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National Institute for Health Development specialist: stop punishing sufferers of drug addictions

Though unpopular with residents, the new needle exchange in Sitsi Street would make the area safer, ministry officials said.
Though unpopular with residents, the new needle exchange in Sitsi Street would make the area safer, ministry officials said.

Aljona Kurbatova, specialist at the National Institute for Health Development (NIHD), stated that the number of people suffering from drug addiction remains relatively high in Estonia, which is why, in her opinion, society as a whole needs to increase its awareness of the issue—not by punishing these people, but rather creating opportunities to help limit the damage caused by, and eventually beat, their addictions.

Annual statistics show that the number of people suffering from drug addiction has not decreased significantly. Speaking on ETV’s morning broadcast “Terevisioon”, NIHD specialist Aljona Kurbatova stated that the situation has remained at a stable level.

“We still have a large number of injecting drug addicts,” Kurbatova explained. “The number of deaths by drug overdose remains high as well, although this number has gone down a bit over the past couple of years as we employ new methods [to combat this]. But if we compare Estonia to other countries, then we are still leagues ahead of them.”

The drug problems in Estonia had begun to develop in the 1990s already, however in Kurbatova’s opinion, not enough effort was made in dealing with addiction at the time; it was simply regarded as being Ida-Virumaa’s problem. In her opinion, Estonia had the opportunity to learn something from its neighbors and acknowledge that doing nothing in response to the spread of drug addiction would not result in anything positive. “We slept on this issue for too long,” Kurbatova admitted. “We dropped the ball on this one.”

“When we first started out," she continued, "Then [the NIHD] did not initially do the most effective work, but we got at least some things right, and we continue to do things right, just not enough to really make a difference.”

The key to success lies in limiting damage as well

In Kurbatova’s opinion, it is difficult to say based on statistics alone which countries have done a better job handling their respective drug problems because each country collects different data. “But if we look at countries that have had similar problems, we can highlight Switzerland, where just a few decades ago they had entire city districts where people were people were injecting drugs publicly,” she said.

In her opinion, in implementing a bold drug policy, Switzerland was able to solve the problem rather effectively, and, in doing so, acknowledged methods of damage control as well. “Their intention was not to get people to stop using, but rather to get people to go about it in a safer manner,” the health promoter explained.

In Switzerland, injecting drug users were given a safe environment in which to administer the drugs, and reuse of needles was restricted as well. “They were given a clean and tidy room [in which to take the drugs], and if anything happened to them, they were able to call for help,” she added.

Society must acknowledge the problem

The Swiss model, however, requires societal acknowledgement of its problems with drug addiction as well as commitment to helping the drug addicts themselves. “In addition to the fact that we should be motivating them to overcome their problems, we should begin with giving up punishing them,” the NIHD specialist explained.

According to Kurbatova, not one successful country has seen proof that punishing drug use helps alleviate the core problem. “That just makes the situation even more complicated for them,” she explained. “The social challenges they face get increasingly worse, and we actually end up causing more problems for ourselves as a result. If we provide people with opportunities for medical help and solutions for overcoming social challenges, and if we then see that that is not enough, we should be providing them with an extra boost of motivation.”

Kurbatova added that there is no one universal solution for all problems involving drugs, rather, that different combinations of opportunities must be created for each different target group. “Of course there is preventive work to be done as well—work with those that do not yet use,” said Kurbatova. “That certainly cannot be forgotten, as choices often tend to be made between preventive and treatment services—honestly, we are sometimes faced with that decision, as we are unable to do everything—but there should be a balance between prevention and treatment, and the two should go hand in hand.”

Editor: Editor: Aili Sarapik

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