Vol 367: 197-198, Jan. 21, 2006
urged to address "Russia's curse"
availability of cheap vodkas and hard spirits is driving Russia's
It wasn't hard
for Boris Kuznetsov to find the drinks he craved. Any grocery store
or roadside kiosk had just what he was looking for. Perfume, brake
fluid, de-icer, methylated spirits, toilet cleaner, nail varnish
remover: "I drank them all", says Kuznetsov, who is 53
years old. "Everything that burns."
Like many Russian
alcoholics, the former laser specialist from a top Moscow physics
institute slithered into his darkest drinking days during the turmoil
of Perestroika. He gave up his prestigious job, was rejected by
his family, and ended up sleeping on the floor of a filthy apartment
without a stick of furniture. And when Gorbachev restricted alcohol
sales he turned to the hard stuff. "I only survived because
I got poisoned by some chemical cleaning agent quite early on and
I couldn't drink it any more", he remembers. "After that
I stuck to cologne."
500,000 Russians die each year for alcohol-related reasons, a figure
that covers 30% of all male deaths (including murders and accidents).
Vodka and other hard spirits remain the swig of choice, encompassing
three-quarters of official consumption, compared with less than
a fifth in the UK. The average Russian drinks 12–15 L of hard
spirits every year, whille poverty forces many drinkers to resort
to the "surrogate" alcohols that sated Kuznetsov's thirst.
In his annual
address last year, President Vladimir Putin described the heavy
toll that alcohol is taking on his country, decimating "young
men, who are breadwinners for their families". Even the old
stalwart of anti-alcoholism, Mikhail Gorbachev, recently spoke up
and voiced his concern. "We are approaching a catastrophically
high figure of spirits consumption", he told one interviewer.
"The country . . . is killing itself."
Putin takes over the presidency of the G8 industrialised countries
this month, he is being urged to transform his concern into concrete
action and tackle "Russia's curse". The World Bank called
for action last month, finding alcoholism plays a major part in
falling male life expectancy—already down to an alarming 58
for drink is nothing new. Production—and cconsumption—
of vodka first became common in the 15th century becausee of increasing
grain yields brought about by the introduction of new crop rotation
methods. Chronicles from the ensuing centuries show villagers swung
between abstinence and wild drinking bouts that could last for days
The Tsars recognised
alcohol's damaging effect but were reluctant to hinder production:
in the 18th and 19th centuries it provided a third to a half of
the treasury's indirect tax revenue. Fast-forward to 2006 and little
has changed. Alcohol is big business, with a spirits market worth
an estimated Â£7 billion (US$12Â·3 billion)
per year. Holidays such as New Year and Orthodox Christmas, this
month, are still a traditional time for mammoth benders, or "drinking
without drying out". Whole bottles of vodka are regularly downed
around kitchen tables. And, all too often, poverty and stress push
hard drinking over the edge into alcoholism.
With the help
of a twelve-step recovery programme Kuznetsov is now in control
of his illness. "I can manage, one day at a time", he
says. Yet millions remain trapped by the disease and new research
suggests worrying trends in consumption. A recent report by Russia's
National Alcohol Association found an increasing chunk of market
share is taken by cheap and potentially lethal "surrogate"
are apparent from the growing frequency of tragic stories in the
Russian press. In November, 33 people were killed in Magadan by
a single batch of drinks contaminated with methanol. Shops in Krasnoyarsk
were recently forced to remove a bath-cleaning fluid from sale because
so many people were drinking it.
of surrogate alcohols consumed in Russia was examined in a paper
published in Alcoholism: Clinical &Experimental Research in
October, 2005. Researchers found a "significant proportion"
of Russian men were drinking products that have either very high
concentrations of ethanol, or contaminants known to be toxic.
that home-made alcohol had about the same amount of alcohol as vodka,
but also contained a number of more toxic alcohols that could cause
damage to the heart and liver", says one of the authors, Martin
McKee, of the London School of Hygiene and Tropical Medicine.
(essentially tinctures containing herbal remedies) were about one
and a half times as strong as vodka, the report found. A third group,
including products such as aftershaves, was more than twice as strong.
highlighted the mounting danger in his annual address, pointing
out that 40 000 people a year are killed by alcohol poisoning, frequently
from drinking surrogates. He has promised to make health issues
key to his G8 leadership.
say legislation designed to battle the problem is ineffective or
even counterproductive. Laws to limit advertising of alcohol and
its consumption in some public places have been applauded but new
regulations introduced on January 1 to improve excise labelling
are unlikely to prevent illegal production, they say.
is a strong suspicion that much of the recent legislation was simply
fixed to benefit big alcohol producers", says Alexander Nemtsov,
a professor and one of the country's leading experts on alcoholism.
President Putin suggested imposing a state monopoly on spirits in
an attempt to regulate the market more effectively but appeared
to step back from the idea after lobbying from manufacturers. Taxation
on alcohol remains low, with the cheapest bottles of vodka costing
30 roubles ($1) each. And production of over-proof moonshine vodka
called Samogon is rife: an estimated four bottles are drunk in the
countryside for every licensed one.
there is a rising scepticism about the common methods of treating
clinics rely on "coding", a method invented by the Soviet
psychiatrist, Alexander Dovzhenko. Patients undergoing this treatment
are scared using hypnosis or suggestion into believing they will
die or be permanently injured if they drink again.
Some are given
a placebo and told it is a drug that reacts violently with alcohol.
For many it
is a swift, brutal method, that is rarely effective over a long
period. "They gabble something at you, make a woo-woo sound
in your ears and then tell you your testicles will fall off if you
touch a drop", says Aleksei, a middle-aged alcoholic in Moscow
who has been coded several times. "It never worked for me."
argue in favour of coding because it is occasionally successful,
and inexpensive. "There's been a lot of black PR for coding
recently saying it's inhumane and dangerous but I think it's scaremongering
by companies that sell cure-all pills", says the head of one
state narcology clinic, who asked not to be named. Another doctor
described it as cheap psychotherapy that helped some patients "radically".
chief doctor of Recovery, a private medical rehabilitation centre
for drug addicts and alcoholics in Moscow, is sceptical. "Many
doctors have a traditional point of view on alcoholism and use prohibitive
methods like coding", he says. "They think a patient has
to be punished, to be taught to work, but it's not effective. An
alcoholic doesn't drink because he's a bad person and he doesn't
fall ill because he drinks a lot. He drinks because he's ill."
conducts his research at Moscow's state scientific and research
institute of psychiatry, thinks coding's time may soon be up. "Coding
worked to an extent on the Soviet person because he was suggestible",
he says. "Now, as we become more sceptical like people in the
West, it's less and less effective."
Back on the
rails, Kuznetsov believes only long-term group therapy can wean
a person off drink for good. "Without that I would never have
managed", he says.
Anonymous has less than 300 groups in the country (compared to 1500
in Poland) and only a few state clinics provide similar programmes.
is lacking in the state approach to reducing alcoholism, Nemtsov
replies: "There is no approach. The leadership of our country
has forgotten about this problem."
There is a
simple answer to why so many Russians fall prey to alcohol, he says:
it's cheap. Between 30–60% of alcohol is clandestinely made,
andd therefore untaxed. A large quantity is run off on "night
shifts" at licensed factories where state inspectors are bribed
to remove tags on production lines at the end of the working day.
all this illegal production thrives on corruption", says the
professor. "Every local policeman in the country knows the
house where samogon is made. But he does nothing about it in exchange
for his own free supply."