Pubdate: 27 Feb 1999 Source: Times, The (UK) Copyright: 1999 Times Newspapers Ltd Contact: http://www.the-times.co.uk/ BRAIN SURGEON CUTS AWAY HEROIN SLAVERY THE famous St Petersburg brain surgeon, Svyatoslav Medvedev, has found a cure for drug addiction and claims a 70 to 80 per cent success rate. However, the process involves inserting a needle into the brain and removing what Dr Medvedev believes to be the offending tissue. Dr Medvedev says the success of his technique lies in the fact that his operation treats the addict's psychological addiction while other methods concentrate first and foremost on the physical side of the illness. Of the hundred or so heroin addicts who have undergone Dr Medvedev's revolutionary procedure over the past two years, most have found themselves suddenly free from a compulsion that had thus far blighted their lives. "This is not a new operation," says Dr Medvedev of the St Petersburg Institute for the Human Brain. "The procedure has been commonplace for more than 30 years. It is just that we have renamed the disease." The operation, according to Dr Medvedev, has long been performed worldwide to treat various obsessive-compulsive disorders and particularly phantom pain syndrome, through which Dr Medvedev drew the inspiration for his addiction cure. Many sufferers of phantom pain syndrome endured such agony in their absent limb that they had become morphine addicts in their efforts to relieve their symptoms. After he had introduced a thin needle into the brain of these patients with the use of only a local anaesthetic, the sufferers found that, not only had their phantom pain disappeared, but their morphine addiction had been alleviated as well. This phenomenon provided Dr Medvedev with the idea for his cure. "You see, addiction is a kind of obsession and this process does not change any part of the personality. We know how to reach the structures we need to eliminate without damaging any other parts of the brain," he says. Dr Medvedev is from a long line of physicians. His great- great-grandfather, doctor to both Lenin and Stalin, disappeared without trace in 1927, and his mother, Natalya Bekhtireva, is a revered neuro-physiologist. Dr Medvedev does not believe that his technique will ever become widespread, for although he thinks it could be used to treat addiction to gambling, over-eating or alcohol, he does not believe it should be. "Of course, any interventive surgery is dangerous. In Czechoslovakia in the 1950s two surgeons were given licence to perform this type of surgery on dangerous criminals and psychopaths. Although the technique was successful, there was obviously a grave moral question. "This surgery is a last resort for my addicts. Heroin can kill you in four years. My patients have almost no functioning liver and they all suffer from hepatitis B and C. The operation is a matter of life and death." Dr Medvedev emphasises that, although he has discovered a cure for addiction, he believes it should only be used in extreme cases. "We are not treating heroin dependency. We are treating imminent death," he says. Despite the obvious advantages of the treatment, there are still those who pour scorn on his institute. Aleksandr Andrianov, head of the Association for the Fight Against Drug Addiction and the Drug Business, says: "If you want to cut off a corn, there is no reason to remove your whole leg. The Ministry of Health has certainly not given its permission for this kind of operation to be performed." But Russia, which has been flooded with heroin since the collapse of the Soviet Union - 390kg (about 858lb) of the drug and 893kg (1964lb) of unprocessed opium were seized en route to Russia from Turkmenistan alone in 1998 - is in dire need of a cure of some kind. A report published last year by London's International Institute for Strategic Studies said: "A very real danger exists that one or more of the Central Asian states will become 'narcocracies' similar to Burma and Colombia." It added that Kyrgyzstan alone was exporting more narcotics by 1995 than Burma or Thailand. Yevgeni Tolkachev, of Moscow's 17th Narcological Hospital, barely has room for his 500 patients who stay about 21 days each. All of them are heroin addicts and he admits that his recidivists are many. It is hospitals like this that might benefit if Dr Medvedev's methods were to become more widely used. Although he believes in his treatment programme of anti-psychotics coupled with psychiatric help, he thinks it is hard for the users, who are getting progressively younger, to extricate themselves from a drug-using lifestyle. With heroin currently priced at 600 roubles (UKP20) a gram, this can be a difficult lifestyle to maintain. "None of them work. The boys steal and the women often sell themselves," he says. Although many methods of treatment have been tried in Russia, including a recent effort on the part of Aleksei Suvernev, a Siberian doctor, to heat patients' bodies to the point of hyperthermia in the belief that this removes the physical dependence on drugs, Mr Andrianov believes that addicts should be left to die. "If they want to stop, they will. There is nothing you can do to help them. There are 1,000 hospital places for addicts in Moscow and there's never a free bed. We don't have the right to refuse them, but they always start again." - --- MAP posted-by: Mike Gogulski