But the decision came amid a major dispute over Afghanistan’s opium poppy production. Russia wants the United States to spray and eradicate the poppy fields, blaming Afghan heroin for the drug addiction of 1.6 million Russians and the deaths of 30,000 every year. The United States, which once endorsed spraying, has decided that eradication is a failed, counterproductive strategy and supports longer-term agricultural alternatives, as well as urging Russia to deal with drugs through treatment and prevention.
Still, drug officials from both countries keep talking, as they did in a joint interview in the library of the U.S. ambassador’s residence before a reception in their honor last week, and they keep saying they are working in the same direction even as they take opposing positions.
“If there is no cultivation of poppy, there is no trafficking,” Viktor Ivanov, director of the Russian Federal Drug Control Service, said in the interview.
Afghanistan produces about 90 percent of the world’s heroin supply on a relatively small amount of land. “If we concentrate our resources to eradicate it there, it would be a thousand or a million times cheaper than fighting it all over the globe,” Ivanov said, reiterating an argument he has made many times.
Gil Kerlikowske, director of the White House Office of National Drug Control Policy, replied as he has before. “The U.S. government is not going to impose eradication,” he said. “It has to be something led by the Afghan government.”
Health activists in Russia find the debate maddening because they would like to see the United States and Europe push Russia to focus on adequate treatment for drug addicts — methadone is against the law here, and treatment protocols reflect a Soviet-era emphasis on punishment.
Still, some experts have praised the United States for engaging Russia on the problem.
“I think it is one area that is challenging in the U.S.-Russian relationship, but one that the U.S. is handling rather well given the different understanding,” said Vanda Felbab-Brown, a fellow at the Brookings Institution who has researched and written extensively about drugs in Afghanistan.
Interestingly, Felbab-Brown said, the United States had been a firm believer in poppy eradication until studies in recent years showed that it didn’t work — alienating local farmers who found it difficult to develop new crops and markets. In another twist, she said Russia was at fault for obliterating much of Afghanistan’s traditional agriculture during the years of Soviet occupation.
“The Russians destroyed rural Afghanistan,” she said. “They controlled the cities well but never controlled the countryside, so they adopted a scorched-earth policy — to bomb the countryside flat and drive the people into the cities. What that meant was that traditional cultivation was destroyed, and poppies, which need no fertilizer and little rain, thrived.”
From 1981, poppy crops grew slowly but steadily, she said, and Afghans forgot how to cultivate pomegranates, grapes, apricots and almonds. Distribution systems also disappeared as other countries, such as Azerbaijan, stepped into the market for such crops.
Now, struggling with health problems that lead to low life expectancy for their older generation and a heroin epidemic that is killing many of its young people, Russia fears a demographic catastrophe.
As it attempts to deal with heroin, authorities are relying on a system developed in the Soviet years to treat alcoholism, which was seen as a moral failing rather than a disease. Drugs were ignored as an ill of capitalism.
“I have to acknowledge that Russia never faced drug treatment and prevention because we never had those problems,” Ivanov said. “Now we are doing something about it.”
Last year, Kerlikowske arranged for a delegation organized by Ivanov to visit Baltimore’s drug courts, where offenders facing jail time can instead opt for treatment programs. Ivanov said he hopes that by the end of the year Russian law will permit a similar option.
In addition, Ivanov said, Russia is developing prevention programs for schools and Russian and U.S. officials are beginning to work together to investigate drug labs in Afghanistan, monitor border security and track money-laundering operations.
But Ivan Varentsov, project coordinator for the Andrey Rylkov Foundation in Moscow, said nothing will change as long as Russia refuses to follow standard practices recommended by the World Health Organization and other bodies, such as needle-exchange programs and methadone treatment for drug withdrawal.
If the best that comes out of the Russian-U.S. engagement is drug courts, that will not do Russian addicts any good, Varentsov said.
“It will worsen the problem” as long as treatment remains unchanged, he said.
Richard Elovich, a medical sociologist and public health policy consultant at Columbia University, said treatment in Russia consists of a top-down centralized command structure, as opposed to centers where doctors can respond to individual situations. And the system rejects methods that research has proven effective in other parts of the world.
“The greater the frequency of treatment,” he said, “the greater the chance that results will be optimal.”
Irina Teplinskaya, a 44-year-old heroin addict from Kaliningrad who has become an activist for better drug treatment in Russia, said the standard treatment for heroin addiction involves 12 days of detox. There are few free rehab centers, she said — most cost about $700 a month, too much for addicts.
Only 8 percent of those treated stay off drugs, she said.
“I have 30 years’ experience of attempts to get treatment at different clinics,” she said, “and I’m still drug-dependent.”