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Could European Court of Human Rights Overturn Russia’s Ban on Drugs to Treat Heroin Dependence?

A recent decision in the European Court of Human Rights (ECHR) could have significant implications for an upcoming challenge against Russia’s ban on opioid substitution therapy (OST).

In ruling issued earlier this month, the ECHR deemed that Germany’s obstruction of OST to Wolfgang Wenner, a man with a history of opioid dependence dating back to 1973, violated Article 3 of the European Convention on Human Rights (CHR): “No one shall be subjected to torture or to inhuman or degrading treatment or punishment”.

Over two decades ago Wenner was first prescribed levomethadone, a synthetic opioid analgesic used in OST to reduce the risk of overdose and contracting blood-borne viruses, and to bring stability to the individual’s life. Despite being engaged in OST for 17 years, Wenner’s prescription was suddenly halted in 2008 when he was arrested and subsequently imprisoned. Germany’s court system struck down numerous appeals to have his OST reinstated.

The ECHR stated in its ruling that “the refusal to provide [Wenner] continuously with drug substitution treatment, despite his manifest opioid addiction, caused him considerable and continuous mental suffering for a long time.”

This recent ruling sets an interesting precedent for a similar case being brought to the ECHR, whereby three Russian plaintiffs are challenging Russia’s long-standing ban of OST.

Alexey Kurmanayevskiy, Irina Abdyusheva Teplinskaya, and Ivan Anoshkin have all long-experienced opioid dependence, and are living with both HIV and Hepatitis C. The three activists state that Russia’s approach to drug dependence  – in which “all treatment […] is abstinence oriented” – is insufficient, and argue that the government’s prohibition of OST violates Articles 3, 8 (right to respect for private and family life) and 14 (prohibition of discrimination) of the CHR.

Among the 47 countries that comprise the Council of Europe, Russia is the only state to prohibit OST.

In Russia, the rate of HIV infection has skyrocketed in recent years, with over 1 per cent of the country's population currently testing positive for the virus. The number of people infected is expected to double by 2020. According to Vadim Pokrovsky, the head of the Russian Federal AIDS Centre, more than 55 per cent of people with HIV acquired it through drug use.

OST, which usually entails patients orally administering their prescribed medicines, rather than injecting them, is recognised by the World Health Organisation as an effective response to HIV transmission. There is no doubt that the Russian government’s OST ban is fuelling the HIV rate.

The ECHR has acknowledged the potential for OST in this regard; during the Wenner case, it stated that OST helps “prevent the spread of infectious diseases such as HIV and hepatitis C”.

Although the Wenner case indicated the Court’s sympathy for people who need OST, the success of the Russian case is not guaranteed and it is important to note a key difference between the two cases.

The Wenner case, though important, was focussed on prisoners’ access to medication that they depend upon. The Russian case, however, is positing that OST access must be viewed as an essential right for people who use drugs. If successful, the case could not only force the Russian government to provide OST, but also lead to other European countries improving their own provisions.

Mikhail Golichenko, the lawyer representing the three activists, is positive about the eventual outcome.

“I expect that the Court will find the Russian government in violation of Article 8, Article 14 and possibly Article 3 [of the Convention] for putting OST under the blanket legal ban”, he told TalkingDrugs.

Repealing the Russian ban on OST would not only reduce the suffering that people with opioid dependence endure, it could significantly combat the worrying spread of HIV among people who use drugs.

The case – for which pre-trial duties have been completed, and plaintiffs are awaiting the hearing date – has the potential to change millions of lives for the better.

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