Drugs and Public Health in Post-Soviet Central Asia: Soviet-Style Health Management (SpringerBriefs in Public Health)

The book outlines post-Soviet style of health management in Central Asia. Regional studies on Central Asia to date have focused on states, politics, religion and inter-ethnic relations but not on the health system within the region. Soviet-style policies have also covered only other aspects relevant for the region. This book highlights the public health situation of the region with a focus on drug abuse, HIV/AIDS in the context of increased mobility, and drug trafficking routes which became even more porous after the break-up of the Soviet Union. Based on a qualitative study, the empirical data in the book was collected during long-term fieldwork conducted in Uzbekistan and Turkmenistan in 2010-2011 as well as shorter stays in Uzbekistan between 2012-2016. The analysis of the empirical material largely draws on the works of Foucault, particularly his concept of biopolitics when analyzing Soviet-style health management that is still practiced in the region. Applying the Foucauldian genealogical method, this study has been structured to trace the genealogy of epidemics to understand the historical path of drug abuse in the region as well as the discursive genealogy of drug politics and drug abuse. Applying the same genealogical method of Foucault, the formative and discursive trajectory of the institution of Uchyot was traced to contextualize the health governance methods that have historical legacy of Soviet-style governance and control of the total population. Drugs and Public Health in Post-Soviet Central Asia: Soviet-Style Health Management is a unique resource for academic specialists, practitioners/professionals, and advanced undergraduate and graduate students in public health, as well as a range of scholars and professionals in sociology, political science, anthropology, and anyone with an interest in the Central Asia region, drug addiction, or HIV. The book also could appeal to international donors in the field of HIV/drug addiction who are working in the region. Preface Acknowledgments Contents About the Author List of Acronyms List of Figures List of Tables Chapter 1: Introduction 1.1 Drug Abuse and Public Health in Central Asia 1.2 (Mis)management of Public Health in Central Asia 1.3 Drug Trafficking Routes in Central Asia 1.4 HIV Epidemics in Central Asia and Migration 1.5 The Link Between Drug Abuse and HIV/AIDS 1.6 Gender Aspects of Drug Abuse 1.7 Using Ethnographic Methods in Public Health Research in Authoritarian Contexts in Central Asia 1.7.1 Limited Ethnography in a Clinical Context 1.7.2 Target Group 1.7.3 Fieldwork and Field Sites 1.7.4 Ethical Issues 1.7.5 Data Analysis 1.7.6 Interviews References Chapter 2: Genealogy of Drug Abuse and HIV Infection in Central Asia 2.1 History of Drug Consumption 2.2 Beginnings of the Punitive Methods to Address Drug Abuse 2.3 From Bangi to Narkoman 2.4 Genealogy of the Relationship Between HIV and STI References Chapter 3: Biopolitics of Foucault in Post-Soviet Central Asia 3.1 Uchyot – Main Tool of Biopolitics 3.1.1 Soviet Narcology 3.1.2 Present Narcology System in Uzbekistan 3.1.3 Narcology Clinics: Case Study Narcology 1 3.1.4 Case Study Narcology 2 (Capital) 3.2 LTP Camps Past and Present 3.3 New Methods with Old Rules: NEPs 3.3.1 Project OST: Failed Efforts of Methadone Introduction 3.3.2 Incarceration and Cleaning References Chapter 4: Individual Concerns of Drug Users and Drug Consumption Patterns Among the Research Participants 4.1 Socio-Demographic Information 4.2 Changing Patterns of Drug Consumption 4.3 Beshabashnoe (Chaotic/Anarchic) Times 4.4 Post-Soviet Patterns of Drug Abuse 4.4.1 Opium: Injection of Kora Dori (Opium) 4.4.2 Heroin Sniffing 4.4.3 Heroin Smoking Patterns 4.4.4 Heroin Injecting Methods and Combination with Other Components Dimedrol® + Heroin Naftizin + Heroin Diazepam and Heroin Etaminal Poly-Drug Use: Sonat, Sedalgin, Carbamazepine, Trawmadol 4.4.5 Shared Drug Solutions 4.5 How Drug Use Started 4.6 Heroin Replacement Is a Solution or a Trap References Chapter 5: Socially and Culturally Embedded Drug Abuse 5.1 Social Status and Drugs 5.2 Identity of PWIDs 5.2.1 Being ‘Chisty’ (Clean) 5.3 The Power of Stereotypes and Stigma 5.3.1 Home Methods of Treating Drug Dependence 5.3.2 Health Problems 5.4 Gender and Drugs References Chapter 6: HIV-Positive Drug Users: Concerns and Problems 6.1 Migration and HIV Infection 6.1.1 Condom Use by PWIDs 6.1.2 Multiple Use of Syringes 6.2 Networking as a Key to Survival for PWIDs? 6.2.1 Networks as a Way of Spreading Drug Dependence 6.3 Demography of Drug Epidemic 6.4 Producing and Reproducing “Risks” 6.4.1 Shift from Drugs to Alcohol References Chapter 7: Lessons Learned and Recommendations Index