THE DUELLISTS - Paolo Marchetti Photographer

Rehab for Drug Addicts

According to the WHO, Estonia has the European record for drug-induced deaths, with 191 deaths per million inhabitants every year, more than double that of second-placed Norway, with about 76 deaths, which in turn is more than twice the number of drug-related deaths in Lithuania, in third place.

Another dramatic primacy of Estonia is the HIV infection rate, the highest in the European Union, with more than 1% of the HIV-positive population – seven times the rate of neighboring Finland. Even hepatitis C, transmitted through the reuse of infected needles, is rampant, in fact 94% of drug

addicts are positive for hepatitis C. In 2002, 105 cases of fatal overdose from illicit drugs were reported, over the next 10 years, cases exceeded 1.000, giving the country the highest mortality rate for overdose per capita in the European Union.

In 2012, with 170 deaths, it became the highest fatal overdose rate in the world.

The initial response to public health in Estonia was deployed on the territory with small initiatives such as the 1997 sterile needle distribution program and the 1999 program, the first methadone drug replacement program.

But according to Mrs. Kurbatova (head of the Department for Infectious Disease Prevention and Drug Abuse), these were small-scale efforts, and

services were only available in some regions, she says. A more targeted response to the Fentanyl did not come until 2012, when the number of deaths from overdoses brought media attention from around the world.

Efforts have brought good results. The rate of new HIV cases has dropped to about 300 a year, from about 1.500 in 2003. In recent years, there have

been fewer deaths due to overdoses – unofficial estimates since 2015 suggest only 84 deaths – but the rate remains the most high per capita in Europe.

The people portrayed in this series are men of various ages, from 20 to 43 years old, and are welcomed in the rehabilitation center for drug addicts of Viljandi, central Estonia.
The program covers about 9 months, including the first 30 days dedicated to detoxification, a period in which patients are helped to clean the body completely from drugs, after which the patients officially enter the rehabilitation program. According to the testimony of the Viljandi hospital professionals, only half decide to continue their treatment in the actual rehabilitation program, the remaining 50% of drug addicts presumably return to old habits.

The program provided by the Viljandi rehabilitation center provides a detailed, structured and detailed path, which consists of many phases based on dialogue, sharing, physical exercise and human confrontation with highly qualified professionals.

In many cases, patients face up to 4 or 5 detoxification programs (30 days each), without ever starting the actual rehabilitation process (the following 8 months). According to hospital professionals, this is an alibi for the addicts who believe they are helping themeselves, cleaning up their bodies but without ever starting the real rehabilitation path, an ambiguous way to feel clean and ready for a new life.

In reality this behavior hides the unconscious desire to return to abuse drugs but with a clear and renewed conscience.

This project is dedicated to the courage that these guys demonstrate, to the struggle they face everyday and to their generosity in wanting me to be among them.


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