drug addiction is not heinous or shameful. [...] Is there any cultural context which I am missing?
Well, in Russia, which has had a massive heroin problem (fueled by cheap supplies from Afghanistan), the authorities have pretty much painted the addicts as terrible people, hardly different from traffickers (by Western accounts, at least):
Domestically, the Russian government adopts a law enforcement model toward traffickers and users alike, rather than harm reduction, drug prevention, and treatment models.
And some concrete examples:
Despite these numerous reasons for concern and the
need for serious and coherent responses, Russian drug
policies are mostly retrograde, politicized, and, to
date, largely ineffective. To a considerable extent, this
is because they are rooted less in the practical needs
of the moment and more so in a politicized narrative.
Pushed by the FSKN for its own political reasons, this
narrative sees the drug challenge as a nationalist and
securitized one. As a result, there has in recent years
been a partial retreat from Western models of rehabilitation and public education and a move toward a
reliance on incarceration and interdiction. For example, in 2004 the government took a step away from
earlier, draconian approaches, and decriminalized
possession of small amounts of drugs, incidentally
leading to the release of thousands of drug users from
overcrowded prisons. In 2006, though, these reforms
were partially rolled back, largely because of pressure
from the police, who claimed that they were encouraging a broader criminalization of society: carrying
amounts that previously would have led to misdemeanor charges again became criminal felonies.
Conversely, a low priority has been placed on effective
treatment, prevention, and harm reduction efforts.
While short-term detox treatments are available, the
same cannot be said about support for lasting rehabilitation. According to Diederik Lohman, senior
researcher in Human Rights Watch’s HIV/AIDS and
Human Rights Program, “The lack of effective drug
addiction treatment in Russia means that drug users
who want to break their addiction cannot, and are
condemned to a life of continued drug use.”26 In 2007,
their researchers found rehabilitation programs
available in state clinics in only a third of Russia’s regions; anecdotal evidence suggests that by early 2014,
fewer than half still offered these services.
Similarly, while a new law signed in 2013 allows addicts to be
forcibly detained for up to 30 days simply for being
addicts, the federal government has still not allocated the funds to cover any meaningful rehabilitation
program while they are in detention. Likewise,
methadone and buprenorphine, widely used around
the world as controlled replacement drugs for heroin addicts—and recommended for that use by the
World Health Organization—remain banned in Russia. In Crimea, following the March 2014 Russian
annexation, this even led to some 800 addicts whom
the Ukrainian authorities had placed on methadone
programs being denied further treatment. As of June
2014, an estimated 20 had died from overdoses.
In general, in Russian political discourse, drugs are linked to foreigners and the culture of the West, for instance:
According to Deputy member Anatol’yevich from the United Russia party, Russian children are today being “destroyed” and it is therefore important to teach children about traditional Russian values:
What should we do today, in my opinion? We must create a multi-level information system, conduct an information campaign to teach patriotism. We must learn to speak the same language as children, teenagers, we must hear them. We must create a trend, a fashion for Russian history, so that Russian children, even those playing computer games, do not choose the Abrams tank, but our Armata, so that this will be normal. Russian children should be proud of our history, should not be influenced by American drug addicts and wear clothes bearing their images, but those of Russian heroes such as Gagarin or the St. Petersburg metro driver who saved dozens, or maybe hundreds of people’s lives. (Anatol’yevich, B. D., United Russia, 170407)
Putin was probably referencing the somewhat strange reciprocal invitations of Poroshenko and Zelensky to take drug tests during the presidential election campaign of 2019. Both men passed the tests, although there was no official setting for these, so they took them in different venues.