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9 September, 2013

Pharmacy Lobbying

Who helps addiction to medicine spread in Ukraine

Drug addiction is an old problem with no solution. Trying to reduce its scale is the only way to deal with it. And one thing is clear: bans and repression do not work. Ukraine’s biggest problem is that its leaders never had – nor do they now have – the political will to solve problems like this. Everyone in the government including regulators is well aware of this fact. I remember talking to an ex-chief of the Kyiv anti-drug trade police department. When I asked him where access to drugs is the easiest and the choice is the best, he shocked me with a very simple answer: “At the International Relations Institute at Kyiv National Shevchenko University.” Which is where Ukrainian elites send their children. Or here is another story. As I was leaving the office of an ex-premier, his assistant invited me to her office for a brief talk. She asked me to help her son, a drug addict. Astonished, I asked her: “How can this be happening? It’s killing your children, not just those of ordinary villagers and workers. Why do you say nothing even though you’re here, in power?” “You see, we can’t speak about this publicly,” she replied.

According to the SBU (Special Service of Ukraine – Ed.), Ukraine currently has around 1.2mn drug addicts. The Health Ministry and police offer very different numbers because they either don’t know anything or do not wish to know anything. Add to this another two or three million of codependents, i.e. the drug addicts’ families, friends and people surrounding them. They all expect the government to react somehow.

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One of the latest and most concerning developments is the disastrous growth of  addiction to medicine. The ratio of ordinary street drugs to medication in the statistic of addiction has now reached 50/50, and abuse of the latter is growing while the use of the former declines. As a result, patients with cancer have a hard time getting the medication they need to go through the terrible pain while young addicts get anything quickly and easily in pharmacies.

Blaming this on one government authority, Health Ministry for instance, is not reasonable. First, pharmacies are privately owned. Their owners have huge countrywide chains and a lot of cash to lobby their interests. Meanwhile, health ministers are replaced every 2-3 years, and even if any of them embarked on the problem seriously, the efforts would eventually turn out futile. Because it is not just the police that provides protection to the pharmacy business. There are people in parliament, government and other authorities that constantly lobby this. They may be three or four, but they stand very high. In fact, the government itself is essentially a powerful lobby of the organized pharmaceutical-police-health care group involved in medication dealership and covering up of pharmacy-enabled medication addiction. At one point, pharmaceutical plants produced six times more tramadol (opioid pain killer – Ed.) than what hospitals needed, and this was done with the green light from the top authorities. The same mafia is now covering up fields of psychoactive plants, presenting them as legal fields for medical purposes. From time to time, scandals erupt, the media buzzes of huge acreages of illegal plants, several scapegoats end up in jail, and everything goes quiet again.

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Hope sprang again when the government decided to establish the State Drug Control Authority as a separate body to supervise the industry. This is what all civilized countries have done. Indeed, the new body started out very briskly but went quiet soon after. Apparently, its employees have been trained to not speak the truth out loud. I see how some people at the very top are impeding their work. The SDCA's attempts to find a comprehensive solution to the problem must have scared someone high up.

For some reason, every step taken towards a more civilized Ukraine eventually has the opposite effect. When Ukraine began to produce morphine in pills and the Health Ministry simplified the procedure for terminally-ill patients to buy it in pharmacies this summer, that turned out a big hit among drug addicts. But the vital medication was not to blame. The same thing happened to methadone which in practice resulted in yet another legal drug easily available on the market. Meanwhile, there is still no state rehabilitation programme or effective control over the industry.


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