Update
on
Drug
and
Harm
Reduction
Policies
in
Central
and
Eastern
Europe
and
the
Newly
Independent
States
4/10/98
- Jean Paul Grund for DRCNet These are interesting times for drug policy in Central and Eastern Europe (CEE) and the Newly Independent States (NIS). In the Russian federation, rather draconian drug laws have recently been passed which will turn providers of needle exchange or substitution treatment into criminals -- even discussing safer drug use practices with an injection drug user could be construed as "inciting to use drugs" under the new law -- and have disastrous consequences for the prevention of AIDS and Hepatitis C. Meanwhile, we are witnessing the dawn of an explosive HIV epidemic in Russia, which will make the epidemic in the U.S. look futile. On the other hand, countries like Poland, Hungary, and Lithuania seem bound on a more pragmatic path. All three countries recently introduced legislation which allows for (increasing) substitution treatment with methadone, and, in Lithuania, other opioid agonists. In the Czech Republic and Slovakia, methadone treatment was introduced in 1997. This treatment is also available in Croatia, Slovenia, Macedonia, Latvia and Estonia. While Poland recently criminalized possession of drugs, it exempted small quantities for personal use. In the Ukraine, which is confronted with an immense injection-related HIV epidemic, the Deputy Minister of Justice recently signed a statement that harm reduction interventions are not in contradiction with the national legislation of the country. The latest decision of President Vaclav Havel to veto the law banning possession of drugs for personal use, citing human rights concerns, is definitively a victory for common sense and pragmatic drug policy. This is a very promising action, especially when taken by a revered man such as Havel, but it does not come totally out of the blue. While the prohibitionist forces are definitively part of the policy spectrum in the Czech Republic, it seems that at present drug policy is made by people with pragmatic and harm reduction oriented attitudes. Pavel Bem, for example, the chairman of the national drug commission (the Czech drug czar), is a young psychiatrist and a very sophisticated thinker. Likewise, drug services in Prague are increasingly working with harm reduction models and cannabis use seems to be tolerated and not a reason for major concern. During my recent visit to the Czech Republic I witnessed rather open use of this drug in several music clubs. In my view the drug policy situation in the Czech Republic resembles the situation in the Netherlands in the 1980s. Perhaps the country can become an example for sensible and pragmatic drug policy for the whole CEE region. I don't know what it's worth as an indicator, but until now, there is hardly any injecting related HIV reported in the Czech republic. (Jean-Paul C. Grund, Ph.D. is Director of International Harm Reduction Development for the Lindesmith Center, a project of the Open Society Institute. You can find them on the web at http://www.lindesmith.org.)
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