Kidnap and Cold Turkey: Russia's Addict "Treatment"

By Walter Armstrong 09/06/11

Russia has the world's highest number of heroin addicts and government policy leads many to get HIV. As if that weren't enough, they're now being disappeared in brutal "rehabs".

Inmate-client in the City Without Drugs dining room. Photo via

“The most important thing is to force [heroin addicts] to quit and keep them clean a certain time,” Yevgeny Roizman, who founded City Without Drugs, told The New York Times. “If they behave, they can go home.” Last weekend, the Times ran an expose (complete with slide show) of Roizman's prisonlike detox center, where addicts spend 30 days in a packed “quarantine” room, sometimes handcuffed to their bunks, and fed bread, water and gruel—once clean, the inmate-clients are kept under lock and key for a year doing menial tasks like cooking and cleaning. Such brutal cold-turkey programs—which offer no medication, no therapy, no support group, no addiction education, no skills building, not even a 12-step meeting—are springing up across Russia, ignoring the protests of human rights groups. “We know we are skirting the edge of the law,” a staff member admitted. “We lock people up, but mostly we have a written request from their family. The police couldn’t do this, because it’s against the law.” Russia has the world's highest number of opiate addicts; estimates range from two to five million. They spent $17 billion on street-traded heroin last year, with 7 billion doses leading to at least 30,000 deaths by overdose, one third of the world’s total. The punitive approach to “rehabilitation” matches the government's own policies, which oppose harm-reduction programs or needle exchanges to protect addicts from HIV. (Recently Moscow even closed down its syringe-giveaway groups, which had long run on funds from foreign NGOs.) As a result, there may be as many as a million Russians with HIV, the vast majority the victims of used needles. Meanwhile methadone is illegal and widely viewed as a Western fad. Yevgeny Roizman claims that his “tough it out” approach has a 70% success rate. Yet the organization has never conducted a single follow-up study, so this boast has no backing. “It’s not treatment, it’s jail,” Sergei Polyatykin, medical head of Russian advocacy group Say No to Alcohol and Drugs, told the Times. “Imprisonment and torture can’t help drug addicts to kick the habit. Only a small percentage stay off drugs.” But Roizman is riding high, having earned stardom and election to parliament as a drug war crusader. 

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Walter Armstrong is the Medical Editor at  Saatchi & Saatchi Wellness and the former deputy editor of The Fix. You can find him on Linkedin.