Why Russians Are Allergic to AA

By Walter Armstrong 08/05/11

Despite an alarming epidemic of alcoholism and addiction, the Twelve Steps get the cold shoulder in Red Square.

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One in 13 Russians is alcoholic, but AA fails to take root.

It's no secret that Russians love booze. The country that invented vodka ranks fourth in the world in per-capita alcohol consumption, and some medical experts estimate that one in every 13 citizens is alcoholic.  A whopping 2.3 billion liters of vodka are sold in the country each year. Though Russian women drink more heavily than women in any other nation, the country's drinking problem has proved especially deadly to Russian men, half of whom expire from alcohol-related illnesses. Drug addiction rates in have also shot up astronomically.  Over a million Russians are reportedly hooked on heroin, which flows in cheaply from neighboring Afghanistan.  The country's wealthier elites have also developed a ravenous taste for cocaine. According to the United Nations, Russia recently replaced the U.S. as the principal market for Colombian coke. 

Russia's affair with alcohol is nothing new, of course. Health officials have long raised alarms about  the social and medical costs of the epidemic. But during the seventies and eighties, image-conscious Soviet leaders were wary of publicly tackling the problem.  But the toll that addiction has afflicted on the nation have now become too dire to ignore. Soon after he took office, Russian president Dmitry Medvedev announced that curbing the country's drinking and drug problem was one of his most pressing  priorities. But his recent decision to reclassify beer as alcohol instead of food was met with outrage by many citizens, who could no longer use their welfare dole-outs to buy their favorite brew. Even Medvedev's teetotal mentor, Prime Minister Vladimir Putin, criticized him for the move.

Last week, the US Helsinki Commission—a federal agency that was established after World War II to investigate human rights abuses in the former Soviet Union—dusted itself off and convened a special meeting to discuss the growing crisis. Hundreds of Russian physicians, politicians and social workers turned out for the event. Panelists proposed national education campaigns and urged the government to tighten Russia's borders. But the issue that received the most attention at the conference was the failure of Alcoholics Anonymous to take root in the country. During the past decade twelve step groups have rapidly multiplied across the world, in nations from Indonesia to Italy. Even in Iran, where alcohol is strictly forbidden and and drug use is punishable by death, the Islamist government has actively promoted Narcotics Anonymous in an effort to combat the country's growing heroin problem. In Teheran, which has a population of 15 million, over 400 NA groups meet virtually around the clock. But Russia, which has a population of 142 million, supports just 370 twelve-step groups nationwide. Experts say the country's aversion to AA is fueled by several sources. “There is a lot of mistrust of twelve step programs because because they're viewed as a Western creation,” said Heidi Brown, an analyst at Kroll Associates, an international security firm. "Russia is a very nationalist culture, and many people are suspicious of  methods that come from abroad.”  A.A.'s roots in Reformed Protestantism have also raised hackles in a country dominated by devout Orthodox Christians.

"The recovery culture that exists in the the U.S. is foreign to most people," adds Sergei Vasyesnev, an addiction specialist at Moscow's Serbsky Institute. "Drinking is so ingrained that behavior that would be viewed as unacceptable in the U.S. is freely permitted here. There are not many rehabs in Russia, so people who seek treatment often have to go abroad. And in a country where drinking is so loved, attacking alcohol is not politically popular." Despite this, many believe that Russian leaders will have to address the problem to maintain the country's footing in an increasingly competitive world. "The costs to our productivity and our economy are astronomical," says Grigori Nescova, an economist at Moscow University. Hundreds of thousands of Russian's don't come to work every day because they feel too sick.  Half a million young people die of alcohol every year.  If the government doesn't move we become a third world country."

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Walter Armstrong is the Medical Editor at  Saatchi & Saatchi Wellness and the former deputy editor of The Fix. You can find him on Linkedin.