Crystal Meth in St. Peterburg: Amphetamine Use in the ‘New Cohort’

Crystal Meth in St. Peterburg: Amphetamine Use in the ‘New Cohort’

Methamphetamine remains a drug with the potential to cause significant harm. St. Peterburg, a major Russian city, has a high number of people who inject drugs (estimated 80,000 PWID), but studies suggest a potential shift in the **younger user demographic toward stimulants**.

Regional Usage and Sourcing

Methamphetamine use is documented to be generally low in Europe, but is concentrated in certain Eastern and Central countries, as well as high-risk groups in major cities.

• Russian Context: A pilot study of young hard drug users (age 18–26) in St. Petersburg found that **amphetamine and other stimulants were common (70%)**. This suggests a ‘new cohort’ is emerging, moving away from the traditional opiate use of previous generations.
• Sourcing: Methamphetamine and other synthetic drugs are trafficked into Russia from Central Asia and Europe, driven by the huge demand and high profit margins.
• Forms of Methamphetamine: Methamphetamine is available in powder form (often mixed with other ingredients like lactose) and highly pure crystalline form (“ice” or “crystal meth”).

Severe Health and Social Consequences

The harms associated with methamphetamine use are universal and pose a severe public health threat in any community, including St. Peterburg.

Physical Effects

• Cardiovascular Damage: Methamphetamine use immediately increases heart rate and blood pressure. Long-term abuse can lead to severe health problems like stroke, heart attack, and heart failure.
• Toxicity and Overdose: Use can cause fatal or non-fatal overdose (“overamping”), seizures, and a rapid, dangerous increase in body temperature (hyperthermia).
• “Meth Mouth”: Chronic use often results in severe tooth decay and loss. This is caused by a combination of drug-induced dry mouth (xerostomia), teeth grinding (bruxism), and poor hygiene.
• Infections: Injecting methamphetamine significantly increases the risk of acquiring and transmitting blood-borne viruses like **HIV and viral hepatitis**. It can also lead to bacterial infections, such as endocarditis (a heart infection).

Psychological Effects

• Psychosis and Paranoia: Long-term use is strongly linked to psychotic symptoms, including paranoia, visual and auditory hallucinations, and fixed, false delusions. A common delusion is the sensation of insects creeping under the skin (*formication*).
• Violent Behavior: Chronic users may exhibit aggressive and violent behavior due to agitation, paranoia, and severe mood swings.
• Cognitive Decline: Long-term abuse causes brain changes, resulting in deficits in memory, attention, problem-solving, and verbal learning.

Social and Community Impact

• Addiction: Methamphetamine has a high potential for abuse and dependence, leading to compulsive drug-seeking behavior.
• Community Harm: Methamphetamine use threatens whole communities, contributing to new waves of crime, unemployment, and child neglect or abuse.
• Health Crisis: Russia’s punitive approach to drug use and prohibition of harm reduction efforts have led to a massive HIV and HCV epidemic among PWID in St. Petersburg.

Legality and Penalties in Russia

Russia maintains an extremely punitive legal framework, with high rates of stigmatization and a restrictive approach to treatment.

• Personal Use: Possession and use of methamphetamine are treated as serious offenses, contributing to high rates of imprisonment.
• Treatment Barrier: The lack of approved substitution therapy (OST) remains a major barrier to effective addiction treatment in Russian cities.
• Trafficking: The production and distribution of methamphetamine are treated as strictly criminal offenses, often carrying long prison sentences to deter supply.