In Russia, dramatic increases in substance abuse occurred in the 1990’s at the same time as religious freedoms were starting to unfold in the population following the break-up of the Soviet Union. The Protestant church took root in some communities where drug abuse and HIV were rife, and during this time these faith-based organisations pioneered the provision of community-based drug-rehabilitation services.
Today these organizations provide drug-rehabilitation services, including services for women, to an estimated 10,000 drug users per year. Most staff and voluntary workers of the religious-based organizations are former drug users, and a high proportion of them are also living with HIV. In addition, some Protestant churches draw members almost exclusively from among former drug users including ex-sex workers and ex-prisoners. Thus these faith-based organisations have direct access to the high-risk groups who cannot be reached by the government or other agencies because of high levels of social exclusion.
Anecdotal evidence suggests that many women resident at the rehabilitation centres and later church members have been victims of sexual violence in the past. Sexual abuse can lead to biological changes in brain functioning that can then lead to mental health related conditions, symptoms and behaviour patterns that include substance abuse to alleviate the symptoms of anxiety and depression in the short-term and, for a variety of reasons, high-risk sexual behaviours including sex work, as a main means to obtain drugs/money for drugs. Yet the issue of overcoming the consequences of sexual violence and abuse is not directly addressed in treatment due to sensitivity of the topic and lack of professionally trained staff in these grassroots community organisations. Many women relapse and complete the rehabilitation course only from the second, third or even fourth attempt. Because opioid-substitution therapy is illegal in Russia, undergoing drug-free treatment is hard. It requires high levels of motivation and adherence to discipline which is not possible for everyone. However, the issue of whether the structure and/or content of the programme are part of the reason for relapse and drop out of women is yet to be explored.
The overall aims of the research are:
- Understanding the link between sexual abuse and addiction in women residents at rehabilitation centres and the impact of sexual abuse on their physical, psychological and social wellbeing.
- Scaling up the range and quality of women’s services provided by faith-based organisations based on increased awareness of the issue of sexual violence and abuse
- Improved collaboration between the faith-based organisations and government agencies and NGO’s in preventing and responding to sexual violence.