Tatyana Dmitrieva
Tatyana Dmitrieva is a current member of the International Narcotics Control Board (INCB) and its Vice-President. She is Russia’s former minister of Health and she is, since 2005, the Chief Consultative Expert Psychiatrist of the Ministry of Health and Social Development of the Russian Federation. She is the Director of the Serbsky State Research Centre for Social and Forensic Psychiatry in Moscow, which is responsible for forensic psychiatry for criminal courts. She is also the Head of the Department for Social and Forensic Psychiatry at the Sechenov Medical Academy of Moscow and Vice-Chairperson of the Russian Society of Psychiatrists and Narcologists.
Dimitrieva does not support evidence-based public health approaches to drug policy:
In 2005, using her INCB affiliation, she was one of five public figures in Russia to sign a memorandum entitled “No to methadone programs in Russia” (Nyet metadonovym programmam v Rossii), published in the Meditsinskaya Gazeta, a widely read newspaper for medical professionals. The text contained numerous inaccuracies and half-truths about methadone. [1] Even after a heavily referenced rebuttal from scientists in numerous countries [2], the institution Dmitrieva heads continued these misrepresentations, repeating many in a volume entitled Careful—Methadone: Substitution Methadone Therapy in “Harm Reduction Programs”, published in 2006 by the Serbsky Institute. This publication claims, for example, that “[m]ethadone (…) never showed any effective results anywhere” and that “[i]t has been proved that methadone’s impact is much stronger and more prolonged than heroin’s, and that it causes new addiction very fast.” (p. 123). In fact, research, conducted in many different countries, has consistently shown the safety and efficacy of methadone. The UN Office on Drugs and Crime, UNAIDS and the World Health Organization all support methadone treatment for opiate addiction. [3]
In an interview on illicit drug use in Russia, Dmitrieva said that “some countries do not fully understand the nuances: for example, the dangers of substitution treatment. That kind of treatment is an attempt by society to close its eyes. To refuse to accept that there is a certain percent of people who are already junkies and that they should be sent to some sort of reservation so they don’t bother others. I hope that we will decide that question correctly.” [4]
Dmitrieva’s independence and impartiality is questionable:
Her current position as Chief Consultative Expert Psychiatrist of the Ministry of Health and Social Development of the Russian Federation, as well as her position as Director of the Serbsky Institute, call into question her independence from the Russian government. Indeed, she espouses routinely the positions of the Russian government on drug policy and methadone treatment, even when they are not based on any scientific evidence.
[1] V Krasnov et al. “Nyet metadonovym programmam v Rossii” (No to methadone programs in Russia). Meditsinskaya Gazeta no. 29, 30 March 2005, 7. Slightly altered version available in Russian here.
[2] C Aceijas et al. “Say no to methadone” memorandum: Correcting the record (memo and open letter).
[3] See, for example: WHO, UNAIDS & UNODC (2004), Position Paper - Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention. Geneva, World Health Organization 2004
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