Russia and its neighbors should lift their ban on using opiates such as methadone to treat addicts who inject drugs, scientists at an international AIDS conference said on Monday.
“Methadone is essentially an AIDS prevention tool,” said professor Chris Beyrer, founding director of the Center for Public Health and Human Rights at Johns Hopkins University in Baltimore.
Beyrer praised Russia for scrapping, starting this year, a measure barring drug users from participating in free AIDS treatment programs.
“This thrills us a lot. But they are still opposed to methadone use, which remains illegal there. They need to get as many people as possible off the needles,” said Beyrer, calling the ban a legacy of the Soviet system.
Methadone is taken orally, avoiding the use of needles that can spread AIDS. This substitution therapy can help satisfy addicts’ cravings while allowing them to function normally.
The World Health Organization recently recommended that the treatment be integrated into national HIV/AIDS programs.
Another scientist at the Rio de Janeiro conference said Russia agreed to treat drug users with AIDS only because it was a condition attached to millions of dollars in foreign aid.
Others said AIDS screening figures from the region, with the exception of those from Ukraine, were not very reliable.
Ukraine, which tops ex-Soviet states in HIV incidence, with 1.4 percent of the adult population infected, has a fledgling substitution therapy program. But it recently upset anti-AIDS groups with a proposal to ban methadone.
Researchers say actual rates in other former Soviet countries could be higher. In Russia, the rate is more than 1 percent.
“It’s a relatively recent epidemic but it’s fast-growing. It is just getting going,” Beyrer said.
Such fast-growing epidemics have never been seen in countries with declining populations, he added. Belarus, Ukraine, Russia and Kazakhstan are all losing people.
“So the implications may be more severe as the disease infects mainly young people and there is already a shortage of the…All this is due to a rising tide of heroin,” Beyrer said.
On a positive note, there was evidence that condom use is becoming the norm in Russia, at least among prostitutes, he added.
Revision date: July 3, 2011
Last revised: by Jorge P. Ribeiro, MD