Shooting up in the CIS

Russia faces a new cold war - soaring drug use 3 million addicts, many of them youths, caught in a$2b industry

By David Filipov

ST. PETERSBURG - From her seat in the corner of the bar, Kseniya scans the clients, looking for the trick she'll need to score within a few hours if she's to pay for her next hit of heroin. Actually, there is no 'if.' She has to score, so she will.

It's a slow night at the 777 Bar, a dimly lit cellar dive where Kseniya and her teenage friends take a break from the subzero cold. It's a 10-minute walk from the grandeur of the museums and theaters that make St. Petersburg one of the world's cultural capitals. They might as well be on another planet.

'Here, I'm a star,' Kseniya says in her dreamy drawl.

And a statistic. Kseniya is one of an estimated 3 million Russian drug addicts, many of them young people from middle-class families like her own. That figure represents an astonishing leap since the early '90s, when addicts numbered in the thousands. Today, Kseniya is part of an illegal narcotics trade that, according to Russia's Interior Ministry, has burgeoned into a $2 billion annual industry.

The clock is ticking for her. Russian heroin addicts have a four-year life expectancy from the moment they get hooked, according to health officials. That span must be lower for $2-an-hour prostitutes. Not long ago, Kseniya stabbed a man who tried to rape her. By all rights, 20-year-old Kseniya should be dead. But she is savvy. She and her friends know not to call an ambulance when someone overdoses, because the drivers let junkies die. She has seen it happen.

They know how to pull each other back from an overdose. She knows how to shoot up in her groin to keep her arms and legs unmarked. She knows in which dark passageways and abandoned apartments to hide. She knows she has to kick this habit and fly away. 'I wanna go to Ukraine,' Kseniya says, distantly. 'I got a grandmother there. I'm gonna live in the village and milk cows.'

Her attention returns to the bar. There are a couple of stoners gyrating and screaming along with music by Courtney Love: 'Go on, take everything, take everything.' There is her 18-year-old brother, Igor, who got her hooked on heroin last year and steals from their mother to pay for his habit. There is Igor's businessman friend. And the big cop playing the slot machine, within eavesdropping range.

'`Menty' are such idiots,' says Kseniya, using the Russian slang for cops. She knows him. She knows all the cops, prostitutes, and drug dealers who work this neighborhood. Sometimes the police sell her heroin they have just shaken down from addict on the street. Sometimes they help find her clients to help pay for her habit. Sometimes they make her give them for free what she sells. Recently one fined her 10 rubles, the equivalent of 50 cents, for using profane language.

'Can you believe that? Ten rubles for calling a ment a jackass,' Kseniya says, her voice rising as the music stops. The cop looks over. Time to leave.

'We are barely holding it back'

In a basement not far away, Misha huddles in his coat against the chill. His 'office' - a small underground dugout with cracked wallpaper - is beneath the Maltsev Market, center of the local drug trade. Misha, who asked that his real name not be used, is an undercover police officer, part of a special task force St. Petersburg police have set up to fight the drug trade. Misha sneers at the word 'fight.' He says, 'We are barely holding it back.'

Last year, the big drug was an opium brew called 'poppy straw.' Then Russia's economy collapsed, and, coincidentally, the heroin supply from Central Asia exploded. Crime groups based in Tajikistan bring the heroin here, where a local gang handles sales at the market. The street price of a 'check,' a small foil wrapper half the size of a stick of gum, fell from over $6 to 80 cents. Misha displays a check. Dealers can conceal it easily and get rid of it fast. Users can swallow it. Unlike poppy straw, which needs to be cooked, heroin is easy to use.

Misha has no idea how many addicts roam the market, but he knows there are a lot. 'They're usually teenagers. They come from good families, but they have nothing to do,' he said. 'They hit the streets, someone in a group tries it. Then they all try it, then you have a group of new addicts. It's a terrible situation.'

Russia has enlisted pop celebrities for an American-style public relations campaign that includes television ads and talk shows dedicated to the horrors of drug addiction. But Russia's financially strapped health-care system has no money for serious rehabilitation programs.

A tough anti-drug law passed last year gives police the right to stop and search people who look as if they are using drugs. According to government figures, more than 250,000 people were arrested in 1998 on drug charges, up from 185,000 the year before.

This law has earned the wrath of human rights activists, who say it targets users rather than dealers and does not get to the root of the problem. Misha agrees. 'Kids do drugs even though they know they're going to jail,' he says. 'We have dealers who get out and go right back to work. As long as there's demand, we won't stop this. This is a problem with our society. Young people's lives have no structure, no reason to believe, no ideals.'

One teenager, 17-year-old Igor, remembers when he got hooked. It was in the fourth grade, and the substance was glue. 'Since then I've guzzled gasoline, eaten mushrooms, swallowed speed, gulped Valium, smoked hashish, shot poppy straw, and now heroin,' Igor says in a raspy monotone at a nameless cafe near the Maltsev Market. Today, he sells checks and shoots up, often 20 times a day.

Igor walks to the Maltsev Market, a short walk from Nevsky Prospekt, the elegant thoroughfare laid out by Peter the Great. Business is brisk. A man with alert eyes and a purposeful gait, known here as 'Squash,' darts over to a vegetable vendor and touches his hand. Squash, a balding man of about 35 in a dark leather jacket, strides to the entrance of the market, where a throng of teenagers waits in watch caps and parkas. Most are pale with dark circles under their eyes.

Squash walks up to one youth, passes on the tiny check, and moves on. No money changes hands. That is done elsewhere, when there are no drugs around. In a minute, Squash has hit them all. Then two muscular security guards with 'Special Forces' stitched into their camouflage jackets chase the kids away. 'We keep this place clean of unwanted elements,' one of them says, winking.

The police - the ones who are trying to stop it - know all about this system. 'Misha' knows that he could never get close enough to Squash to make an arrest in the few moments he actually carries the heroin. The dealers have too many lookouts who can identify Misha. And there are so many Squashes. 'We arrest a drug dealer, and there are 20 in line to take his place,' says Misha.

The number of cases of HIV doubled in 1998 to 10,483, Vadim Pokrovsky, head of the Russian Center for AIDS Prevention, told the Interfax news agency this week. Russia's health minister, Vladimir Starodubov, said last fall that 90 percent of the country's new cases of HIV were needle users.

Over the protest of some residents, St. Petersburg Governor Vladimir Yakovlev has supported a program that distributes clean needles to drug users to prevent the spread of disease. 'Some people are against us'

A block away from the Maltsev Market, psychologist Olga Timofeyeva hands out needles and does blood tests in a freezing bus. She has registered 7,000 drug users, about seven people each day. 'Most of the kids tell me, `If I had something to do, I wouldn't have started taken drugs,'' says Timofyeva, 29. 'A lot of them come from well-off families. Often, when they come on the bus, you can't tell they are addicts ...'

Her voice trails off. Timofeyeva's coworkers nervously check to see that her visitors are not carrying drugs. Some local police have tried to close the bus down, saying it is a den of drug users. 'Some people are against us,' Timofeyeva says. A short walk away, Kseniya and her friends are back on the street, stomping their feet in the cold.

The Times (UK), February 27 1999

Brain surgeon cuts away heroin slavery

By Anna Blundy

The famous St Petersburg brain surgeon, Svyatoslav Medvedev, has found a cure for drug addiction and claims a 70 to 80 per cent success rate. However, the process involves inserting a needle into the brain and removing what Dr Medvedev believes to be the offending tissue.

Dr Medvedev says the success of his technique lies in the fact that his operation treats the addict's psychological addiction while other methods concentrate first and foremost on the physical side of the illness. Of the hundred or so heroin addicts who have undergone Dr Medvedev's revolutionary procedure over the past two years, most have found themselves suddenly free from a compulsion that had thus far blighted their lives.

"This is not a new operation," says Dr Medvedev of the St Petersburg Institute for the Human Brain. "The procedure has been commonplace for more than 30 years. It is just that we have renamed the disease." The operation, according to Dr Medvedev, has long been performed worldwide to treat various obsessive-compulsive disorders and particularly phantom pain syndrome, through which Dr Medvedev drew the inspiration for his addiction cure. Many sufferers of phantom pain syndrome endured such agony in their absent limb that they had become morphine addicts in their efforts to relieve their symptoms.

After he had introduced a thin needle into the brain of these patients with the use of only a local anaesthetic, the sufferers found that, not only had their phantom pain disappeared, but their morphine addiction had been alleviated as well. This phenomenon provided Dr Medvedev with the idea for his cure. "You see, addiction is a kind of obsession and this process does not change any part of the personality. We know how to reach the structures we need to eliminate without damaging any other parts of the brain," he says.

Dr Medvedev is from a long line of physicians. His great- great-grandfather, doctor to both Lenin and Stalin, disappeared without trace in 1927, and his mother, Natalya Bekhtireva, is a revered neuro- physiologist.

Dr Medvedev does not believe that his technique will ever become widespread, for although he thinks it could be used to treat addiction to gambling, over-eating or alcohol, he does not believe it should be. "Of course, any interventive surgery is dangerous. In Czechoslovakia in the 1950s two surgeons were given licence to perform this type of surgery on dangerous criminals and psychopaths. Although the technique was successful, there was obviously a grave moral question.

"This surgery is a last resort for my addicts. Heroin can kill you in four years. My patients have almost no functioning liver and they all suffer from hepatitis B and C. The operation is a matter of life and death." Dr Medvedev emphasises that, although he has discovered a cure for addiction, he believes it should only be used in extreme cases. "We are not treating heroin dependency. We are treating imminent death," he says.

Despite the obvious advantages of the treatment, there are still those who pour scorn on his institute. Aleksandr Andrianov, head of the Association for the Fight Against Drug Addiction and the Drug Business, says: "If you want to cut off a corn, there is no reason to remove your whole leg. The Ministry of Health has certainly not given its permission for this kind of operation to be performed."

But Russia, which has been flooded with heroin since the collapse of the Soviet Union - 390kg (about 858lb) of the drug and 893kg (1964lb) of unprocessed opium were seized en route to Russia from Turkmenistan alone in 1998 - is in dire need of a cure of some kind.

A report published last year by London's International Institute for Strategic Studies said: "A very real danger exists that one or more of the Central Asian states will become 'narcocracies' similar to Burma and Colombia." It added that Kyrgyzstan alone was exporting more narcotics by 1995 than Burma or Thailand.

Yevgeni Tolkachev, of Moscow's 17th Narcological Hospital, barely has room for his 500 patients who stay about 21 days each. All of them are heroin addicts and he admits that his recidivists are many.

It is hospitals like this that might benefit if Dr Medvedev's methods were to become more widely used. Although he believes in his treatment programme of anti-psychotics coupled with psychiatric help, he thinks it is hard for the users, who are getting progressively younger, to extricate themselves from a drug-using lifestyle.

With heroin currently priced at 600 roubles (ú20) a gram, this can be a difficult lifestyle to maintain.

"None of them work. The boys steal and the women often sell themselves," he says. Although many methods of treatment have been tried in Russia, including a recent effort on the part of Aleksei Suvernev, a Siberian doctor, to heat patients' bodies to the point of hyperthermia in the belief that this removes the physical dependence on drugs, Mr Andrianov believes that addicts should be left to die.

"If they want to stop, they will. There is nothing you can do to help them. There are 1,000 hospital places for addicts in Moscow and there's never a free bed. We don't have the right to refuse them, but they always start again."

Jan 11, 1998 From Reuters via Johnson's Russia List

FEATURE - Ex-Soviet nuclear base home to drug addicts

By Pavel Polityuk

KHMELNITSKY, Ukraine, - Drug addicts tending pigs and chickens at a top secret Soviet nuclear missile base -- the very idea would have had Cold War generals packing their bags for Siberia. Yet that pastoral scene has become a reality at the former base of the Red Army's Fifth Strategic Missile Regiment, hidden away among the hills and barren fields of western Ukraine.

Soviet troops pulled out from Khmelnitsky after the Union collapsed in 1991. Now only a crumbling concrete obelisk screaming 'Glory to the Soviet Strategic Missile Forces!' stands as a reminder that here nuclear apocalypse was once just the touch of a button away. A nearby silo housing one of 176 intercontinental ballistic missiles originally stationed in Ukraine was blown up early last year in line with the U.S.-Soviet START arms reduction treaty. Ukraine has handed over all its rockets to Russia.

But despite the Soviet military retreat, well-worn khaki uniforms are still much in evidence at Khmelnitsky. They are regulation issue for the 15 or so hardened drug addicts undergoing a rehabilitation course at the base. And like the soldiers who once paced their lives to the shrill sirens of nuclear alerts, they perform their daily chores at a rhythm set by a gong hammered by the three men in charge, the 'masters,' who are themselves reformed addicts.

DISCIPLINE SEEN AS WAY TO NEW LIFE

'Our method is a combination of work therapy and psychological correction,' said Anatoly Fedoruk, 35, one of the masters who spent 18 years of his 'former' life on drugs. He believes that the rigorous order established on the former base and daily labour can heal the addicts. 'The effect of labour is such that a person changes and starts thinking in a new way,' he said. 'Our patients just have no time to think about narcotics.'

In line with a programme designed by the Khmelnitsky regional authorities in January last year in an attempt to save the lives of at least some of the thousands of locally registered drug addicts, a group of enthusiasts was allowed to open the rehabilitation centre. They called it 'Viktoria.'

Strict discipline reigns. All patients must sign a pledge to abstain from drugs, alcohol and sex, to be honest and not to leave the territory of the base. As in the army, orders are orders, insubordination is never discussed and the lonely base, 20 km (12 miles) from the nearest village, seems an ideal location for the camp.

Every morning, each patient is given work orders for the day. Daily chores range from tending pigs and chickens at a former military storehouse to repairing barracks left in a mess after the last Soviet soldiers retreated a few years ago. Despite hard work, tough discipline and sordid living conditions, the inmates seem satisfied with their life.

'Only by going through a centre like this can you become human again,' said 30-year-old Natasha, who once ran a bookshop. Viktoria is her third attempt at quitting drugs. 'We are taught everything here. This is the place to get rid of our dependence.'

MORE REHABILITATION CENTRES PLANNED

Larisa Vysotska, director of the centre, said around 1,500 drug addicts are officially registered in the Khmelnitsky region, while the number of those not reflected in official statistics may be 10 times higher. There are no official statistics for Ukraine as a whole, where the 50 million population includes a growing army of desperate young people seeking refuge from hardship in drugs.

Vysotska said centres similar to Viktoria would be opened in several other western regions, as well as in the capital Kiev, in Odessa on the Black Sea and in Donetsk region in the east. But she said the planned new centres were unlikely to be able to cope with the growing ranks of drug addicts. 'We understand we cannot help everyone. But if we only save a few lives, our efforts won't be wasted,' she said.

Vysotska said she had managed to save her own son, who used to take drugs, through a similar centre in neighbouring Poland. Fedoruk said that turning former addicts into educators was a key to success. 'A lot of people think a junkie can't quit. But we prove here that this is possible, that drug addicts can be the same as every other human being,' he said.

Natasha, who also carries the HIV virus which leads to AIDS as a result of sharing an infected needle, has been at the centre for 10 months and her term will be end in two. She would like to help the others to escape addiction when her own treatment is over.

'Drug addiction is a horrible disease, incurable for many, but I want to help people to break free of that nightmare,' she said. 'I would like to become an educator, a master. I was given help, and now I would like to help the others.'