In January, it was reported that around 100 drug abuse patients in the formerly Ukrainian peninsula of Crimea had died because the substitution treatment they had been undergoing was now illegal under newly placed Russian laws. This is only a small percentage of the estimated 800 drug users in Crimea who were undergoing the treatment.
There are some activists who believe the number of patients who died under new drug treatment laws could be even higher.
Substitution treatment is a program that allows those who are addicted to heroin or any other form of opiates to instead take methadone or Buprenorphine as a safer, more gradual way to conquer an addiction. Using these drugs also keeps a patient from injecting opiates, thus drastically lowering their risk of contracting infections or spreading the HIV virus.
This approach to drug treatment had the effect of decriminalizing drug use, making it a bit easier for drug addicts to lead normal lives while still receiving treatment. Substitute treatment programs are widespread and legal in many countries.
It became an option for opiate addiction treatment in the Ukraine in 2005, with around 8,700 patients in the Ukraine and Crimea reported on the treatment plan in 2014.
After Russia annexed the peninsula in the Spring of 2014, the practice of treating drug addiction with substitution therapy was immediately halted despite the fact that other Crimean laws were allowed to gradually be phased out. This type of therapy is illegal under Russian law, where a much different approach to treating drug addiction is used instead.
Addicts are required to quit cold turkey and undergo medical detoxes that often put their health and lives in danger. Russian authorities quickly began shutting down the substitution therapy programs all across Crimea.
Many patients who were undergoing therapy in Crimea fled the peninsula for nearby Ukraine, where the therapy was still legal. Other patients were not able to leave their homes or families or were otherwise too afraid to make the journey.
Many of the patients who stayed behind in Crimea died in the Russian detox centers or returned to using heroin and other opiates.
Substitution therapy is recognized by several international health organizations as an effective way to treat opiate addiction. An abrupt halt in treatment, like the one imposed on patients in Crimea, causes an individual to shift from living a relatively stable life, to return to being physically and emotionally dependent on drugs.
The head of Russia's drug control agency says that there is no proof that substitution therapy works and that the therapy had even caused a number of deaths among patients. The Russians' view of therapy has remained steadfast, even in the face of protests from activists and health experts.
There is no way of telling whether the estimate of deaths due to the abrupt halt of substitution treatment by the Russians is even accurate. The information was released by Russian sources who are likely trying to downplay the situation.
East of the Ukraine, pro Russian rebels control several areas where there are even more patients who are at risk of losing their access to therapy. In those regions, there are an estimated 550 patients currently undergoing the treatment.
Ukrainian activists are working hard to ensure people there can still get access to the methadone they need so that what happened in Crimea will not happen again.