RENEE MONTAGNE, host:
Russia is known for its heavy drinkers with vodka, mostly, contributing to a traditionally high rate of alcoholism. Heroin is a relatively new addiction. Heroin first exploded in the 1990s when the country was in turmoil and uniquely unprepared to cope with the problem. Now, Russia is one of the world's top consumers of the drug and it's affected an entire generation of young people.
NPR's Anne Garrels has this report from western Siberia.
ANNE GARRELS: The scene: A ramshackle house in a largely abandoned village, a good hour from Tyumen, the nearest city. It's an iffy trip by dirt roads covered with a layer of slick ice. Petite 30-year-old, Natasha Ustiuzhanina, sits at the head of the dinner table. The other five people at the meal look to her for inspiration.
Ms. NATASHA USTIUZHANINA: (Russian spoken)
GARRELS: Natasha's been through it all. A good student from a well-off family, she got hooked on heroin. After five years, she finally broke the habit here in the village of Gerasimovka, home to a non-governmental 12-step program. She now runs it.
She's also a leading figure in Russia's association for those living with HIV. Like the majority of intravenous drug users who come here for help, she's HIV-positive.
This beautiful young woman says she's a classic member of what's often called Russia's lost generation
Ms. USTIUZHANINA: (Through translator) Nine years ago, heroin became fashionable, 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.
GARRELS: 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 who go though government rehab programs suffer a relapse because there's not adequate therapy or post-treatment support.
Dr. ALEKSEI SALENKO (Tyumen Government Narcotics Center): (Russian spoken)
GARRELS: He says NGOs, like Pokoleniye, Natasha's organization, are essential, and he believes there need to be many more of them
The day begins with a race through the Siberian wind to a pump where recovering addicts are required to douse themselves with freezing water.
(Soundbite of screaming)
GARRELS: 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 are all former addicts who volunteer their time
Thirty-two-year-old Denis Prokin, who's been hooked on heroin for 15 years, finally turned to Pokoleniye after learning about its success rate.
Mr. DENIS PROKIN: (Through translator) The government programs I went through just isolate you, 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
GARRELS: 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's notable that while the U.S. funds aerial eradication programs in South America, where drug production is direct danger to Americans, Washington seems totally indifferent to Afghanistan's threat to Russia.
Mr. VIKTOR IVANOV: (Through translator) 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.
GARRELS: The Russian government has largely relied on education and healthy living campaigns to fight drug abuse. There's no government money for needle exchange programs to stem the explosion of drug-related HIV. NGOs rely on foreign funds for that, but after threats of legal action, Natasha's afraid to continue the needle project.
Methadone, widely used in the West to wean people off heroin, is illegal, and Natasha believes Russia is currently ill-prepared to handle methadone correctly.
Ms. USTIUZHANINA: (Through translator) 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's none.
GARRELS: According to experts here, heroin use may have peaked, though officials say the number of intravenous drug users - an estimated 2.5 million people - remains a national security threat. The rate of drug-related deaths -80 a day - is among the world's highest.
Mr. PROKIN: (Russian spoken)
GARRELS: Addict Denis Prokin 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, and users are also able to distill easily obtained over-the-counter medications into strong narcotics.
Undermined by a combination of synthetic drugs, 26-year-old Katya Indrulenas has come thousands of miles from Moscow for treatment in remote Gerasimovka. She says these new drugs are everywhere, along with pressure to try them.
Ms. KATYA INDRULENAS: (Through translator) My friends still don't understand that club drugs are just as addictive and dangerous.
Mr. DENIS DRIAGIN: (Russian spoken)
GARRELS: Denis Driagin is here to deal with serious alcoholism. He managed to kick his heroin habit, in part because of social pressure. He says he'd become a pariah. So, instead he turned to beer and vodka because it was socially acceptable.
Dr. Salenko, at the Tyumen narcotics center, says rising alcoholism among young people is even more deadly in the long run than drugs. 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. This is not something Russia can blame on Washington.
In addition to its anti-drug campaign, the government is launching yet another anti-alcohol campaign. But Dr. Salenko isn't optimistic the modest measures proposed will have any effect.
Dr. SALENKO: (Russian spoken)
GARRELS: He says the government gets way too much income from alcohol sales. He calls entrenched Russian attitudes and the strong alcohol lobby formidable adversaries.
Anne Garrels, NPR News.
(Soundbite of music)
MONTAGNE: This is NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.