RUSSIA: Land of Opportunity! (NEW: Nov 15'04)
By Robert Newman, MD

“Every opportunity implies an obligation.” John D. Rockefeller, Jr. 1941

Just a few weeks ago the head of the Russian Federal Drug Control Office estimated the number of addicts in this country at approximately 4 million. And yet, I consider the drug problem in Russia an extraordinary opportunity, one that very few nations or generations are privileged to experience. But first, the bad news:

1)Despite decades of intensive research and some major scientific breakthroughs, we do not know what causes addiction! It is likely that the etiology is complex, and involves both genetic and environmental factors. But just what these factors are, how they interact, and why they cause some people who experiment with opiates to become addicted but not others – these critically important questions remain unanswered.

2)In addition to not knowing what causes addiction, we also have no idea how to “cure” it.

Precisely the same “bad news” applies to virtually all chronic illnesses. Why do some people develop dementia in their 50s, while others retain their mental faculties until they are over 100? Why do some athletes in the prime of their youth and in the most superb physical condition die of heart attacks – like Arthur Ashe, one of the most famous and successful tennis players the world has ever known, while Winston Churchill ate and drank to great excess and smoked like a chimney, and had more stress than most of us can even imagine – and yet lived in apparently excellent health well into his 80s? No one knows – just as no one knows who will become an addict, and why. As for “cure,” by definition it does not exist for any of the chronic diseases.

So why do I describe addiction in Russia as a “good news story,” and as an extraordinary opportunity? For this reason: although addiction is incurable, it can be treated with very great effectiveness! Those whose every waking minute has been plagued for years by the all-consuming, destructive, compulsion to use drugs can be restored to healthy, productive, self-fulfilling lives. As to the nature of the treatment that holds such potential, more good news! There is not just one form of promising therapy available, but many; some utilize medications, some counseling, some acupuncture, etc. I am sincere in my support for any and all methods of treatment that offer help and hope to those in need. And yet, the fact is that without opiate agonist treatment(such as with methadone or buprenorphine), only a very tiny minority of opiate dependent individuals will be given access to care; the vast majority will be abandoned to their fate!

And what is required to make treatment available to all who want it and need it? Remarkably little, and that is the best news of all! Around the world, for over 30 years, we have seen massive, rapid expansion, to the point that tens of thousands could be accommodated almost from one year to the next. From this extensive experience we know there are no insurmountable barriers to making treatment available to all who are willing to accept it. Money is not a limiting factor; facilities are not a limiting factor; professional staff resources are not a limiting factor. There is only one prerequisite: commitment, and a willingness to act!

I urge you to seize the opportunity now to save lives, lessen suffering, and reduce the pain and costs that are borne by every citizen of this great country. Not to do so would be irresponsible; it would be a crime; it would be murder!

Sources:
1-Quoted in John Bartlett (Ed.), Familiar Quotations, 15th Edition
2-http://en.rian.ru/rian/index.cfm?prd_id=160&msg_id=4895278&startrow=11&date=2004-09-24&do_alert=0






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