Anya Sarang on Russia and Drugs

use any type of drug. Hello, Psychoactive listeners. Today, I'm gonna be talking with Anya Sere. And Anya is perhaps the most well known and leading and longstanding activist for harm reduction in Russia, which is no easy job as you can imagine, as she's mostly been based in the Netherlands in recent years, where she is the chair of the Andre Rolka Foundation, which does harm reduction activity and

activism in Russia. And yes, that has still been possible to some extent, but I thought that especially given what's going on in the world now with Russia's invasion of Ukraine and more and more attention and more and more consciousness among Americans and really the global audience to what's

going on not just in Ukraine but in Russia. I thought would be interesting to have an episode specifically about drugs and drug policy and harm reduction and activism in Russia and maybe reflect a little bit about what you know insights that provides into Russia more generally. So, Anya, thank you so much for joining me on Psychoactive. You've done huge Thanks for inviting me and the It's a big owner for me. I'm really humble to be a

guest on one of your great episodes. And you and I have not seen one another for quite some time, but you have been deeply involved in this now what for something like twenty years about trying to advance harm

reduction policies and programs and thinking in in Russia. Years over twenty years now, So Russia, right, I mean, you know, if we go back historically, right, the Soviet Union kind of comes apart in the early nineteen nineties and there's a kind of wild and crazy period in the nineties where borders are open or as Yelson is the president, things are a bit chaotic. I think drug use, you know,

it begins to increase significantly. You know, what was that period like back in the late nineties before Putin and especially looking at the drug situation back then as well. I was born in nineteen seventy too, so I was young, but I was like at the age when people start

to experiment with drugs, and you are absolutely right. It was like something completely new and something too came to us quite massively and unexpectedly, and a lot of young people started to use drugs and started to use drugs by injection, and when they started to work with medicine san printiers, there was a huge concern about the future of HIV epidemic and Russia which did not start yet,

but I was about to start. Because a lot of young people, inexperienced people, and people who did not have any information about drugs from there, you know, like parents or they did not see the previous generation using drugs, they started to use and they started to use in quite harmful ways. And was it mostly heroine and heroin coming from the Afghanistan? Was that the principle issue? Oh know, firstly it was a homemade heroin we called the hunk

or churners. So it's like homemade opius and homemade stimulants. I don't know, maybe you've heard about Interrussian math vetamine also the kind of uh homemade product, and at first it was that so hunk and veined. They were, as far as I remember, like one of the first like most popular drugs. And then maybe several years later actually in the early nineties, the heroin like completely took up all the drugs scene, like city by city in Russia.

But yes, a bit later. But even if you go back to the days when when Russia was occupying Afghanistan, was there already situations of heroin coming back into the country by Russian soldiers for example. Bringing it back to things like that, it was a fairly small scale until things really kind of opened up in the in the later nineties. I think it was quite small scale. There was no like a public health emergency. People did not

hear much about that. I heard that there was some even like always like small scale always substitution program somewhere in Georgia, but it was not like a huge or visible problem before Now, I have to tell you, the only time I've ever been to your country, it was back in the spring of nineteen nineties six I think it was the annual Russian AIDS conference in St Petersburg, And I guess was that a period mean sort of a relative openness you think in those late nineties early

two thousands, when the sort of more open discussion could happen even in kind of semi official gatherings. Yes, even you are absolutely right. Ninety six is probably when harm aduction started in Russian It started in Saint Pietsburg with the support of Medicine's Dumont. I think they set up the first harm aduction program in Russia that the still running.

And uh again in the late nineties, like nineties ninety eight ninety nine, when I worked with Medicine San Frontiers who set up a huge national program for training of doctors and drug treatment specialists as doctors, there were huge hopes that the like all this training programs were done with the support of the Ministry of Health. I remember going to outreach in Moscow with the guy who was the chief consultant of the Ministry of Health on drug issues.

So the scene was quite quite open and Russian specialist, the Russian doctors, especially drug treatment doctors and especially in factious disease doctors who are looking at the HIV epidemic, they will quite open to the idea of harmonduction, and I remember these conferences. They were always very interesting, Like the First AIDS conferences were amazing. You could meet people from all around the world talking about the experience and

age prevention in their countries. The training that MSF set up for the regional doctors was great, and we learned so much from our colleagues from other countries. And there was a time of create of great aspirations and the time when we believe that it will be possible to really stop the AGS epidemic in people who use drugs,

people who in jeb drugs in Vassia. Despite the huge scale of this group and the all so expectations that the donors will support the pilot programs of harm induction, but then they will be taken up by the state and they will be implemented all over Russia, scaled up to reach like sixty percent of people who who inject drugs, and every city is recommended by WHO organization and so on and so on and and a lot of people were released from prisons. I think it was about thirty

thousand people that were released from prisons back then. Uh and it was like but unfortunately it is the last time the Russian drug policy changed to the pattern. For example, I remember, with the support of df IDA, there was a huge program planned to scale up harm reduction into Russian regions and the Ministry of Health was supporting it. Unfortunately, this program didn't happen due to the world uh in

the rock when the funds were withdrawn. But there were great, you know, like preparations to scaling up harm reduction in a big way in Russia, which never happened because there were a well, huge boys to turn after two thousand eight, which we can talk about later, right, Well, we'll get to that, so just for our listeners, just uh, you know, and has mentioned a few organizations Mont San San Frontier, which was an organization of doctors working in war zones

and otherwise trying to help with things, founded by Bernard Kushnair, the former French health minister and politician, and then the organization met Saint Dumont, which sort of spun off, you know, Doctors of the world that spun spun off from its frontier with the same leadership. Interestingly enough, I think there was some internal division there. And she also mentioned different which was basically the A I D. The International Aid Department of the British government, and so these were all

quite involved. Now, even when putin comes in around roughly two thousand, right, for the first five or six years, I think things were fairly open. I mean there was even a kind of shift in the law where drug users were let out of prison. Just say a little more about that, you know, that continuing sort of open period. Right, there was a little shift in the law. I think it was around two thousand three, two thousand four, quite an achievement in the reform of the Criminal Code of

Drush and Federation. Before the shift, it was possible to literally lock person up for i don't know, like ten years for just like something that was found in there. So it was really harsh, and any amount of drugs was considered a large amount of drugs. But after the

reform it became a little better. So unfortunately in Vassia, the amount for which a person can be incarcerated is defined by the state and not by a judge, and so the state has to confirm this like table of amounts, and in two thousand three was probably the last drug policy reform was successful. When the amounts for example, if you talk about heroin, it was from zero point zero zero something a large amount. It came to half half Graham, so half gram of heroin before the half cram. A

person was is not liable for criminal responsibility. But I think also it's important stand that I think, you know, as an activist, you know, I mean, my my attentions were always global, but the US is obviously my principal preoccupation. And one of the great humiliations of being an American was the fact that we had the highest incarceration rate in the world going back to roughly the late eighties, early nineties and continuing to today. But typically Russia was

number two. Russia was the second, always, always after you guys, and I think that may still be the case. How do you explain this, like, you know, long standing commitment of Russia at the high levels of incarceration. I think it's just because it's like, you know, big land, big prisons, and in this economic transition time, and there was the equation like what to do with the large population, like

people could not get jobs. People. I remember because I worked with this Doctor's Without Borders Medicine some frontiers, and we went around the Russian Siegies. I went to maybe well, I don't know, like not every Russian beaching, but like

a lot of them. And they've seen some Russian cities and this cities were economically depressed, like people could not find the job, people couldn't like the onli like basically the only thing people were interested in those drugs all like drug Well not everywhere, of course people studied then, like there was still some groups that could live better. But like for the poor population, I think was just

the Russian solution. Yeah, and prisons became so big. Prisons became like a big part of the response to the problem. But I have to say when you talk about the role of poverty, I mean lots of other countries have gone through terrible poverty without having anything like the incarceration rates that Russia the US have had. So has there been a racial ethnic dimensioned that was going on in Russia? Is it mostly about poverty? There's kind of comfort with

putting people in jail and prison. What is that about in Russia? Well, it's difficult to say. There is a history. I mean, if you look at the yells some time, it was the first several years, less than ten years when we had the glassness, you know, historic when people started to be involved in the discussion. But before people were just silent and it was convenient to you know, build up a huge system, and of course it had

to be filled in. There is always an ethnical aspect to the war on drugs I think the main marker for people to be locked up was, Yeah, it was the poverty. I mean, like the drug use associated with overtire. So it wasn't as if you had disproportioned numbers of checking it's going in, or disproportional numbers of people that come from you know, former Soviet republics and Central Age

or something like that. It was basically about people, poor people who were using drugs, selling drugs involved in that world who were getting locked up, whereas you know, more affluent people using drugs generally avoided getting in trouble and a kind of real comfort with the police and government

authorities who just throw the people away. I think there was definitely not lily an ethnic you know bias, and especially as you mentioned, people from the Central Asian especially from Tajikistan, Peakistan, but also Roman people were greatly affected by this bias. But in general, I think the main population that went to prison was just for people who

who got addicted to drugs. And this time a lot of reports sort of go back to roughly two thousand six two thousand seven as a kind of moment when things really began to change, when when Putin seems to change, maybe partially in response to things that are happening with NATO in the West, but also with things that are

happening domestically in Russia. I would say for us the turning point was was two thousand nine, because we remember it quite clearly, because in two thousand eight there was an interesting moment when the Russian Ministry of Health was presenting at the regional eighth conference was called ECOQ, the Eastern European Central Asian Aids Conference, which was goal sponsored by the Russian government and the United Nations Programs Program

on AIDS, and she was speaking at the conference. There were many guests from the Global Fund to Fight its UH Tuberculuis and MILLARYA, which became the main donor for the harmonduction programs and other ADS programs in Russia by then, and I should say it was about eight harmorduction programs back then in Russia funded by the Global Fund, and she said that we will be able to pick up

all these programs. We have the capacity, we have the resources, we have the money, and we will continue everything ourselves. Then a year later she talks of the Security Council before Dmitry mediated if I think he was the president

back then, and putting the prime minister. Well, she talks before the government and she says that harm reduction contributes the Russian way, and we have our own way to deal with the AIDS problem and harmonduct and is not one of them, because harm reduction programs have proved in effective in the Russian context, and we will have to follow our own Russian way to deal with drugs and AIDS. And that wasn't two thousand nine. So that for us was the main kind of turning point when the official

government of policy has completely changed. And if before like two thousand eight, two thousand nine, we had at least some hopes that it will be possible to do something and like really like prevent AIDS and HIV in Russia. Up to two thousand nine, we just realized that the government policy has changed and we will be living in

much more challenging times. So just for our listeners to fill in a little context here, And when I mentioned the Global Fund, I mean that was the organization that's creating early two thousand's the Global fun to fight AIDS,

tuberculous tuberculosis and malaria. Just something something that's just called the Global Fund, which is a sort of international financing and partnership organization funded by governments and some private foundations like the Gates Foundation, which is given out almost fifty billion dollars to fight AIDS to regulus the malaria over the last roughly twenty years. So there comes this point where the Russian government basically says we don't want your

money and we don't want your ways. And that's roughly two thousand and nine. And yes, in two thousand and nine, days started to really like close up on the international partnerships and slowly slowly sending home all the donors, including the UN agency is the UN Office on Drugs and Crime has been shut down in Russia, and well UN Development program of course, so all the like major UN

programs have been shut down. When I think about it, you know, it means though what you're saying, though, isn't that first decade of the two thousands you say they were roughly seventy eighty harmorduction programs up and going in Russia, and I have assumed many of them were doing needle exchange. And it was not just in big cities like Moscow and St. Petersburg, but in quite a number of other

places in Russia. It was all over rushal like, Russia has eighty nine I think so called oblast or territories, and in every of these territories we had the harm aduction program pilot in a major city. Yeah. Uh so there were over eighty programs in some smaller cities as well. So we had like violence and bigger and smaller cities to see how they can reach out to people. And yes, they will needle exchange programs and needland citrange programs. Alboways.

Substitution treatment has been always prohibited in Russia, and there is a provision into the Russian law that prohibits to provide all like any kind of prohibited or controlled substances to people with drug addiction. So apilways substitution treatment was not.

It was like an issue for the international organizations and later for ourselves more like local grassroots Unity advocacy group to fight for substitution treatment but the Midlands each programs, outreach programs, um you know, access to HIV testing and later treatment, improved access they were available in Russia. So it was a period of relative openness, I guess. And in that way, no, I mean, I also presume that certain regions were much more sympathetic and open where others

were much more grudging or repressive. That I mean, were there any standout regions back in the day that were particularly supportive of harm reduction in a more cutting edgeway. Yeah, I mean the world visions that were most supportive. And I remember, for example St. Petersburg from the very early times.

They enjoyed the support of the city here, you know, the hospitals and the munistable budget and the local specialists and the local decision makers were much more open to the idea of harm reduction and scaling it up through the local medical system like health system, whereas for example, in Moscow where we worked, all harm aduction was prohibited by the former mayor, and he he issued an order prohibiting all the like health organizations in the city to

participate in any kind of harm reduction Midland city inch programs, outreach and so on. So there was definitely a difference in approaches, but like most of the cities were convinced by the Ministry of Health and other partners like earlier in the history, that harm aduction is a good approach to the problem. And only the most conservative the city governments, like the Moscow the Mostcow city government, they really opposed harm reduction from the early days. So I actually have

to ask you this question. So, I mean, you've been living in the Netherlands for a number of ers now but seven years, but you're still a Russian citizen, right and and you're still a family in Russia, and you're learning a foundation andre Ricco Foundation or you know, sharing it that that is active there. So in our us having this conversation now, it's seeming like increasingly repressive just

this year and since the invasion. Do you have to worry about some of this stuff in your conversation with me right now? Uh? Not in the conversation. But we do have the worries about the security of our work. I mean, we had this worries before. And I should say that our organization is a for an agent organization. We were included in the least than two thousands sixteen I mean, this station was getting worse and worse year after year, and now after day after Russia started the

war in Ukraine. The situation in Russia is becoming very very dark and we honestly don't know what will happen.

We have of course, like discussed a lot all the security measures and like we have relocated several people from our organization al Radio to other countries, to Georgia, but most of the people are still in Moscow and we are still doing everyday outreach work and need land Syrange provision to our clients, the case management, the street lawyers program, the mental health program, so we're still doing the work. But we just like more and more prepared that this

may not be maybe at some point even possible. But to be honest, like I told you about this station, but the most school government like years ago, but still we were we were the first who started new and Syrange program in Mosque, which despite all this concerns and we kind of trained ourselves to uh he had to work in very difficult conditions and like in this situation when maybe next year or even like next months, we'll have to suspend our activities and we've been able to

continue our work since two thousand nine, every day with every day awareness that it may not be for a long time. And now we are very concerned what will happen in Russia, uh, because we are looking at the complete like probably a closure on the civil society here. And you probably know that a number of well all the international human rights organizations have been expelled in Dussages

this week, including Human Rights Watch, Amnesty International and so on. Yes, it's not safe, definitely not a safe space for civil sides organization to do the harm induction work. And is it apart from Moscow at St. Petersburg, are there still some other pockets in the country where harmorduction programs and activism is still possible. There are some other organizations that are doing harmonduction. But I think now do to the financial and of course the political situation, uh, it will

become more and more. Well, it's already too difficult, too difficult, and people are being really like exposed to a huge pressure on behalf of the government or all the Yeah, because I was reading about one program or one area, like I think in the city of kan in the Republican tatarstand which is I think, well, you know, republic has maybe one third Muslim, and that that was also a place at at harm aduction at least until recently

or hopefully even until today. He's actually the Tarstan was one of these like territories where they plan to scale up, like when I was talking about the DEFT program. They Arstan was one of the friendly territories that were ready to support harmonduction financially, and that we're quite open to the idea, and where there were a huge number of great specialists who work in the a's or drug field and they were supporting harm aduction. But now I think

all this activities have stopped. Yeah, there is no harm aduction program anymore. Just became too too dangerous, too young

to continue this work. We'll be talking more after we hear this add You know, you mentioned before that there's no opioid substitution treatment, no method on now, no bupern orphine, and and that Russia is really I mean, it's been remarkable in its absolute indifference to the science, the evidence, the fact that this is the recommended treatment for heroin other opioid addiction by the World Health Organization and almost every other repeal organization around the world, and that even

as you see method on maindance programs emerging in parts of Asia, you know, Vietnam, China, Indonesia, you name it, where which you couldn't have an imagine method on maintenance programs twenty years ago. You know, even as you see it popping up in even all all other countries that used to be part of the Soviet Union, Russia has this sort of fierce ideological opposition to it, right, and

this I think they call it a narcological establishment. Narcology is which they call like the drug addiction expertise, me, can you just give us some more insight into this and why this crazy ideological crazy is in terms of opposing any method and buprenorphine, especially in the phase of rising opioid detection problems. Yeah, even it has always been a mystery for me and for anyone who tried to

understand this issue. Why there is such a huge position to a simple public health intervention like the first line intervention for people with apioid or dependency or other problems related to aupioid use. So it is not clear why there is such a huge opposition. There is a theory though, that is a historical position and one of the fathers

of Russian like founding fathers of their Russian archology. Academisian Bobaiyan, who was also a very prominent figure in the Russian psychiatry in the Erpsky Institute, the kind of homeland for their repressive psychiatry, the psychiatry that was used against the

dissidents in the late seventies and ages. He was the first person who who started to deal with drug drug addiction and alcohol addiction problems, and he modeled these uh interventions on the basis of this repressive psychiatry kind of philosophy. He was also for a long time member of the

International Narcotic Control Board. You know, Russia has been on the board for a long, long long time, and maybe also one of the reasons why the International Narcody Control Board became such a comparatively depressive organ in monitoring the

implementation of the Conventions on drugs. So this is the same person, the same person who was in power very much on the international arena, but he was also in power in Russia, and he kind of conceptualized the whole like this, you know, mandatory labor and the labor camps for people who use drugs or people who are addicted or to drugs or alcohol. And he is the one

who was very much opposed toward your substitution treatment. He thought that drugs could not be provided to people with addiction, that drug cannot be a solution to a drug problem. And this philosophy it became the kind of main belief of the of the Russian ideologists who worked in the drug treatment field. You know, like uhh, it almost seems

like a closeye religious commitment. It was because you know, you can understand, like you know, China with the history of the opium wars, and they had this resistance, you know, not just the heroin, but obviously even a methodic maintenance. And then fifteen years ago whatever they make, you know, they turn around on this thing. And countries malais I said, Malaysian, Indonesia, Iran, right,

you know, which has method on maintenance. And then you even see, I mean, as I when I was looking at the map just recently of the former Soviet public, it looks like essentially all of them, you know, except for uh maybe a Turkmenistan or something like that, but all of the other formers have had needle exchange and methodon with a few small exceptions, So it seems like this failure mentioning may have influenced things more broadly during the Soviet Union. It's only a Russia where it remains

this almost article of faith. Would you meet people working in the Ministry of Health and others who are sort of embarrassed by this ideological opposition to methodon, yes, definitely. Well, I agree with you completely that it's rather like a symbolic symbolic belief or as you say, religious belief of

the Russian specialists. And I think it was used from the very beginning as this kind of point that Russian narcology as it was called, is different from the Western narcology that is based on its own like I don't know, epistemology,

and is based on its own Russian way. So it was from the very beginning like a very big, very big thing for the decision makers, and a lot of decision makers, including some people worked in the mystery of health, both on the sides of aids and on the sides of drugs, they tried to challenge that because they understood, understood perfectly well that it's a great tool to stop the ase or at least like slow down the as epidemic in this population, and also to provide help to

people with obvio dependency. Of course, later it also became an issue when a lot of people already had HIV and they could not get access to enter a troviral medicines because they were considered not productive for the society and also because they could not be maintained without the substitution treatment. So there was all and of course also treatment of tuberculoise is substitution treatment could be a great key to like preventing the munstruct resistant to perculosis epidemic

that we had in Russia. Uh So it was clear to everyone who worked in health that it would be a really like great solution to a lot of problems and be pool including great you know, medical specialists, accademissions and like uh you know, professors and even officials from the Ministry of Health. They were supporting substitution treatment, but there was always something that was opposing it, and this

something was the conservative ideology. And whenever people pushed too far, they just lost their positions, and at some point it became just impossible for Russian professionals, and that probably in the midle thousands when it became completely impossible for the Russian professionals to talk about audio substitution treatment. Yeah, it's amazing because you know, I remember I looked, I took a look at your website for the Andrew Record Foundation, Uh,

and there's almost nothing on it now. And my recollection was, you know, years ago there was a lot of interesting information about harm reduction and maybe stuff on method on and and your cases in the European Court of Human Rights and all that sort of stuff. But now I think, you know, it's it's it's almost such a defined there.

And is it basically the point where even talking about method on maint and it's much less advocating for it is actually criminalized in Russianale, Yeah, talking about all all the illegal substances is a danger. And like the first time, our yeah, you're right, we had a great, great website and of course we put all the like regulations and all the normative guidance and all the like medical guidance

on the website. And we also had the recommendation from w. Chow from the UN Committee on Economical, Social and Cultural Rights that recommended that Russia legalized perious substitution treatment back in two thousand eleven or two thousand twelve. And our website was first attacked by the Federal Drug Control Service back in two thousand and thirteen and it was just shut down without any illegal action by the Federal Drug

Control Service. Then we challenged them in court and the side went back online and we have maintained it for another like long time. All we received a lot of administrative punishment and fines. One of the biggest fine was when we published information about harm reduction on UH newly

psychoactive substances like the METHODRON harmonductional METHODRON. We published the information and we will find with like around ten thousand Europe for just like publishing the harmonuction information on the website.

But the last attack was in twenty twenty when during the COVID pandemic, journalist published an article with our citations and about the very difficult situation economic collustiuation during the pandemic for people who use drugs, and we will attacked by the parliament member of the Russian Federation, and we just realized that it's too dangerous to have so much open information and we put our website to the bare minimum. We now only have the Contacts Center like basic information

about the organization and donate button. Yeah, you know, I remember that that you guys in your allies were doing some very creative activism in the past. That reminded me of some of the stuff that act UP to the United States back in the eighties and nineties and early arts around around drugs and around eights and this sort of stuff. Letteral honeys know a few examples of some of your you know, more provocative and successful campaigns over

the years. Well, I love to remember the name of the person Andre, the person who was our friend and hero. He's the one like who was the leader and probably like the initiator of this act UP inspired movement in Russia, the movement to include people who use drugs into the

list of patients who can receive untrovital treatment. So in let's say two thousand three, two thousand four, it was two thousand five, it was still quite difficult for people who use drugs, and there was many it was always like eighty percent of all people with HIV in Russia, but they could not get access to the red ReViral treatment because they were considered like socially unreliable and so on.

And Andre Rikov and some other other our friends have set up the Front AIDS movement, and that was the like very bright movement which the guys changed themselves to like the municipal buildings or to the Ministry of Health. There was a huge banner in Moscow and there was an action, you know when they came out to Saint Petsburgh with the coffins and also attracting attention to the tragedy of the AIDS, you know, of the ads that could be prevented. So it was quite inspired movement the

Front AIDS in Russia. Andrekov died in two thousand and six. He was also an activist, drug user and the great, great inspiration for all of us um but he died and in two thousand nine when we started our organization, we decided to take his name and to continue his create like drug user activists. He was activism. He was

a great inspiration. You know. Going back to these narcologists right in their anti method on saying, I mean my understanding is that they sometimes in place of methodon back some really bizarre forms of drugs what they call drug treatment al as sometimes it sounds to me more like torture.

Can you just say a little more about that well, the drug treatment in Russia is really like um based on the very old protocols, and the drug treatment in Russia is organized in the way that the like the medical part of drug treatment is controlled by the states, so it's impossible to run a drug clinic if you're not a state institution. So we have a system of uh so called narcology drug treatment centers and drug treatment clinics, but they are all run by the states, so basically

they work for the state. And there is a lot of more private or church or like religious groups based rehabilitation centers, and unfortunately both of the systems are not effective. So the state run system is based on well, as we all ready discussed, we don't have a methodon or orphan substitution treatment, so there is not really much that

the system can offer. Uh So they use the taxification and sometimes they use yes, they do use like very old protocols and some medicines that been all radios but like how a paradol for example, that has been all radio like uh not used even in the psychiatry, but they use in the drug treatment protocol up to now. But they're also the most cruelty you probably came from the private rehabilitation center. I don't know if you remember or if you've heard the story of the City Without

Drugs in Euclidian book. It was a popular group book is a b exceeds a big industrial city about three million people, I think in the bural in the euro mountains.

Uh So, in the beginning of Siberia, so there was a group called City Without Drugs who started to fight with the Roman people with ethnic minorities and with people who used drugs, and they promised to clean up the city with their owns, with their own means, and they started to like kidnap people from their homes, sometimes prompted by their parents who did not know what to do, and people were kept on like in very tortuous conditions.

They were beaten up, and they were chained to beds for like months without proper food, and it was considered quite normal. I would say, it's not anymore. But back then, in their earlier and mide A two thousand, it was considered quite a reasonable approach to solving the drug problem. And if you talk to like Russian people, they would say, yes, of course, it's quite extreme to beat up and torture people, and like chain them to bads, but you know it's

uh junkies, and they first have to become humans. And to become humans, they have to go through all this like horrible, you know, all this horrible treatment, and this model it became quite popular. And I would say that until now, kidnapping people from their homes, keeping them in vivid tortures conditions, not providing them with medical treatment for their I don't know, infectious diseases or any other diseases.

It's quite a norm. And there was like always an attempt at the state to introduce some quality standards or some safety guidance, guidance, and of course many of these actions are illegal, like kidnapping people or like keeping them against their will. But this model of so called the abilitation it became like super popular in Russia and in

many cities. It's still like the wound their quote and quote quote solution, like for familists who don't know what to do with their children, and people would even pay for their for their children to be tortured in this you know, the abilitation centers. You know, I wish I could say that, oh this is outrageous compared to America,

but you know, even United States. I mean, we had these private organizations that there was one fairly notorious one, I think based in Florida, and it was the same thing you'd have, you know, upper middle class, somewhat wealthy parents who were freaked out about their kids doing drugs.

Sometimes the kids had real drug problems, sometimes it was just you know, smoking too much wheat or something like that, and they would pay to have them sent to these programs, you know, these kind of tough kind of tough love type things. And ultimately, you know, some people died in these programs, and eventually they were shut down because they were sued and things like that. Never I don't think

any criminal charges. But part of what gave it its staying power was that the founders was a couple named Mel and Betty Sembler. Betty Sembler was one of the leading kind of you know, kind of like anti drug fanatics who should have just been dismissed as a kind

of you know, nutcase. But her husband, Mel happened to be chairing the finance committee of the Republican National Committee, you know, appointed by I think Reagan or Bush to the ambassador to Italy and to Australia, you know, he could get any single you know, he could get the White House out of phone call, he get any Republican senator, and these guys were enormously politically powerful and able to you know, semi legitimize this type of approach, you know,

in our own country. So America was not just you know, exceeding Russia in terms of incarceration rates, but we were also on somewhat in lockstep on some of these other repressive approaches. Yeah, but I think America was the modal country where all this like you know, political campaigns based on the war on drugs, and like toughness in the war on drugs on this or that scale, built on the scale of the nation or like on the local scale,

that became well, they proved themselves effective. If you are against drugs by any means, then you will be popular. And the same actually happened in the Utilian book. There was the person behind all of this, Vgeny Roisman, who became a super popular person. He was elected in the state doom in the parliament, and he became the mayor of your Catilian book exactly for torturing people and keeping

them in this reabilitation centers. So it's quite amazing. But this approach, it has been super popular, so I think it also inspired you know, other so called seal society activists in a bad way to promote the same model because they saw that they can also gain some political weight from men. I see. You know, I only ask

you about on the policing side. I mean, you know, you co authored an article some years ago with some other scholars and such about the nature of drug policing in Russia and pointing out not just how you know, kind of vicious it could be, but how sometimes there were oftentimes you know, even elements of torture um and sometimes even fairly pervasively in terms of the way in which police interacted with drug users, not just humiliating them

and beating them, but actually torturing them. It makes me wonder when you look at something like the Philippines with a president and democratically like the president do tirt Day who basically encourages police around the country to go out and literally kill people involved with that's amphetamine um and not just not just sellers, but oftentimes just simple users as well. And you know where thousands, maybe tens of thousands people have been killed, and where the president says

I'll protect you. I'll protect you, right. I mean what keeps Putin from doing something like that? Could Putin do it? Do turt day? Could he send out that word? Could you see such a phenomenon happening in Russia? I think is doing but just in a different way. And I think the police they can pretty much do anything they want,

probably not kill people, but they don't need to. They can just like send a person to prison or to a camp and the person is very likely to die of aids UH complications of tuberculosis, of overdoses on the release from the camps. There is the whole system that kills people for you. You don't need the police officer to do it. But the police officers are definitely given

like impunity in treating people who use drugs. And like we reported on the tortures that are everyday routes seen normalized, completely accepted tortures to those people who use drugs, women who use drugs. The system is designed in a way to kill a person and basically any sentence for drug use becomes a death sentence. But also the system is tortures through out, like from the first contact with the medical service, from the first contact with the police, from

the first contact with other law enforcement. I don't know, like courts and so on. People are going through humiliation, people are going through physical torture, people are going through money extortion. People are just not treated, you know, women getting deprived of their children. Like the whole system is tortures. And we have been documenting it since the very beginning of our work, and unfortunately, what we're seeing now in

Ukraine the tortures of peaceful civilians. Unfortunately, we've seen it before, and we've been witnessing and documenting this on the fields of the War on drugs in Russia since two thousand nine. Yeah, I mean I was sort of one example, I guess of what you see this is when when Russia sees TREMEA from Ukraine in two thousand fourteen, and my understanding is they basically just shut down all the method on

programs and within the space of a year. I don't know, it was a ten or of all the people during these programs had had died when we or another yes, well, I think it was a thousand people at least who were just basically kicked out on the street, and it was a huge tragedy. For all of us. Our Ukrainian qualites could not believe that this is possible until the

very like last minute. They were, you know, writing to us and saying no, no, no, But we will write to the World Health organizations, we will write to the UN, we will write to the UN Program on Ease, and they will talk to the Russian Minister of health. They just don't know what's going on. You know that people are getting kicked out on the street and getting like depride of of their medicine. But I was just so amazed how the Ukrainian qualities believed that it's impossible to

just do that to people. And I think that's why I realized how different our mentality was. We were already witnessing this evil for so many years, and we were witnessing what was like happening with people. So two thousand fourteen, when like a thousand people were kicked out on the street, it was just kind of normal for us, witnessing the same thing every day for many years in Russia. And of course it was a huge tragedy and many people,

like people did not get any support. They will promise support, they will promise that they will be taken to Russia, but even like to the rebilitation centers and so on, and a few people were but a few people also died in this like rebilitation programs in Russia, or like they run away or it just never happened. So most people are lost their treatment. And you are right that

about maybe ten percent of these people have died. We don't know the precise estimates because of course the medical specialists who had the contact before with their patients they lost all contacts. Let's take a break here and go to an add you know, I mean, I have to say, I mean, maybe this is the American in me, but I've also been a you know, a student of natural relations for much of my adult life. Prudent has always just struck me. I mean, I've been saying this for

twenty years. Is basically the world's greatest gangster, like the ultimate mafiosa kingpin in a way that he thinks that way, his mentality is that way. It's not that that's also some broader, greater vision of greater Russia and all this

sort of stuff, and that helps to justify things. But in terms of the tactics and mentality, on some level, that seems to be the way he thinks, the way he operates, and when you look at the people, I mean, if you look, for example, the occupation Denza Lhands, it almost just seems like he puts the gangsters in charge. And if you look at Czechna once again, it's putting in basically gangsters in charge. Just the idea of kind of fusing gangsterism and governance in a way that's not

unique to what prudence doing. It happens in other parts of the world as well. The whole things sort of seems of a piece and and maybe there's even an element of that when one looks at the invasion of Ukraine and you know, yes, the greater division of Greater Russia and his claims that Ukraine was always part of Russia and it's part of the heart of Mother Russia. But on the other hand, the tactics and mentality and

the people he puts in charge. You know, I'm not saying this about the Russian army, but on other levels, a kind of gangster mentality that permeates things, and it manifests obviously in drug policy and the way we've been talking about, but maybe more globally as well. I don't know. If you're totally free to speak about this, But are there any thoughts and reflections and reactions to the way I just laid that out well, Ethan, I think you

laid it out perfectly. As a Russian citizen, I can only say that Putin is the great leader of our people and he will bring us to the final victory of Putinism. Can I say anymore? Uh huh. So there's another question I wanted to ask you about. My understand thing is that you know, after this home growing meth and opioids that that that you were talking about, would you call it, uh conca, the homemade opioid and then

the homemade meth amphetamine. But then it goes through a period of heroin from Afghanistan coming through Central Asia being a major part of the problem. And then there's a more recent era a few years ago with the explosive growth of the use of the Internet and the dark net and the website hydra it seems to play a

major role in changing drug markets. Also the telegram messenger another thing, So just tell us about, you know, how that has changed the drug situation, illicit drug situation in Russia. It is amazing how Russia has like completely, well maybe not completely, but majorly switched to the dark web technologies in terms of like the selling drugs. And that's probably a happened mostly in like major cities, but in other

cities as well. I mean, Hydro was a huge market that governed not only Russia but also like other Russian speaking countries, maybe to a less extent, but in Russia, I would say, especially like in Moscow. At some point it became impossible to all, very difficult to buy drugs in any other way other than through this UH market. And as you know, Hydro has been recently shut down by the German and American services. That happened just last week.

And we don't know how the system will adjust because for many many years Hydra and the large market before that, it was the main kind of platform for drug like the drug purchases. But how it will change now we don't know. But yes, you are right, it has completely changed the way UH that Russian people have at least

procure drug and drugs. And I don't know if your listeners have heard about like this whole ethnography of the you know treasures and so basically when you purchase drugs on HYDRA you purchase with the cryptocurrency and you get a location in return, so you don't get your drugs by mail, but you get the geolocation, and then you have to go to this geolocation and find the treasure, and that can be like nearer to your house, but

that can be also very far. And the restories about like people going through cemeteries like in the middle of winter, or like you know, forests and having to dig in the snow. I don't know, like half meter meter treasures. So it's a lot of like folklore about hydra and about the way the rush market operates operated until now.

We don't know what will happen, but yes, it was quite an amazing I think phenomenon, well, if you have a darkness source likeness, it can evolve all sorts of other things that an autocratic government like you have in

Russia doesn't want happening. And so you would think that an autocratic government would see this is something of a threat, a kind of Russian language darknet source, and that therefore, you know, I mean, I only can speculate that it's only allowed to persist because security agencies have some understanding um about what's going on there. Or what will be tolerated.

But you say there's no evidence one or the other. Really, yeah, I mean it's interesting because the Russian like official retric they always target that the Internet and even putting a couple of years ago he talked about the danger of like drugs, the drugs are sold on the Internet, so we could never figure out was there in confusion and why they focused on the Internet and the way like it happened that they focused on the information about drugs

or information on harm aduction rather than the darknet where the drugs actually were. Nobody just sold drugs on internet. So it's interesting, yes, but it's not clear and the picture is completely What's interesting also about about the shift of illicit drug markets from the streets to the darknet.

And obviously it's not a one to one switch, and people can be buying some drugs and bulk on the darknet and then distributing them on the streets as well, but there's also interesting harm reduction potential in a variety of ways when drugs sales shift to the darkness. I mean, one is the fact that you don't have the problems with you know, selling drugs on the street, which can be disruptive of communities, not just in Russia, but I'm thinking even more, you know, the Western world as well.

A second thing is that the extent that you have people writing reviews and the products here getting, there's the opportunity to post information about what these drugs are, and maybe it put a higher level of reliability in terms of what the drug suppliers and what consumers are getting.

And so I'm curious, I mean, how to harm reduction organizations, you know, I mean yours and your meditran action, the fielders that exist, how did they perceive the ups and downs of Hydra and Telegram and all that in terms of the evolution of drug markets. Well, I must acknowledge

that Hydra did good harm reduction work themselves. I should tell you one thing that fantanil was never available on Hydra, or it was available maybe in the very very beginning, but then they just prohibited the cell of fantanil in their shops on the market. So fantanial epidemic did not

touch Russia because it was prohibited by Hydra themselves. And they also had like even the harm aduction facility, well they didn't call harm aduction facilities, but they have had drug testing, so they would randomly like test and publish the results of the purchase on their reviews. And they even had like a drug treatment narcology doctor consulting people, like a hotline for drug issues. They organized themselves as well. So there was someone or I don't know, like maybe

a community of thought behind this interventions. But the fact that we did not have a fantonial epidemic, I think it's a really huge thing, and that was due to the harm reduction measures implemented on hydra. Well, let me ask you another question and also a theory of mine. I don't have anything to prove it, but in some respects Russia is really the great colonial empire of the

twentieth century. You know, Colonialism was something we associated with with France and England and a few of the Dutch European countries in really the seventeenth eighteenth nineteenth century, and really colonialism for Russia, I think, maybe especially the twentieth century Andrews Soviet Union, where you have significant migrations of Russian you know, ethnic Russians into other of the Soviet republics.

And then this comes here's the part of my theory that gets down to the drug piece here that when the Soviet Union crumbles thirty years ago and you have these Russians speaking minorities left in many of these now independent countries. And I'm thinking here especially of the Baltics, you know a lot of the Lithuania, Estonia, but maybe

it's true elsewhere as well. And my perception has been that sometimes the drug problems and injecting drug problems that emerged are worse among the Russians speaking minorities in these

countries than among others. And my theory is is that this is a group of people whose grandfathers and even parents had been in a relatively privileged position in these countries, in the Baltics and maybe some others, and now they are in a kind of disprivileged now as Russian speakers, sometimes not even speaking of the national language Estonia, Lithuanian, Latvian, or maybe in other countries, that they are now worse off, you know, whereas their fathers and grandparents had been better off,

now they're worse off. And maybe that helps explain higher rates of drug problems among the Russian speaking minorities. What do you think of my theory? Yes, for sure, especially in the Baltic I mean, I've been involved in some research, especially in Estonia and in some like Russian regions of Estonia are in the earlier two thousands, and definitely the Russian population was very facted because they lost the jobs and they lost the citizens rights, and they they became

like the most marginalized economically group. And of course this group in some of the regions, or especially in the Baltic countries, they became very very affected by the drug problems and by the HIV epidemic. So, you know, I haven't really asked you about how you got involved in all of this. Why. I mean, were you you yourself an active drug user and got caught up in the way many people get caught up in harm reduction or was it in another way, I mean, what brought you

to this. I was never a systematic drug user, I would say, or I never had like major problems with drugs. But I got involved because my friends. I was just, you know, really interested in this work that my friends got involved in the work of the doctors without boards.

Do you remember the American photographer Jean Raynard who spent a lot of time in I don't know if you've seen his work, but he was an an amazing person who spent a lot of time in Russia, and he was really looking at the beginning of the HIV epidemic and at the time when the injunction drug use suddenly became very very popular, and he was the one who linked the medicine some frontiers back then with the community of people who use drugs in Moscow, and so my

friends and me we were part of one of these communities. They got involved and I got very interested in this work, and then I got to meet like quite amazing people through like this collaboration in the first outreach project, and it just became quite and fascinating and amazing past for me. I mean, I didn't have a career back then, and it seemed to me like a very very very fascinating and interesting things to be involved in. So that's how

I got involved. And of course a lot of my friends were affected because yes, there were young people and a lot of young people were using drugs, and a lot of people were using drugs problem magically, and a lot of people will radio dying and that affected me personally as well. And when you were still living in Russia before you moved to the other winds. I mean, were there moments where you were really afraid for your safety or ter getting arrested? Yeah, well we were. We

were always afraid. I mean I felt its safe until like two thousand nine when I work for international organizations and later for like the Russian Harmeduction Network. But when we started our own Russian Harmeduction Network was was also like a big and show that provided support mostly from the Global Fund to the Russian community of like this

harm auction enthusiasts. But like starting in two thousand nine when we started to work, when we started to hand out needles on the streets of Moscow, we were afraid because like the Moscow government was against and they were like measures against needlands Nage program, you know, the civil society activists like that, for example, the uh guys from the City without Drugs which has also it branched in Moscow, and it was always like quite scary, and they must say,

the people I work with are like real heroes in this regard. So basically we decided our strategy already back then and like up to now, is that we decided that, I mean, we have to do this work. I and we see the people, you know, I mean, we know the miracle of harm reduction. We see that people are suffering, and we know how to provide tools for people to suffer less. So we have to do this work. We

have to serve our community. Of course it's scary, and of course they are like always like so many dangerous. But then I mean we decided, okay, I mean we will just keep working until it's possible, and we are adjusting our you know, safety measures, We are adjusting our communications, we are adjusting our work. Every day. Were like very well, trying to be as careful as it's possible in these conditions,

given that we are dealing with very, very controversial issue. No, I mean it's when you see what put In saying now about an ever broadening minority of Russians, you know, those who don't fully support the cause. It does seem like he's basically taking the prototype that that that the targeting of drug users and people involved with illicit drugs really became a model for a broader targeting or broader sector of society who did not want to go along with his vision or it. And I can tell you more.

You know, the first word he used in his public speech after the war started towards Ukrainian the first that he called them was Kaman. So it's absolutely I mean, the same rhetoric is the same dehumanization that is used by propaganda, first propaganda of the war on drugs. Yeah, I mean it seems I remember thirty years ago when with the downfall of the Romanian dictator Cichsco exact same thing, and there's been so many other leaders who have done

the same thing using the accusation of drugs. Exactly. The cold person a junkie is the first step to dehumanize the person. After that you can do whatever you want with the person. The person is not considered a human being or just a junkie, then they deserve everything. And you have the feeling if you have a real, true public opinion in Poland Russia and ask what should be done, you know with a million or two million, or three million or whatever it is drugs five millions, that some

substantial minority, if not a majority, might just say kill them. Well, I would say that We've been doing a lot of work with the mass media, and we had a lot of partners in Ourncaphobia project, where we tried to challenge the you know, drug war propaganda, and we tried to

challenge the stigma of drugs. And I would say that in the recent years, maybe like eight, nine, ten years, the attitude has started to change and people are more critical towards this concept of dehumanizing a human being because the human being is you know, using drugs. So it becomes more and more obvious for people that this doesn't work anymore. And now I think people understand more and

more that policy can be humane. Drug policy can be based on protection of health, on protection of people, dignity of human rights. Drug policy does not have to be based on like military or police action. It does not have to destroy people's lives. Uh. And there is more and one standing in the Russian society, in the public that you know, there are more effective and more more humane approaches to these issues than the war on drugs and especially the form of the world on drugs that

we have in Russia. I remember, you know, decades ago, when people would play out, well, you know, one benefit of a closed society and closed borders is that they don't have much of a drug problem in Russia. And my response would be that Russia's problem, it's health problem with alcohol was greater than the accumulative problem with alcohol and all illusive drugs put together in the US or

almost any other country. And I wonder, I mean, you know, alcohol is just seen in Russia as part of the national tradition and put an entirely different category, right, I mean there's that mentality of alcohol being a drug just like these other drugs. Is that still a fundamentally alien

idea in Russia? Well? Yeah, I think it's still like a very challenging to make this cognity of kind of jump from like treating alcohol as something completely like else to feeding alcohol as a category of drugs or like substances, psychoactive substances. And I think it's because, yes, I mean, you're right, alcohol is very much in like Russian tradition, uh traditional drug. I don't know what to call it, but yes, it's also because of the Soviet history and

because of the post Soviet history a little bit. But people don't understand that alcohol can be a harder drug than a drug drug. So it's really difficult to explain that. No, if actually you're regulate Arthur drugs, it may be easier. It's because they're not worse than alcohol. Alcohol is the worst, I mean, one of the worst drugs and the hardest drugs that we have. Uh So it's really difficult for people to believe that alcohol, well it's almost like the

hardest drug we have. And where is cannabis fit into the whole picture? Is it something where there's a more relaxed fiel with it. Well, I think that cannabis is I mean, like there was a cannabis like local cannabis production traditionally in Russia. If you look at the law, it's still like, you know, in the same category as other prohibited drugs, but maybe culturally it's like class sigma as I speak. I remember like some kind of jokes or not caphobic jokes that I made about cannabis smokers

and some slur words that I used for them. So of course it's like ambivalent. I would say that alcohol badly stands out as a like separate kind of substance that is treated differently from all the drugs. But I mean there wore some attempts to like push for marijuana legalization or even lately by the state you know, officials, to discuss or bring up the issue of medical Mirijuana suddenly in the press. But there was never a huge movement for legalization of marijuana in Russia for some reason.

So even like in the more open times, there was some movement, and there was some protests and marijuana marshas were organized in Moscow for several years, but it was not like strong, strong movement. Well and you listen, thank you so very very much for taking the time to talk to me on Psychoactive. I wish you all the best. I wish you the best for your country and that things may turn in a more positive direction, you know, not just for the situation of drug users in Russia,

but for the rest of the population as else. So thank you for your work, your amazing work over all these many years, um and for the work that you'll do in the future. Thank you, Eaton. Thank you so much for inviting me to speak. I mean, I'm always like the most depressing guest at the table, and I hope that at some point we will also be able to discuss amazing development and drop pol city form happening in passion. That would be wonderful. Thank you very much,

that's my greatest hope. Thank you, even if you're enjoying Psychoactive. Please tell your friends about it, or you can write us a review at Apple Podcasts or wherever you get your podcasts. We love to hear from our listeners. If you'd like to share your own stories, comments and ideas, then leave us a message at one eight three three seven seven nine sixty that's eight three three psycho zero, or you can email us at Psychoactive at protozoa dot com,

or find me on Twitter at Ethan Naedleman. You can also find contact information in our show notes. Psychoactive is a production of I Heart Radio and Protozoa Pictures. It's hosted by me Ethan Naedelman. It's produced by Noam Osband and Josh Stain. The executive producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren Aronofsky from Protozoa Pictures, Alex Williams and Matt Frederick from my Heart Radio and me Ethan Nadelman.

Our music is by Ari Blucien and a special thanks to a Brio s f Bianca Grimshaw and Robert BP. Next week I'll be talking with the comedian Adam Strauss, who created a wonderful play called The Mushroom Cure, in which he talks about using psychedelics to cure his O c D. My own psych get experiences. Humor and laughter is such a central part of them. To be very specific, I mean the way I've laughed. I'm mushrooms particularly, and and Sasha Shulgin talks about and something of peak all

this or INTI call this trip to mean laugh. It does seem to be a fairly intimate um and I think personally a non trivial connection between psychedelics and laughter. To me, one of the one of the many powerful things about laughter is there something humbling about it. When you're laughing, you're basically there's an element of surprise, something

you didn't see coming. And I don't think it's too far a reach to say that there is In the best jokes, there's sort of a mind expanding element where you see a possibility or a connection that you didn't previously see. And it's that that snap moment of recognition and connection that elicits the laugh. Subscribe to cycleactive now see it, don't miss it.