Vyacheslav Apanasenko, a retired Russian admiral who killed himself in February, left a note: "I ask not to blame anyone except for the Health Ministry and the government," he wrote on the day he killed himself, International Business Times reports. And according to his family, earlier that day Apanasenko had received word that his prescription for painkillers had been turned down.
Apanasenko's note provides a clue to what might be driving an uptick in suicides in Russia: it is exceedingly difficult to get access to strong painkillers, even in the cancer ward and even if there is no hope for the patient's recovery. IBT explains:
Treatment for strong pain—very common in people with cancer—is particularly problematic. Russian laws around morphine are far more restrictive than required under the international drug control conventions or recommended by the World Health Organization (WHO) and International Narcotics Control Board.
Multiple people must sign off on every prescription for these medicines; you can only get a limited supply per prescription; and very few pharmacies stock the medications. According to WHO, morphine is absolutely necessary for the treatment of cancer pain and should be available to any patient with a medical need for it.
Although there's no way to prove that a lack of painkillers was behind all of the suicides, it seems like it could have played a role. As another victim wrote in his suicide note in March: "I am tired of living in agony."
What is available in Russia is krokodil, a morphine substitute, made with codeine, that more than a million Russians have developed an addicition to. In 2012, the country stopped selling codeine over the counter, too. Krokodil's effects aren't exactly palliative, though: the drug eats away at the flesh of users. Russia's drug control agency has called for increased access to legitimate drugs for terminal patients, but, either way, it's clear that the country's relationship with pain is suffering.