Drugs, Crime And Criminal Justice

Drugs, Crime And Criminal Justice

Introduction

Public health research and intervention among socially marginalised populations requires appreciation of how social environmental factors mediate individual and community capacity for risk avoidance (Blankenship, 2000, S11). In Russia, as elsewhere in eastern Europe, large scale social and economic changes associated with political transition may have contributed to the creation of environments conducive to HIV epidemics. There is growing appreciation of the critical role of social structural factors in the production and reduction of HIV risk among injecting drug users (IDUs), including in relation to legal restrictions placed on the availability, distribution and exchange of needles and syringes (Rhodes, 2005, 1026-10).

There is substantial evidence noting the potential for negative health effects among IDUs of intensive street policing initiatives. Some view anti-drug policing as a potential “public health menace (Blankenship, 2000, S11). Studies have associated intensive street policing, and police 'crack-downs' in drug market areas, with market displacement or disruption rather than eradication, little effect on drug prices and related revenue-raising crime levels, reduced access among IDUs to health services and clean injecting equipment, elevated levels of health risk including overdose and bacterial infections or vascular damage associated with hurried injection, and increased HIV risk including linked to syringe sharing (Rhodes, 2005, 331:220-2). A perceived fear of police arrest among IDUs can be associated with reluctance to carry needles and syringes, reluctance to access pharmacies or syringe distribution points, and increased risk of syringe sharing at the point of drug use or sale (Rhodes, 2005, 1026-10).

The HIV epidemic in Russia remains predominately associated with IDU, with explosive outbreaks reported in some cities. The majority of IDUs in Russia are reliant upon pharmacies for their access to clean needles and syringes. There are approximately 70 syringe exchanges throughout the Federation, which according to crude estimates, have low levels of coverage of local IDU populations. While pilot syringe exchanges since 1998 have been technically operable within Federal laws the legality of syringe exchange remains under some dispute. Article 230 of the 1996 Criminal Code makes “inclining to consumption” of illegal narcotics an offence, which some have interpreted as including actions judged to be facilitative of another person's use of drugs. While there are no documented examples of harm reduction projects being prosecuted in relation to this article, such a policy context has not facilitated collaboration between law enforcement and harm reduction initiatives (Rhodes, 1999, 1323-13). An explanatory note to Article 230 was added in 2003 giving formal recognition to the distribution of drug injecting equipment for the purposes of HIV prevention.

Research in Russia, as elsewhere, suggests that reluctance among IDUs to carry needles and syringes, or to access syringe exchanges or pharmacies for clean equipment, may be linked with a fear of detention or arrest. Prior to 2004, such fears of arrest were not unfounded given that the Criminal Code enabled the possession of very small amounts of street heroin (up to 5 g) to be punishable by ...