Press conference of Yuri Fedotov and Viktor Ivanov
54th Commission on Narcotic Drugs 22 March 2011
There are still countries that do not use the full range of demand-reduction programs,
And ... I would like to ask,
is there any way that UNODC can promote,
for example, substitution treatment,
in those countries where these programs are not implemented?
That is an issue which needs to be treated professionally,
based on scientific and medical analysis,
and should not be politicized.
Only in this way can we achieve some objective.
And in cases, as you mentioned,
when in some countries, they are not
in a position to provide adequate treatment
to people who are addicted to different kinds of drugs,
of course our role, as UNODC, is to develop the programs
which would help them to develop their own skills,
to develop their own national capacities,
but the ownership remains with the member state,
that is a crucial point.
Would you expect something more from Mr. Fedatov
as the new head of UNODC and as a Russian,
to support or to promote substitution treatment in Russia especially?
Well I think that puts Mr. Fedatov in a really difficult position
because for any of the heads of these agencies to single out particular countries
is very difficult,
but there are ways to deal with this, I mean ... you can point to the region
as one of the palces where the HIV epidemic is still growing,
and is growing in relation to UNODC's mandate:
which is injecting drug use.
In that way it has to be dealt with,
In that way he can stand alongside Michel Sidibe, the head of UNAIDS,
he can stand alongside the heads of other UN agencies.
and just be very very clear,
that this is not something that should be optional
for member states, this is something that HAS to be done
as an obligation
if we're going to really meet the millenium development goals,
if we're going to really begin to halt and reverse the spread of HIV.
There's no getting around that.
It has to be said forcefully and it has to be said directly.
Some experts say that actually, it would be also more effective
to lay more emphasis on treating the demand-side in Russia
and introduce new methods to
treat the demand-side,
for example, opiate substitution programs.
In this context of course substitution comes to mind
how we substitute opiates for other substances
some people refer to methadone,
Of course we are studying this experience
and we studied the experience in the United States,
We can conclude that there are no clinical trials
to prove the effectiveness of this method.
It's fantasy! It's sheer fantasy,
if not outright mendacity.
There's no drug treatment protocol
that's been better studied than methodone maintenance treatment.
And it's consistently, not only performed well in its own terms,
but in comparison with other forms of drug treatment,
it generally performs better.
So, the notion that the United States is abondoning methadone,
or doesn't support methadone,
or is finding that methodone doesn't work is just ludicrous.
You cannot go to a US government drug-related website
and not find POSITIVE mentions of methadone.
You will find the links to the studies.
So I suggest taht Mr. Ivanov go to the Cochrane Collaboration
and read what they've written about methadone.
Or that they go to the NIDA webpage in the US,
or even to the Office of National Drug Control Policy in the US,
all of which are firmly in favor of methadone.
In fact, the only critical problem we have with methodone in the United States
which is acknowledged by all these organizations, is that we don't have enough.
The problem is that drug users are not lining up
and are not in a hurry to get treatment.
Yes, drug users are not staying in line
for the government treatment programs and rehabilitation programs,
but maybe the question must be why they are not doing this?
Maybe they are not
in favor of such programs and they need again something else.
There must be other opportunites for them,
for example, substitution therapy,
Russia is not using the most effective medications
or the most effective approach to
dealing with their drug problems
Now, UNODC is kind of a repository of
good science, it collects information from around the world,
it promotes best practice.
UNODC should be promoting best practice!
And this is best practice, they should be promoting it to Russia!
Obviously, they can't dictate what a country does
in its national programming to address drug problems,
it cannot dictate that!
But it can certainly use it's influence
and knowledge to suggest,
"Yes, you should be doing this"
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Transcribed and Subtitled by Hunter Holliman