Can the AA 12-Step Program Thrive in Russia?

August 5, 2011

by Richard Weitz

The US Helsinki Commission is charged with monitoring human rights compliance in the former Soviet Union. But on August 2, the commission took a break from its routine responsibilities to examine the thorny issue of alcoholism in Russia.

Russians’ capacity for drink is legendary. During the hearing, titled US-Russian Cooperation in the Fight against Alcoholism, one of the witnesses, Heidi Brown, an analyst at Kroll Associates, tried to quantify the impact of spirits on Russian society. The numbers she proffered were alarming: half-a-million deaths each year in Russia are alcohol-related, and approximately half of all male deaths in Russia are in some way connected to excessive alcohol consumption. In addition, a whopping 2.3 billion liters of vodka are sold every year in Russia, a country with a current estimated population of 142 million.

Another witness at the hearing was Dr. Eugene Zubkov, the co-founder of a 30-bed clinic in Leningrad Oblast outside St. Petersburg that specializes in treating alcoholics. Zubkov noted that there are 2.7 million officially registered alcoholics in Russia, but added that the official count was probably low. “It means probably three times that many patients … are not registered,” he said. If Zubkov’s estimate is accurate, it means that approximately one in every 13 Russian citizens may be an alcoholic.

The hearing spent a fair amount of time examining the applicability to Russia of the 12-step program developed by Alcoholics Anonymous (AA), a mutual assistance movement designed to promote sobriety that was founded in 1935 in the United States.

Margaret Murray, the director of the International Research Program at the US National Institute on Alcohol Abuse and Alcoholism, told members of the Helsinki Commission that AA “has been an extremely important mainstay of [alcoholism] treatment in the United States.” Among the benefits, Murray said, was the “social support for abstinence that AA provides, as well as enhancing an individual’s spirituality, which we know is key to recovery for a lot of people.”

Zubkov said his clinic, called the House of Hope on a Hill, utilizes AA’s 12-step method in its 28-day treatment program. Since its opening in 1996, the House of Hope has treated about 4,500 patients, he said, adding that the facility has acted as a catalyst for the slow spread of AA chapters across Russia. “There are now 370 AA meetings … in Russia, and 40 percent of those meetings were started by – initiated by the graduates of the house,” he said.

AA encounters lots of opposition in Russia, Zubkov noted. Efforts to open an AA-based clinic in a new location often generate official opposition because the 12-step method is seen as a foreign import.

“There is a lot of mistrust of Alcoholics Anonymous there because it is seen as Western. … There are a lot of people who still have sort of a nationalism or a resentment about methods that have come from abroad,” added Brown. Some opposition also appears to be faith-based, as AA is seen by many Orthodox Christian Russians as essentially a creature of the Reformed Protestant tradition.

Preferred treatment methods in Russia lack an adequate after-care component, Zubkov said. “Russian treatment methods are largely very biologically oriented and sometimes strange.” The most popular method relies on the use of Antabuse, a drug that makes people sick when they drink alcohol. But this does not address the cultural and physical sources of the addiction. “And after this, [the] patient is basically – he is on his own,” Zubkov said. “He doesn’t get any therapeutic support. He doesn’t get any – he doesn’t go to any meetings. And when he has a personal crisis, the easiest way for him to resolve it is try to drink, and very often this could end in fatalities.”

Beyond cultural differences, the lack of a tradition of philanthropic giving in Russia is hampering the ability of AA programs to expand their reach. The House of Hope, Zubkov noted, depended on financial support provided by an American philanthropist, Lou Bantle, who died in 2010. Now, the clinic is facing an uncertain financial future. Finding Russian benefactors is an extreme challenge, Zubkov added.

Not only does the Russian government tax charitable contributions, but those corporations and philanthropists that do donate “prefer to support high-profile, socially acceptable organizations, such as the performing and visual arts.” The only exception has been the Baltika brewery, which has been “continuously supporting us for many years,” he said.

Editor's note: Richard Weitz is a senior fellow at the Hudson Institute in Washington, DC.

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