Epidemic Of Addiction Threatens Russia's Future Russia has long grappled with alcoholism among its population. Now, a second plague is afflicting the country: intravenous drug use. Officials say addiction — whether it's drug or alcohol dependency — is reaching a crisis level.
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Epidemic Of Addiction Threatens Russia's Future

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Epidemic Of Addiction Threatens Russia's Future

Epidemic Of Addiction Threatens Russia's Future

Epidemic Of Addiction Threatens Russia's Future

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Natasha Ustiuzhanina, 30, heads Pokoleniye, a drug and HIV counseling and rehab program in a small village in remote western Siberia. She is shown here with her longtime partner, Yuri, and their 4-year-old son. Russia is battling a rising tide of IV drug and alcohol addiction, and nongovernmental programs such as Pokoleniye are stepping in where government measures are falling short. Anne Garrels/NPR hide caption

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Anne Garrels/NPR

Natasha Ustiuzhanina, 30, heads Pokoleniye, a drug and HIV counseling and rehab program in a small village in remote western Siberia. She is shown here with her longtime partner, Yuri, and their 4-year-old son. Russia is battling a rising tide of IV drug and alcohol addiction, and nongovernmental programs such as Pokoleniye are stepping in where government measures are falling short.

Anne Garrels/NPR

Russia has long grappled with alcoholism among its population. Now, a second plague is afflicting the country: intravenous drug use. Officials say addiction — whether it's drug or alcohol dependency — is threatening the country's future.

Heroin use is a relatively new phenomenon in Russia. It first exploded in the 1990s, when the country was in post-Soviet turmoil and uniquely unprepared to cope with the problem, and it has spread like wildfire. Alcoholism, long Russia's bane, is also rising, especially among young people.

Officials acknowledge the country will have difficulty resolving its demographic crisis if it does not do more to confront these problems. Russia's population has been falling since the mid-1990s, the result of higher death rates and lower birthrates.

The rate of drug-related deaths, at 80 a day, is among the world's highest. Researchers say alcohol is the cause of more than half of all deaths of people ages 15 to 54 — often from accidents, violence or alcohol poisoning.

One group is trying to make a difference at a rehabilitation program in remote western Siberia.

The largely abandoned village of Gerasimovka lies a good hour from Tyumen, the nearest town. It is a risky trip by dirt roads covered with a layer of slick ice.

In a ramshackle house, 30-year-old Natasha Ustiuzhanina sits at the head of the dinner table on a recent evening. The other five people at the meal look to this petite woman for inspiration.

Ustiuzhanina has been through it all. A good student from a prosperous family, she got hooked on heroin. After five years, she finally broke the habit in a 12-step program run by a private agency in Gerasimovka. She now runs it.

Ustiuzhanina is also a leading figure in Russia's association for those living with HIV. Like the majority of intravenous drug users who come to Gerasimovka for help, she is HIV-positive.

This young woman says she is a classic member of what's often called Russia's lost generation

"Nine years ago, heroin became really fashionable. We sat in the best hotels, the best restaurants and sniffed it. We knew nothing about the dangers. Eventually, I started shooting up," she says.

She wants to make sure the next generation is not as ignorant as she was. She also hopes this 12-step program can do what the government has not done: provide effective help for addicts.

Dr. Aleksei Salenko, with the Tyumen government narcotics center, says most addicts who go though government rehab programs suffer a relapse because there is not adequate therapy or post-treatment support.

He says nongovernmental groups like Ustiuzhanina's organization Pokoleniye — which means "generation" — are essential, and he believes there need to be many more of them

At the rehab clinic, the day for recovering addicts begins with a race through the Siberian wind to a pump where they are required to douse themselves with freezing water.

After work, study and therapy sessions, the day ends with an intense sweat in the banya — the traditional Russian steam bath. The staff supervising the four-month program includes former addicts who volunteer their time

Denis Prokin, 32, has been hooked on heroin for 15 years. He finally turned to Pokoleniye after hearing about its success rate. Ustiuzhanina says about 50 percent of addicts treated through her program stay drug free — a high rate compared with most programs worldwide.

Every morning, residents at the Pokoleniye program douse themselves with freezing water in an outdoor shower such as this one. Anne Garrels/NPR hide caption

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Anne Garrels/NPR

Every morning, residents at the Pokoleniye program douse themselves with freezing water in an outdoor shower such as this one.

Anne Garrels/NPR

"The government programs I went through just isolate you and pump you full of pills. I didn't learn anything about myself. I got out and immediately started shooting up again. I know a lot more now, and when I finish here, I know where to find support groups," Prokin says.

Heroin from nearby Afghanistan has flooded the country, turning Russia into the world's top consumer.

Russia's leading drug enforcement official, Viktor Ivanov, blames the U.S. for this. He says the military is not doing nearly enough in Afghanistan to eradicate poppy production. He says it is notable that while the U.S. funds aerial eradication programs in South America, where drug production is a direct danger to Americans, Washington seems totally indifferent to Afghanistan's threat to Russia.

"Given the damage by Afghan heroin, we have to call it a weapon of mass destruction, selectively attacking the young, the future of our country," Ivanov says.

The Russian government has largely relied on education and healthy living campaigns to fight drug abuse. There is no government money for needle exchange programs to stem the explosion of drug-related HIV. Private agencies rely on foreign funds for this, but after threats of legal action, Ustiuzhanina is afraid to continue Pokoleniye's needle project.

Methadone, widely used in the West to wean people off heroin, is illegal in Russia, and Ustiuzhanina believes the country is currently ill-prepared to handle methadone correctly.

"I know there are successes with it elsewhere, but Russia is so corrupt, supplies would end up on the streets. And it would be misused by incompetent doctors. However I do think the government should encourage discussion about this. Now, there is none," she says.

According to experts in Russia, heroin use may have peaked, though officials say the number of intravenous drug users — an estimated 2.5 million people, or about 2 percent of Russia's population of 142 million — remains a national security threat.

Prokin, the addict seeking treatment at Pokoleniye, believes heroin is losing its appeal as young people see the effects. But he and others say it's being replaced by a wave of new disco drugs, including methamphetamine and ecstasy, and strong narcotics that are distilled from easily obtained over-the-counter, codeine-based medications.

Undermined by a combination of synthetic drugs, 26-year-old Katya Indrulenas has come thousands of miles from Moscow for treatment in Gerasimovka. She says these new drugs are everywhere, along with pressure to try them.

"My friends still don't understand that club drugs are just as addictive and dangerous," Indrulenas says.

Denis Driagin is at the clinic to deal with serious alcoholism. He managed to kick his heroin habit in part because of social pressure. He says he had become a pariah. So instead he turned to beer and vodka because it was socially acceptable.

Salenko, of the Tyumen narcotics center, says rising alcoholism among young people is even more deadly than drugs in the long run. Russians consume roughly 4.75 gallons of pure alcohol a person annually, more than double the level that the World Health Organization considers a health threat and twice the consumption figure for the U.S.

In addition to its anti-drug campaign, the government is launching yet another anti-alcohol campaign. But Salenko isn't optimistic that the modest measures proposed — such as stiffer penalties for the sale of alcohol to minors and a ban on beer sales at kiosks — will have any effect.

He says the government gets too much income from alcohol sales and that entrenched Russian habits and the alcohol lobby are "formidable adversaries."