St. Petersburg addicts offered Finnish-style rehab

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By Lasse Kerkelä
     
      Cocaine for breakfast, heroin for lunch, and methadone for dinner.
      Svetlana Savchenko, age 27, smiles and giggles often in her small room in the St. Petersburg district of Krasnogvardeisk when she recalls the past eight years.
      If body language were all one had to rely on, it would be hard to imagine how difficult an issue this fashionably-dressed woman is talking about.
     
Krasnogvardeisk is the part of St. Petersburg that is visible from the Hotel Moskva, which is familiar to many Finns, on the far side of the River Neva.
      However, few foreign visitors have observed the life of the city's most drug-infested and HIV-riddled area as closely as Svetlana Savchenko.
      She started using heroin in 1997.
      The years have not deprived her of her will to live. Now she is seriously trying to stay off drugs. She has been getting Finnish help in this.
     
The Finnish Ministry for Foreign Affairs is financing a project aimed at establishing a substance abuse rehabilitation model similar to that of Finland's network of A-Clinics. In the model, the treatment of a patient involves the participation of a doctor, as well as a social worker, a nurse, and a psychologist, all working as equal partners.
      The model is quite new in Russia, where the treatment of those with substance abuse problems has traditionally taken place under the direction of a doctor. The purpose of the new model is to get an all-inclusive assessment of a patient's situation, and to draw up an appropriate rehabilitation plan. To this end, more than just medical expertise is needed.
      Drug rehabilitation in Russia usually does not go beyond a diagnosis and treatment with pharmaceuticals.
      St. Petersburg's first treatment group involving a variety of professionals began its operations in Krasnogvardeisk in May last year. Training for the unit was provided by the Kotka A-Clinic organisation.
      By the end of February this year a total of 117 clients had been helped by the group.
      "Most of them have used heroin for seven or eight years, have suffered various diseases, and committed all kinds of crimes", says the group's doctor, Anton Kozlov.
     
Svetlana was regularly given heroin by a person close to her, who also sold it to others.
      However, her 28-year-old friends Vladimir Krylov and Kiril Nikitenkov had to finance their addictions by committing crimes. "Mugging and theft", Vladimir explains.
      In spite of the difficulties, Svetlana managed to study law and work during her years as an addict. At one time she managed to stop using heroin for more than two years, and later for shorter periods of time.
      "If someone who is close to you is in drug trafficking, there is always a temptation at home to start using."
      Four years ago, Svetlana got something else from her close person: HIV.
      "Then I suffered a deep depression and distress. Nevertheless, I did not want to go into treatment, because I needed money, and I had to work."
      Last summer her pain led to a situation in which Svetlana would take cocaine in the morning, heroin during the day, and methadone at night to prevent the next morning's withdrawal symptoms.
      In the autumn she decided to try again to get off drugs. She quit her job and sought treatment. Vladimir and Kiril also decided to stop using drugs at about the same time.
     
Through the multidisciplinary treatment group the three were later provided with places for treatment in a rehabilitation centre outside St. Petersburg run by the Orthodox Church. They can live there full time for three months.
      They all would like to stay there longer.
      Svetlana's last relapse was a few weeks ago when she went to St. Petersburg. "I had illusions about my own will power, but then I learned that I cannot make it without help from God."
      Six days later she returned to the rehabilitation centre.
      A black Lada gleams in the sunlight on the street in front of the treatment unit. "The boys have fixed it up", Svetlana says.
      The three step into the car and drive off from Krasnogvardeisk straight to the rehabilitation centre. They know that a new fix might prove to be too tempting any time, and destroy their dreams of a normal life.
     
Helsingin Sanomat / First published in print 22.3.2005

More on this subject:
 BACKGROUND: Finnish aid extends to three parts of St. Petersburg

Links:
  A-Clinic Foundation

LASSE KERKELÄ / Helsingin Sanomat
lasse.kerkela@hs.fi