Red Hot Cures
Sydney Morning Herald
Saturday August 14, 1999
Russian doctors claim they can detox drug addicts by dropping them in scalding baths or be removing tine bits of their brain. Bronwyn McLaren reports.
IT'S nearly -30 C outside and, in an operating theatre at a rundown hospital in the Siberian city of Novosibirsk, doctors are preparing to boil a young, desperate drug addict.
After eight years of daily opium use, Alexei, a 23-year-old construction worker, will undergo a somewhat unorthodox operation. To cure him of his drug dependency, doctors will raise his body temperature to 43.5 C, a point at which most Western medical professionals say it is impossible to survive without serious complications.
But the doctors at Hit Plus, a private medical company, say their method of raising the body temperature is foolproof and will kill up to 95 per cent of heat-susceptible "bad" cells. They say the treatment not only cleans the blood of most cancerous cells and boosts the immunity of HIV-positive patients, but breaks the cycle of physical dependence on drugs.
It is only one of many unorthodox treatments in Russia claiming to cure drug dependency.
It is called hyperthermia - a condition in which the body temperature is abnormally high - and it was used as a treatment for syphilis as far back as 400 BC. The heat can come from hot air, ultrasound or hot water, or by heating the blood outside the body and returning it. Today, doctors will heat Alexei in a bath heated to 47 C.
Here in the barren, icy expanses of far-flung Siberia, a trauma specialist and Hit Plus doctor, Alexei Suvernyev, says they are the only doctors in the world using such high temperatures. Doctors in Germany and the United States use hyperthermia at 42 C to treat cancer, but doctors here say that temperature will kill only 40 per cent of bad cells. The Siberian doctors are also the only doctors in the world using hyperthermia to treat drug addiction.
In Russia, this is a potentially lucrative business. The country has evolved into a major drug market since the 1991 Soviet collapse. The amount of drugs flooding into the country from countries such as Afghanistan, Tajikistan and Kazakhstan rose fivefold from 1997 to 1998 and grossed some $US1.2 billion ($1.85 billion), according to customs officials. More than 2 million Russians use drugs regularly and about 300,000 are registered addicts. The real figures are estimated to be 10 times that.
This is the second time Alexei has undergone treatment here. After the first time, he felt rejuvenated and escaped the city to camp, hunt and log trees. But four months later, back in Novosibirsk, he was shooting up again. He had also contracted hepatitis C from sharing infected needles.
"At first I didn't believe in it," he says of the treatment. "But it really is a miracle."
Back in Moscow, however, the Health Ministry's Vladimir Egorov says the procedures are illegal and are not officially approved. The cash-strapped ministry has withheld approval from hundreds, if not thousands, of private companies in Russia that have sprung up to fill the holes left by inadequate treatment in impoverished and overcrowded state hospitals.
Suvernyev refuses to divulge the special combination of medicines in his treatment, pending the award of an international patent. The trauma specialist will say only that it is safe, approved by local health authorities and that none of his patients has suffered fatal complications.
After 23 years of research and experiments, Suvernyev says he and his colleagues have pioneered a solution to possible complications which include brain damage, damage to internal organs and death.
At 11 am Alexei is called to a stretcher next to a blue plastic bath swirling with antiseptic. After a series of injections, doctors transfer him to life support and a glucose drip and lower him unconscious into the hot bath. His temperature is measured from a thermometer steered down his throat to the oesophagus. An inflatable pillow around his neck stops him from sliding into the bath and drowning and doctors place a rolled-up bandage into his mouth to stop the tongue from sliding and suffocating him.
The beads of sweat gather on Alexei's brow as the water churns and his temperature slowly rises. Thirty minutes later, Alexei reaches the target temperature of 43.5 C.
The operating theatre springs to life. Three doctors haul him onto a stretcher where he is removed from life support. His naked body shakes and jerks, and one of the nurses holds him down as another wraps his head in wet towels to bring down the body temperature.
"Blink if you can hear me," demands a nurse. Alexei strains to blink and his limbs jerk spasmodically. The operation is considered a success. In just 35 minutes, the doctors claim, he has been through 15 days' worth of cold turkey and has been cured of hepatitis C. Within two hours he is fully conscious. Within five hours, he is up and joking with the nurses. He says he feels great and has no craving to shoot up. He will be released the next morning. LENA, a mousy 22-year-old hairdresser, lives on the cheerless, industrial outskirts of Novosibirsk and is one of only three women who have undergone the treatment. She was introduced to drugs at 17 by her boyfriend. After Lena had spent four years shooting ephedrine, opium and heroin, her desperate mother called Hit Plus.
She has stayed clean for a year. She has discarded all her old friends and married a local businessman, who knows nothing of her past.
She is one of the success stories. It is thought some 50 per cent of the 30 addicts treated with hyperthermia since September 1997 turned back to drugs. It is difficult to monitor patients' progress after the procedure, because fee-paying patients cannot be forced to take part in monitoring.
But Evgeny Brun, a Moscow-based drug specialist who has referred HIV-positive drug addicts to Hit Plus, says breaking physical dependency is only 20 per cent of the battle: "The rest is psychological. I view [hyperthermia] as preparation for giving up drugs."
Hit Plus provides no psychological rehabilitation. Suvernyev says: "We do the operation so that if [addicts] want to live without drugs, physically they can."
At $3,000, the treatment is out of reach for all but the richest addicts. But the Hit Plus doctors say they are expecting the bulk of their patients to come to them with a different problem, and not just from Russia. "By the end of this year, we hope to announce to the world that we have found a cure for AIDS," Suvernyev says.
The doctors say hyperthermia could, in theory, be used to treat HIV and AIDS because it cleans the blood of many cells causing the virus, and boosts low immunity. Suvernyev says one HIV-positive drug addict from the southern Russian city of Saratov increased his CD4 cell count from 450 to 770 in two treatments spaced three months apart.
Many Western medical professionals are sceptical of the treatment as a cure for HIV, saying it is expensive, potentially dangerous and cannot compete with the results of combinations of protease inhibitors and nucleoside analogs.
Russia's drug culture is particularly conducive to HIV infection. Of the 7,900 registered Russians infected with HIV, 90 per cent are intravenous drug users. The real number is thought to be 10 times this figure, and widespread apathy and lack of knowledge mean the problem will only grow. AT ST Petersburg's Human Brain Institute, a different group of doctors say they may have the solution to Russia's drug problem. By drilling two small holes into the right and left hemispheres of the brain under local anaesthetic, doctors remove the 1.5 cubic millimetres of brain tissue they say governs drug dependency.
"It is a painless and effective method," says Dr Svyatoslav Medvedev, director of the institute which has overseen more than 150 of these operations during the past two years and which monitors former patients methodically. "Eighty per cent of our operations have been successful," he says.
Russian doctors use magnetic resonance imaging, a type of 3-D colour x-ray, to map the brain, but it is not used during the three-hour operation because it would be painful and require a general anaesthetic. Instead, the Russian surgeons rely on their own calculations. Not only is this cheaper but it allows doctors to monitor patient progress, something Medvedev says is absolutely vital. A dialogue is kept up with the patient throughout the operation.
The institute discovered the treatment by accident 40 years ago when it began operating on patients suffering from phantom pains. By removing a small piece of brain tissue, doctors found patients' cravings for morphine disappeared.
Medvedev says the institute is reluctant to take any but the most desperate patient who is completely dedicated to kicking the habit. He prefers to wait until an addict has been using for three years (one year before fulfilling the state's statistical life expectancy of four years).
The $2,500 cost is daunting to most addicts but the institute recently started accepting foreigners who are able to pay $5,000. MOST of Russia's addicts have no choice but to undergo treatment either at home, or in state hospitals which are the only institutions that can legally guide addicts through cold turkey.
Only 10 per cent of patients who undergo treatment at these hospitals will stay off drugs, says Dr Andrei Semin, from State Drug Hospital No 17, in Moscow. Some patients return as many as six times a year. "Only 10 years ago the state's emphasis was on rehabilitation," he says. "But the sheer volume of addicts now means we can only provide the bare minimum. Some of our patients even have to sleep in the corridors."
© 1999 Sydney Morning Herald