Svetlana R., 37, Kazakhstan.
Used drugs for 13 years, the last five years has been an opioid substitution therapy (OST) patient. A leader of an OST initiative group. Expert in community work at the public foundation Answer. Also works at an advertising agency.
Looking back in time
I began using drugs after I got married. My husband was an active user and had unlimited access to injectable drugs. I fought against his addiction but ended up using drugs myself. What it was, tiredness or desperation, I don’t know. But with each shot my troubles got further away from me. Everything became simple and clear, I saw life in a positive light. I didn’t realize that the troubles were still there and accumulating like a snowball. I began having problems with police and I got an incurable disease. Instead of realizing what was going on and stopping, I continued to walk down the same path. “It makes no difference how you die,” I used to think.
It was hard to watch how my relatives were reacting. I should say my family has never let me down and went with me through thick and thin. I saw how much pain and suffering I brought them and that was heartbreaking. They pleaded and I promised. They kept asking and I kept saying that it was over. But even when I saw my mother’s tears and promised to quit, for the umpteenth time, I realized right there and then that I was lying. I told my mother what she wanted to hear to avoid seeing that pain in her eyes… and then I went and used drugs again, telling myself it was all because of the stress.
Deep inside, I wanted to quit but I couldn’t. I probably didn’t have enough willpower. I tried all I could: getting away from my environment and living in other cities, and they took me to various experts, from drug treatment specialists to hypnotists and psychics. Nothing worked and each time I relapsed and went down that slope again and again.
Substitution therapy and its role in my life
I familiarized myself with the topic of harm reduction when I encountered needle exchange sites; this was five years ago. Soon I became a client of a substitution therapy program – there is a pilot OST program in ten cities of Kazakhstan.
To say that OST helped me would be an understatement. For five years I’ve been an OST patient and my life has changed completely. From an outcast that didn’t deserve trust I became a normal, adequate person capable of being responsible for my act. I’m no more a would-be criminal; I am a fully functional member of society. My colleagues from the ad agency are not even aware of my issues and see me as a regular person. Moreover, I was able to regain the trust and respect of my relatives, which is priceless. Now my relatives fully trust me and don’t hide their money and jewelry when they see me. And I’m not afraid or ashamed of anything.
I recommend OST to all who, like me, have seen it all and for whom nothing has worked. OST works, and I’m convinced of that; there are lots of proofs for that – take our program for example.
I would love to quit methadone at some point. Unfortunately, this isn’t possible yet and the main problem is that in Kazakhstan, we don’t have quality detox programs for OST patients. Without that, even if you gradually reduce your methadone doses to a minimum, detox is a must. But I know many examples of people minimizing their methadone intake and quitting, and not returning to drugs after that. OST is a way out, and it is the most effective way out as my experience shows.
Also, from an economic standpoint OST is more cost-efficient than rehabilitation. And once you consider the expenses related to incarcerating and guarding someone who stole something to support their drug habit, and compare those expenses to those for OST, this cost-efficiency becomes obvious. This is what we are trying to get across to government workers.
Contradictions: should I or should I not go open about my status
I often face the choice: should I talk openly about my experience, or should I remain anonymous. The reason is, my mother works in police and obviously having a daughter with a reputation like mine probably doesn’t have a positive impact on her career. This is why I don’t speak out and open my face. If it was about me only, I would. Not just because I’m not ashamed of my views, but also because it’s always easier to convince others when you set an example. But I have my mother, father and sister, and I can’t let them down.
Sometimes I run into sensitive situations. Once my photo where I had a methadone cup in my hand ended up on the internet. Surprisingly, the first person who shamed me because of that was the nurse that provides our methadone at the OST clinic. She had so much disdain in her voice that I broke down and asked to have the photo removed from the internet. If healthcare people react to public disclosure in this way, it’s not hard to imagine how the public would react. Our people are not ready yet to see this as a healthcare issue.
Sometimes I think, if I can’t go open, should I continue doing what I do at the foundation and the OST group? Does it make sense to defend my point of view while worrying that someone might learn about your story? For me this is still a dilemma, frankly speaking.
Happiness does exist
At this moment I can call myself a happy person. Although I wouldn’t wish what I’ve been through on anyone, today my life has meaning.
As for my personal life, when attending the OST program I met my second husband, and we have a family. The most positive thing is that my relatives are not concerned about me anymore. Seeing calm and trust in their eyes means a lot. I am guilty of a lot of things and I’m trying to compensate for the years of suffering they endured because of me.
In my professional life, I also see how meaningful what I’m doing is. Essentially, what I do is make the lives of drug users easier, more positive. I improve the quality of their lives to help them stop feeling like second-rate people.
Of course, life is not without its problems. The most important one is the lack of take-home methadone and the fact that we are tied to the OST site. Although we realize that this is an issue of legislation and it’s not really up to us, we still knock on all doors and try to influence it. If we could at least facilitate take-home methadone provision for people in inpatient treatment, that would be a huge achievement.
Nevertheless, certain changes have occurred. For example, we have helped ensure that the methadone is provided in two shifts. We also have our own doctors at the site and the guys don’t have to spend days waiting in line at regular clinics. These may not look like fundamental changes but they are still important.
If I had a chance to replay my life again, I would never choose the same route. And to those who still use drugs and want to quit, my advice is to try all possible methods. Don’t despair! Everyone has a key and you’ll definitely find it. You have to fight, no matter how hard it is. The most important thing here is the desire to quit. You have to want it for yourself, not for your relatives. And this desire doesn’t come by itself, I know. Usually it requires some kind of a watershed. Somebody may be afraid because of ill health, others lose their children… You need a push, something that would shake you up and make you realize the time has come to stop. Then you’ll need support because you can’t handle it on your own. You need a person who will not just sympathize with you but also cheer you up and help you see things in a positive light. It’s absolutely necessary to realize that you’re not alone, that someone will definitely get you out of the swamp. But I’ll repeat myself: first you need to desire to get out, and once that happens you’ll succeed!
For five years I’ve been an OST patient and my life has changed completely. From an outcast that didn’t deserve trust I became a normal, adequate person capable of being responsible for my act. I’m no more a would-be criminal; I am a fully functional member of society.