, and this
Speaker 1: model it became quite popular. And I would say that
Speaker 1: until now, kidnapping people from their homes, keeping them in
Speaker 1: vivid tortures conditions, not providing them with medical treatment for
Speaker 1: their I don't know, infectious diseases or any other diseases.
Speaker 1: It's quite a norm. And there was like always an
Speaker 1: attempt at the state to introduce some quality standards or
Speaker 1: some safety guidance, guidance, and of course many of these
Speaker 1: actions are illegal, like kidnapping people or like keeping them
Speaker 1: against their will. But this model of so called the
Speaker 1: abilitation it became like super popular in Russia and in
Speaker 1: many cities. It's still like the wound their quote and
Speaker 1: quote quote solution, like for familists who don't know what
Speaker 1: to do with their children, and people would even pay
Speaker 1: for their for their children to be tortured in this
Speaker 1: you know, the abilitation centers. You know, I wish I
Speaker 1: could say that, oh this is outrageous compared to America,
Speaker 1: but you know, even United States. I mean, we had
Speaker 1: these private organizations that there was one fairly notorious one,
Speaker 1: I think based in Florida, and it was the same
Speaker 1: thing you'd have, you know, upper middle class, somewhat wealthy
Speaker 1: parents who were freaked out about their kids doing drugs.
Speaker 1: Sometimes the kids had real drug problems, sometimes it was
Speaker 1: just you know, smoking too much wheat or something like that,
Speaker 1: and they would pay to have them sent to these programs,
Speaker 1: you know, these kind of tough kind of tough love
Speaker 1: type things. And ultimately, you know, some people died in
Speaker 1: these programs, and eventually they were shut down because they
Speaker 1: were sued and things like that. Never I don't think
Speaker 1: any criminal charges. But part of what gave it its
Speaker 1: staying power was that the founders was a couple named
Speaker 1: Mel and Betty Sembler. Betty Sembler was one of the
Speaker 1: leading kind of you know, kind of like anti drug
Speaker 1: fanatics who should have just been dismissed as a kind
Speaker 1: of you know, nutcase. But her husband, Mel happened to
Speaker 1: be chairing the finance committee of the Republican National Committee,
Speaker 1: you know, appointed by I think Reagan or Bush to
Speaker 1: the ambassador to Italy and to Australia, you know, he
Speaker 1: could get any single you know, he could get the
Speaker 1: White House out of phone call, he get any Republican senator,
Speaker 1: and these guys were enormously politically powerful and able to
Speaker 1: you know, semi legitimize this type of approach, you know,
Speaker 1: in our own country. So America was not just you know,
Speaker 1: exceeding Russia in terms of incarceration rates, but we were
Speaker 1: also on somewhat in lockstep on some of these other
Speaker 1: repressive approaches. Yeah, but I think America was the modal
Speaker 1: country where all this like you know, political campaigns based
Speaker 1: on the war on drugs, and like toughness in the
Speaker 1: war on drugs on this or that scale, built on
Speaker 1: the scale of the nation or like on the local scale,
Speaker 1: that became well, they proved themselves effective. If you are
Speaker 1: against drugs by any means, then you will be popular.
Speaker 1: And the same actually happened in the Utilian book. There
Speaker 1: was the person behind all of this, Vgeny Roisman, who
Speaker 1: became a super popular person. He was elected in the
Speaker 1: state doom in the parliament, and he became the mayor
Speaker 1: of your Catilian book exactly for torturing people and keeping
Speaker 1: them in this reabilitation centers. So it's quite amazing. But
Speaker 1: this approach, it has been super popular, so I think
Speaker 1: it also inspired you know, other so called seal society
Speaker 1: activists in a bad way to promote the same model
Speaker 1: because they saw that they can also gain some political
Speaker 1: weight from men. I see. You know, I only ask
Speaker 1: you about on the policing side. I mean, you know,
Speaker 1: you co authored an article some years ago with some
Speaker 1: other scholars and such about the nature of drug policing
Speaker 1: in Russia and pointing out not just how you know,
Speaker 1: kind of vicious it could be, but how sometimes there
Speaker 1: were oftentimes you know, even elements of torture um and
Speaker 1: sometimes even fairly pervasively in terms of the way in
Speaker 1: which police interacted with drug users, not just humiliating them
Speaker 1: and beating them, but actually torturing them. It makes me
Speaker 1: wonder when you look at something like the Philippines with
Speaker 1: a president and democratically like the president do tirt Day
Speaker 1: who basically encourages police around the country to go out
Speaker 1: and literally kill people involved with that's amphetamine um and
Speaker 1: not just not just sellers, but oftentimes just simple users
Speaker 1: as well. And you know where thousands, maybe tens of
Speaker 1: thousands people have been killed, and where the president says
Speaker 1: I'll protect you. I'll protect you, right. I mean what
Speaker 1: keeps Putin from doing something like that? Could Putin do it?
Speaker 1: Do turt day? Could he send out that word? Could
Speaker 1: you see such a phenomenon happening in Russia? I think
Speaker 1: is doing but just in a different way. And I
Speaker 1: think the police they can pretty much do anything they want,
Speaker 1: probably not kill people, but they don't need to. They
Speaker 1: can just like send a person to prison or to
Speaker 1: a camp and the person is very likely to die
Speaker 1: of aids UH complications of tuberculosis, of overdoses on the
Speaker 1: release from the camps. There is the whole system that
Speaker 1: kills people for you. You don't need the police officer
Speaker 1: to do it. But the police officers are definitely given
Speaker 1: like impunity in treating people who use drugs. And like
Speaker 1: we reported on the tortures that are everyday routes seen normalized,
Speaker 1: completely accepted tortures to those people who use drugs, women
Speaker 1: who use drugs. The system is designed in a way
Speaker 1: to kill a person and basically any sentence for drug
Speaker 1: use becomes a death sentence. But also the system is
Speaker 1: tortures through out, like from the first contact with the
Speaker 1: medical service, from the first contact with the police, from
Speaker 1: the first contact with other law enforcement. I don't know,
Speaker 1: like courts and so on. People are going through humiliation,
Speaker 1: people are going through physical torture, people are going through
Speaker 1: money extortion. People are just not treated, you know, women
Speaker 1: getting deprived of their children. Like the whole system is tortures.
Speaker 1: And we have been documenting it since the very beginning
Speaker 1: of our work, and unfortunately, what we're seeing now in
Speaker 1: Ukraine the tortures of peaceful civilians. Unfortunately, we've seen it before,
Speaker 1: and we've been witnessing and documenting this on the fields
Speaker 1: of the War on drugs in Russia since two thousand nine. Yeah,
Speaker 1: I mean I was sort of one example, I guess
Speaker 1: of what you see this is when when Russia sees
Speaker 1: TREMEA from Ukraine in two thousand fourteen, and my understanding
Speaker 1: is they basically just shut down all the method on
Speaker 1: programs and within the space of a year. I don't know,
Speaker 1: it was a ten or of all the people during
Speaker 1: these programs had had died when we or another yes, well,
Speaker 1: I think it was a thousand people at least who
Speaker 1: were just basically kicked out on the street, and it
Speaker 1: was a huge tragedy. For all of us. Our Ukrainian
Speaker 1: qualites could not believe that this is possible until the
Speaker 1: very like last minute. They were, you know, writing to
Speaker 1: us and saying no, no, no, But we will write
Speaker 1: to the World Health organizations, we will write to the UN,
Speaker 1: we will write to the UN Program on Ease, and
Speaker 1: they will talk to the Russian Minister of health. They
Speaker 1: just don't know what's going on. You know that people
Speaker 1: are getting kicked out on the street and getting like
Speaker 1: depride of of their medicine. But I was just so
Speaker 1: amazed how the Ukrainian qualities believed that it's impossible to
Speaker 1: just do that to people. And I think that's why
Speaker 1: I realized how different our mentality was. We were already
Speaker 1: witnessing this evil for so many years, and we were
Speaker 1: witnessing what was like happening with people. So two thousand fourteen,
Speaker 1: when like a thousand people were kicked out on the street,
Speaker 1: it was just kind of normal for us, witnessing the
Speaker 1: same thing every day for many years in Russia. And
Speaker 1: of course it was a huge tragedy and many people,
Speaker 1: like people did not get any support. They will promise support,
Speaker 1: they will promise that they will be taken to Russia,
Speaker 1: but even like to the rebilitation centers and so on,
Speaker 1: and a few people were but a few people also
Speaker 1: died in this like rebilitation programs in Russia, or like
Speaker 1: they run away or it just never happened. So most
Speaker 1: people are lost their treatment. And you are right that
Speaker 1: about maybe ten percent of these people have died. We
Speaker 1: don't know the precise estimates because of course the medical
Speaker 1: specialists who had the contact before with their patients they
Speaker 1: lost all contacts. Let's take a break here and go
Speaker 1: to an add you know, I mean, I have to say,
Speaker 1: I mean, maybe this is the American in me, but
Speaker 1: I've also been a you know, a student of natural
Speaker 1: relations for much of my adult life. Prudent has always
Speaker 1: just struck me. I mean, I've been saying this for
Speaker 1: twenty years. Is basically the world's greatest gangster, like the
Speaker 1: ultimate mafiosa kingpin in a way that he thinks that way,
Speaker 1: his mentality is that way. It's not that that's also
Speaker 1: some broader, greater vision of greater Russia and all this
Speaker 1: sort of stuff, and that helps to justify things. But
Speaker 1: in terms of the tactics and mentality, on some level,
Speaker 1: that seems to be the way he thinks, the way
Speaker 1: he operates, and when you look at the people, I mean,
Speaker 1: if you look, for example, the occupation Denza Lhands, it
Speaker 1: almost just seems like he puts the gangsters in charge.
Speaker 1: And if you look at Czechna once again, it's putting
Speaker 1: in basically gangsters in charge. Just the idea of kind
Speaker 1: of fusing gangsterism and governance in a way that's not
Speaker 1: unique to what prudence doing. It happens in other parts
Speaker 1: of the world as well. The whole things sort of
Speaker 1: seems of a piece and and maybe there's even an
Speaker 1: element of that when one looks at the invasion of
Speaker 1: Ukraine and you know, yes, the greater division of Greater
Speaker 1: Russia and his claims that Ukraine was always part of
Speaker 1: Russia and it's part of the heart of Mother Russia.
Speaker 1: But on the other hand, the tactics and mentality and
Speaker 1: the people he puts in charge. You know, I'm not
Speaker 1: saying this about the Russian army, but on other levels,
Speaker 1: a kind of gangster mentality that permeates things, and it
Speaker 1: manifests obviously in drug policy and the way we've been
Speaker 1: talking about, but maybe more globally as well. I don't know.
Speaker 1: If you're totally free to speak about this, But are
Speaker 1: there any thoughts and reflections and reactions to the way
Speaker 1: I just laid that out well, Ethan, I think you
Speaker 1: laid it out perfectly. As a Russian citizen, I can
Speaker 1: only say that Putin is the great leader of our
Speaker 1: people and he will bring us to the final victory
Speaker 1: of Putinism. Can I say anymore? Uh huh. So there's
Speaker 1: another question I wanted to ask you about. My understand
Speaker 1: thing is that you know, after this home growing meth
Speaker 1: and opioids that that that you were talking about, would
Speaker 1: you call it, uh conca, the homemade opioid and then
Speaker 1: the homemade meth amphetamine. But then it goes through a
Speaker 1: period of heroin from Afghanistan coming through Central Asia being
Speaker 1: a major part of the problem. And then there's a
Speaker 1: more recent era a few years ago with the explosive
Speaker 1: growth of the use of the Internet and the dark
Speaker 1: net and the website hydra it seems to play a
Speaker 1: major role in changing drug markets. Also the telegram messenger
Speaker 1: another thing, So just tell us about, you know, how
Speaker 1: that has changed the drug situation, illicit drug situation in Russia.
Speaker 1: It is amazing how Russia has like completely, well maybe
Speaker 1: not completely, but majorly switched to the dark web technologies
Speaker 1: in terms of like the selling drugs. And that's probably
Speaker 1: a happened mostly in like major cities, but in other
Speaker 1: cities as well. I mean, Hydro was a huge market
Speaker 1: that governed not only Russia but also like other Russian
Speaker 1: speaking countries, maybe to a less extent, but in Russia,
Speaker 1: I would say, especially like in Moscow. At some point
Speaker 1: it became impossible to all, very difficult to buy drugs
Speaker 1: in any other way other than through this UH market.
Speaker 1: And as you know, Hydro has been recently shut down
Speaker 1: by the German and American services. That happened just last week.
Speaker 1: And we don't know how the system will adjust because
Speaker 1: for many many years Hydra and the large market before that,
Speaker 1: it was the main kind of platform for drug like
Speaker 1: the drug purchases. But how it will change now we
Speaker 1: don't know. But yes, you are right, it has completely
Speaker 1: changed the way UH that Russian people have at least
Speaker 1: procure drug and drugs. And I don't know if your
Speaker 1: listeners have heard about like this whole ethnography of the
Speaker 1: you know treasures and so basically when you purchase drugs
Speaker 1: on HYDRA you purchase with the cryptocurrency and you get
Speaker 1: a location in return, so you don't get your drugs
Speaker 1: by mail, but you get the geolocation, and then you
Speaker 1: have to go to this geolocation and find the treasure,
Speaker 1: and that can be like nearer to your house, but
Speaker 1: that can be also very far. And the restories about
Speaker 1: like people going through cemeteries like in the middle of winter,
Speaker 1: or like you know, forests and having to dig in
Speaker 1: the snow. I don't know, like half meter meter treasures.
Speaker 1: So it's a lot of like folklore about hydra and
Speaker 1: about the way the rush market operates operated until now.
Speaker 1: We don't know what will happen, but yes, it was
Speaker 1: quite an amazing I think phenomenon, well, if you have
Speaker 1: a darkness source likeness, it can evolve all sorts of
Speaker 1: other things that an autocratic government like you have in
Speaker 1: Russia doesn't want happening. And so you would think that
Speaker 1: an autocratic government would see this is something of a threat,
Speaker 1: a kind of Russian language darknet source, and that therefore,
Speaker 1: you know, I mean, I only can speculate that it's
Speaker 1: only allowed to persist because security agencies have some understanding
Speaker 1: um about what's going on there. Or what will be tolerated.
Speaker 1: But you say there's no evidence one or the other. Really, yeah,
Speaker 1: I mean it's interesting because the Russian like official retric
Speaker 1: they always target that the Internet and even putting a
Speaker 1: couple of years ago he talked about the danger of
Speaker 1: like drugs, the drugs are sold on the Internet, so
Speaker 1: we could never figure out was there in confusion and
Speaker 1: why they focused on the Internet and the way like
Speaker 1: it happened that they focused on the information about drugs
Speaker 1: or information on harm aduction rather than the darknet where
Speaker 1: the drugs actually were. Nobody just sold drugs on internet.
Speaker 1: So it's interesting, yes, but it's not clear and the
Speaker 1: picture is completely What's interesting also about about the shift
Speaker 1: of illicit drug markets from the streets to the darknet.
Speaker 1: And obviously it's not a one to one switch, and
Speaker 1: people can be buying some drugs and bulk on the
Speaker 1: darknet and then distributing them on the streets as well,
Speaker 1: but there's also interesting harm reduction potential in a variety
Speaker 1: of ways when drugs sales shift to the darkness. I mean,
Speaker 1: one is the fact that you don't have the problems
Speaker 1: with you know, selling drugs on the street, which can
Speaker 1: be disruptive of communities, not just in Russia, but I'm
Speaker 1: thinking even more, you know, the Western world as well.
Speaker 1: A second thing is that the extent that you have
Speaker 1: people writing reviews and the products here getting, there's the
Speaker 1: opportunity to post information about what these drugs are, and
Speaker 1: maybe it put a higher level of reliability in terms
Speaker 1: of what the drug suppliers and what consumers are getting.
Speaker 1: And so I'm curious, I mean, how to harm reduction organizations,
Speaker 1: you know, I mean yours and your meditran action, the
Speaker 1: fielders that exist, how did they perceive the ups and
Speaker 1: downs of Hydra and Telegram and all that in terms
Speaker 1: of the evolution of drug markets. Well, I must acknowledge
Speaker 1: that Hydra did good harm reduction work themselves. I should
Speaker 1: tell you one thing that fantanil was never available on Hydra,
Speaker 1: or it was available maybe in the very very beginning,
Speaker 1: but then they just prohibited the cell of fantanil in
Speaker 1: their shops on the market. So fantanial epidemic did not
Speaker 1: touch Russia because it was prohibited by Hydra themselves. And
Speaker 1: they also had like even the harm aduction facility, well
Speaker 1: they didn't call harm aduction facilities, but they have had
Speaker 1: drug testing, so they would randomly like test and publish
Speaker 1: the results of the purchase on their reviews. And they
Speaker 1: even had like a drug treatment narcology doctor consulting people,
Speaker 1: like a hotline for drug issues. They organized themselves as well.
Speaker 1: So there was someone or I don't know, like maybe
Speaker 1: a community of thought behind this interventions. But the fact
Speaker 1: that we did not have a fantonial epidemic, I think
Speaker 1: it's a really huge thing, and that was due to
Speaker 1: the harm reduction measures implemented on hydra. Well, let me
Speaker 1: ask you another question and also a theory of mine.
Speaker 1: I don't have anything to prove it, but in some
Speaker 1: respects Russia is really the great colonial empire of the
Speaker 1: twentieth century. You know, Colonialism was something we associated with
Speaker 1: with France and England and a few of the Dutch
Speaker 1: European countries in really the seventeenth eighteenth nineteenth century, and
Speaker 1: really colonialism for Russia, I think, maybe especially the twentieth
Speaker 1: century Andrews Soviet Union, where you have significant migrations of
Speaker 1: Russian you know, ethnic Russians into other of the Soviet republics.
Speaker 1: And then this comes here's the part of my theory
Speaker 1: that gets down to the drug piece here that when
Speaker 1: the Soviet Union crumbles thirty years ago and you have
Speaker 1: these Russians speaking minorities left in many of these now
Speaker 1: independent countries. And I'm thinking here especially of the Baltics,
Speaker 1: you know a lot of the Lithuania, Estonia, but maybe
Speaker 1: it's true elsewhere as well. And my perception has been
Speaker 1: that sometimes the drug problems and injecting drug problems that
Speaker 1: emerged are worse among the Russians speaking minorities in these
Speaker 1: countries than among others. And my theory is is that
Speaker 1: this is a group of people whose grandfathers and even
Speaker 1: parents had been in a relatively privileged position in these countries,
Speaker 1: in the Baltics and maybe some others, and now they
Speaker 1: are in a kind of disprivileged now as Russian speakers,
Speaker 1: sometimes not even speaking of the national language Estonia, Lithuanian, Latvian,
Speaker 1: or maybe in other countries, that they are now worse off,
Speaker 1: you know, whereas their fathers and grandparents had been better off,
Speaker 1: now they're worse off. And maybe that helps explain higher
Speaker 1: rates of drug problems among the Russian speaking minorities. What
Speaker 1: do you think of my theory? Yes, for sure, especially
Speaker 1: in the Baltic I mean, I've been involved in some research,
Speaker 1: especially in Estonia and in some like Russian regions of
Speaker 1: Estonia are in the earlier two thousands, and definitely the
Speaker 1: Russian population was very facted because they lost the jobs
Speaker 1: and they lost the citizens rights, and they they became
Speaker 1: like the most marginalized economically group. And of course this
Speaker 1: group in some of the regions, or especially in the
Speaker 1: Baltic countries, they became very very affected by the drug
Speaker 1: problems and by the HIV epidemic. So, you know, I
Speaker 1: haven't really asked you about how you got involved in
Speaker 1: all of this. Why. I mean, were you you yourself
Speaker 1: an active drug user and got caught up in the
Speaker 1: way many people get caught up in harm reduction or
Speaker 1: was it in another way, I mean, what brought you
Speaker 1: to this. I was never a systematic drug user, I
Speaker 1: would say, or I never had like major problems with drugs.
Speaker 1: But I got involved because my friends. I was just,
Speaker 1: you know, really interested in this work that my friends
Speaker 1: got involved in the work of the doctors without boards.
Speaker 1: Do you remember the American photographer Jean Raynard who spent
Speaker 1: a lot of time in I don't know if you've
Speaker 1: seen his work, but he was an an amazing person
Speaker 1: who spent a lot of time in Russia, and he
Speaker 1: was really looking at the beginning of the HIV epidemic
Speaker 1: and at the time when the injunction drug use suddenly
Speaker 1: became very very popular, and he was the one who
Speaker 1: linked the medicine some frontiers back then with the community
Speaker 1: of people who use drugs in Moscow, and so my
Speaker 1: friends and me we were part of one of these communities.
Speaker 1: They got involved and I got very interested in this work,
Speaker 1: and then I got to meet like quite amazing people
Speaker 1: through like this collaboration in the first outreach project, and
Speaker 1: it just became quite and fascinating and amazing past for me.
Speaker 1: I mean, I didn't have a career back then, and
Speaker 1: it seemed to me like a very very very fascinating
Speaker 1: and interesting things to be involved in. So that's how
Speaker 1: I got involved. And of course a lot of my
Speaker 1: friends were affected because yes, there were young people and
Speaker 1: a lot of young people were using drugs, and a
Speaker 1: lot of people were using drugs problem magically, and a
Speaker 1: lot of people will radio dying and that affected me
Speaker 1: personally as well. And when you were still living in
Speaker 1: Russia before you moved to the other winds. I mean,
Speaker 1: were there moments where you were really afraid for your
Speaker 1: safety or ter getting arrested? Yeah, well we were. We
Speaker 1: were always afraid. I mean I felt its safe until
Speaker 1: like two thousand nine when I work for international organizations
Speaker 1: and later for like the Russian Harmeduction Network. But when
Speaker 1: we started our own Russian Harmeduction Network was was also
Speaker 1: like a big and show that provided support mostly from
Speaker 1: the Global Fund to the Russian community of like this
Speaker 1: harm auction enthusiasts. But like starting in two thousand nine
Speaker 1: when we started to work, when we started to hand
Speaker 1: out needles on the streets of Moscow, we were afraid
Speaker 1: because like the Moscow government was against and they were
Speaker 1: like measures against needlands Nage program, you know, the civil
Speaker 1: society activists like that, for example, the uh guys from
Speaker 1: the City without Drugs which has also it branched in Moscow,
Speaker 1: and it was always like quite scary, and they must say,
Speaker 1: the people I work with are like real heroes in
Speaker 1: this regard. So basically we decided our strategy already back
Speaker 1: then and like up to now, is that we decided that,
Speaker 1: I mean, we have to do this work. I and
Speaker 1: we see the people, you know, I mean, we know
Speaker 1: the miracle of harm reduction. We see that people are suffering,
Speaker 1: and we know how to provide tools for people to
Speaker 1: suffer less. So we have to do this work. We
Speaker 1: have to serve our community. Of course it's scary, and
Speaker 1: of course they are like always like so many dangerous.
Speaker 1: But then I mean we decided, okay, I mean we
Speaker 1: will just keep working until it's possible, and we are
Speaker 1: adjusting our you know, safety measures, We are adjusting our communications,
Speaker 1: we are adjusting our work. Every day. Were like very well,
Speaker 1: trying to be as careful as it's possible in these conditions,
Speaker 1: given that we are dealing with very, very controversial issue. No,
Speaker 1: I mean it's when you see what put In saying
Speaker 1: now about an ever broadening minority of Russians, you know,
Speaker 1: those who don't fully support the cause. It does seem
Speaker 1: like he's basically taking the prototype that that that the
Speaker 1: targeting of drug users and people involved with illicit drugs
Speaker 1: really became a model for a broader targeting or broader
Speaker 1: sector of society who did not want to go along
Speaker 1: with his vision or it. And I can tell you more.
Speaker 1: You know, the first word he used in his public
Speaker 1: speech after the war started towards Ukrainian the first that
Speaker 1: he called them was Kaman. So it's absolutely I mean,
Speaker 1: the same rhetoric is the same dehumanization that is used
Speaker 1: by propaganda, first propaganda of the war on drugs. Yeah,
Speaker 1: I mean it seems I remember thirty years ago when
Speaker 1: with the downfall of the Romanian dictator Cichsco exact same thing,
Speaker 1: and there's been so many other leaders who have done
Speaker 1: the same thing using the accusation of drugs. Exactly. The
Speaker 1: cold person a junkie is the first step to dehumanize
Speaker 1: the person. After that you can do whatever you want
Speaker 1: with the person. The person is not considered a human
Speaker 1: being or just a junkie, then they deserve everything. And
Speaker 1: you have the feeling if you have a real, true
Speaker 1: public opinion in Poland Russia and ask what should be done,
Speaker 1: you know with a million or two million, or three
Speaker 1: million or whatever it is drugs five millions, that some
Speaker 1: substantial minority, if not a majority, might just say kill them. Well,
Speaker 1: I would say that We've been doing a lot of
Speaker 1: work with the mass media, and we had a lot
Speaker 1: of partners in Ourncaphobia project, where we tried to challenge
Speaker 1: the you know, drug war propaganda, and we tried to
Speaker 1: challenge the stigma of drugs. And I would say that
Speaker 1: in the recent years, maybe like eight, nine, ten years,
Speaker 1: the attitude has started to change and people are more
Speaker 1: critical towards this concept of dehumanizing a human being because
Speaker 1: the human being is you know, using drugs. So it
Speaker 1: becomes more and more obvious for people that this doesn't
Speaker 1: work anymore. And now I think people understand more and
Speaker 1: more that policy can be humane. Drug policy can be
Speaker 1: based on protection of health, on protection of people, dignity
Speaker 1: of human rights. Drug policy does not have to be
Speaker 1: based on like military or police action. It does not
Speaker 1: have to destroy people's lives. Uh. And there is more
Speaker 1: and one standing in the Russian society, in the public
Speaker 1: that you know, there are more effective and more more
Speaker 1: humane approaches to these issues than the war on drugs
Speaker 1: and especially the form of the world on drugs that
Speaker 1: we have in Russia. I remember, you know, decades ago,
Speaker 1: when people would play out, well, you know, one benefit
Speaker 1: of a closed society and closed borders is that they
Speaker 1: don't have much of a drug problem in Russia. And
Speaker 1: my response would be that Russia's problem, it's health problem
Speaker 1: with alcohol was greater than the accumulative problem with alcohol
Speaker 1: and all illusive drugs put together in the US or
Speaker 1: almost any other country. And I wonder, I mean, you know,
Speaker 1: alcohol is just seen in Russia as part of the
Speaker 1: national tradition and put an entirely different category, right, I
Speaker 1: mean there's that mentality of alcohol being a drug just
Speaker 1: like these other drugs. Is that still a fundamentally alien
Speaker 1: idea in Russia? Well? Yeah, I think it's still like
Speaker 1: a very challenging to make this cognity of kind of
Speaker 1: jump from like treating alcohol as something completely like else
Speaker 1: to feeding alcohol as a category of drugs or like substances,
Speaker 1: psychoactive substances. And I think it's because, yes, I mean,
Speaker 1: you're right, alcohol is very much in like Russian tradition,
Speaker 1: uh traditional drug. I don't know what to call it,
Speaker 1: but yes, it's also because of the Soviet history and
Speaker 1: because of the post Soviet history a little bit. But
Speaker 1: people don't understand that alcohol can be a harder drug
Speaker 1: than a drug drug. So it's really difficult to explain that. No,
Speaker 1: if actually you're regulate Arthur drugs, it may be easier.
Speaker 1: It's because they're not worse than alcohol. Alcohol is the worst,
Speaker 1: I mean, one of the worst drugs and the hardest
Speaker 1: drugs that we have. Uh So it's really difficult for
Speaker 1: people to believe that alcohol, well it's almost like the
Speaker 1: hardest drug we have. And where is cannabis fit into
Speaker 1: the whole picture? Is it something where there's a more
Speaker 1: relaxed fiel with it. Well, I think that cannabis is
Speaker 1: I mean, like there was a cannabis like local cannabis
Speaker 1: production traditionally in Russia. If you look at the law,
Speaker 1: it's still like, you know, in the same category as
Speaker 1: other prohibited drugs, but maybe culturally it's like class sigma
Speaker 1: as I speak. I remember like some kind of jokes
Speaker 1: or not caphobic jokes that I made about cannabis smokers
Speaker 1: and some slur words that I used for them. So
Speaker 1: of course it's like ambivalent. I would say that alcohol
Speaker 1: badly stands out as a like separate kind of substance
Speaker 1: that is treated differently from all the drugs. But I
Speaker 1: mean there wore some attempts to like push for marijuana
Speaker 1: legalization or even lately by the state you know, officials,
Speaker 1: to discuss or bring up the issue of medical Mirijuana
Speaker 1: suddenly in the press. But there was never a huge
Speaker 1: movement for legalization of marijuana in Russia for some reason.
Speaker 1: So even like in the more open times, there was
Speaker 1: some movement, and there was some protests and marijuana marshas
Speaker 1: were organized in Moscow for several years, but it was
Speaker 1: not like strong, strong movement. Well and you listen, thank
Speaker 1: you so very very much for taking the time to
Speaker 1: talk to me on Psychoactive. I wish you all the best.
Speaker 1: I wish you the best for your country and that
Speaker 1: things may turn in a more positive direction, you know,
Speaker 1: not just for the situation of drug users in Russia,
Speaker 1: but for the rest of the population as else. So
Speaker 1: thank you for your work, your amazing work over all
Speaker 1: these many years, um and for the work that you'll
Speaker 1: do in the future. Thank you, Eaton. Thank you so
Speaker 1: much for inviting me to speak. I mean, I'm always
Speaker 1: like the most depressing guest at the table, and I
Speaker 1: hope that at some point we will also be able
Speaker 1: to discuss amazing development and drop pol city form happening
Speaker 1: in passion. That would be wonderful. Thank you very much,
Speaker 1: that's my greatest hope. Thank you, even if you're enjoying Psychoactive.
Speaker 1: Please tell your friends about it, or you can write
Speaker 1: us a review at Apple Podcasts or wherever you get
Speaker 1: your podcasts. We love to hear from our listeners. If
Speaker 1: you'd like to share your own stories, comments and ideas,
Speaker 1: then leave us a message at one eight three three
Speaker 1: seven seven nine sixty that's eight three three psycho zero,
Speaker 1: or you can email us at Psychoactive at protozoa dot com,
Speaker 1: or find me on Twitter at Ethan Naedleman. You can
Speaker 1: also find contact information in our show notes. Psychoactive is
Speaker 1: a production of I Heart Radio and Protozoa Pictures. It's
Speaker 1: hosted by me Ethan Naedelman. It's produced by Noam Osband
Speaker 1: and Josh Stain. The executive producers are Dylan Golden, Ari Handel,
Speaker 1: Elizabeth Geesus and Darren Aronofsky from Protozoa Pictures, Alex Williams
Speaker 1: and Matt Frederick from my Heart Radio and me Ethan Nadelman.
Speaker 1: Our music is by Ari Blucien and a special thanks
Speaker 1: to a Brio s f Bianca Grimshaw and Robert BP.
Speaker 1: Next week I'll be talking with the comedian Adam Strauss,
Speaker 1: who created a wonderful play called The Mushroom Cure, in
Speaker 1: which he talks about using psychedelics to cure his O
Speaker 1: c D. My own psych get experiences. Humor and laughter
Speaker 1: is such a central part of them. To be very specific,
Speaker 1: I mean the way I've laughed. I'm mushrooms particularly, and
Speaker 1: and Sasha Shulgin talks about and something of peak all
Speaker 1: this or INTI call this trip to mean laugh. It
Speaker 1: does seem to be a fairly intimate um and I
Speaker 1: think personally a non trivial connection between psychedelics and laughter.
Speaker 1: To me, one of the one of the many powerful
Speaker 1: things about laughter is there something humbling about it. When
Speaker 1: you're laughing, you're basically there's an element of surprise, something
Speaker 1: you didn't see coming. And I don't think it's too
Speaker 1: far a reach to say that there is In the
Speaker 1: best jokes, there's sort of a mind expanding element where
Speaker 1: you see a possibility or a connection that you didn't
Speaker 1: previously see. And it's that that snap moment of recognition
Speaker 1: and connection that elicits the laugh. Subscribe to cycleactive now
Speaker 1: see it, don't miss it.