Initiatives to curb alcohol abuse and alcoholism in the former Soviet Union

Alcohol Health & Research World, Fall, 1991 by Nancy D. Dorman, Leland H. Towle

Official concerns about alcohol consumption in the Soviet Union have been evident since at least 1914, when the Czarist regime implemented prohibition. In 1922, a campaign to crack down on illicit stills was initiated. Prohibitions were imposed by Stalin in the late 1920s, by Khrushchev in 1958, and by Brezhnev in 1972 and 1979 (The Economist 1989). From Khrushchev on, the antidrinking campaigns emphasized the role of the Ministry of Internal Affairs rather than the Ministry of Health, and focused on compulsory treatment and punitive measures. The campaigns were seen, even by the Soviet government, as fragmented and ineffective (Ivanets and Lukomskaya 1990), and, according to Vladimir Treml (1987), heavy drinking and alcohol-related problems continued to increase into the early 1980s.

When Mikhail Gorbachev became leader of the Soviet Union in 1985, the Presidium of the U.S.S.R. Supreme Soviet and the Soviet Republics issued edicts to initiate a new anti-alcohol campaign. Although evidence indicates that the objectives of that campaign, which are now being reexamined, have not been met, the program did result in a national focus on the problem that placed greater emphasis on health issues than had prior campaigns. In addition, the program established the All-Union Research Center on Medico-Biological Problems of Narcology (the Narcology Center), to coordinate research on the problems of alcohol and other drug dependence.

Also in 1985, the Soviets made the first inquiry regarding increased communication and cooperation with the United States in research on alcohol abuse and alcoholism. In 1988, after drafting a plan for scientific cooperation between the U.S.S.R. and the United States, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) began an active program of cooperation and scientific exchanges with the Narcology Center in Moscow. As a result of the initial linkage of the Narcology Center to the area of psychiatric and forensic sciences, and the allegations of human rights abuses in psychiatry (Judd 1989), nearly 3 years had passed before this cooperation could actually begin.

ALCOHOL CONSUMPTION, ALCOHOL-RELATED PROBLEMS, AND ALCOHOL CONTROL POLICY PRIOR TO 1985

Although the data are inconsistent on per capita alcohol consumption in the Soviet Union in the last 30 to 40 years (partly because of difficulty in obtaining data from the U.S.S.R. and partly because of lack of data regarding the production of home distillates), Treml (1987) has estimated that by 1985 annual consumption of absolute alcohol exceeded 16 liters per person over the age of 15. This rate is substantially greater than the 1976 Soviet estimate of 11.6 liters per capita, itself cited as a 500-percent increase over 1950 consumption (Segal 1976). Official data from the U.S.S.R. State Committee on Statistics indicate that, between 1960 and 1980, annual per capita consumption of alcoholic beverages more than doubled, from 3.9 liters of absolute alcohol in 1960 to 8.7 liters in 1980 (Ivanets and Lukomskaya 1990). These latter data, however, probably do not reflect consumption of "samogon," an alcohol distilled in the home. (It should be noted that alcohol consumption patterns in the former Soviet Union differed according to region and ethnicity. For example, people living in Russia, Ukraine, and Byelorussia primarily consume vodka and samogon and are the heaviest drinkers; those in the Baltics consume more alcohol, but are primarily beer drinkers; the Georgians, Moldavians, and Armenians are wine drinkers and drink less; and in the Muslim countries, consumption is generally low [The Economist 1989].)

Treml (1987) noted that "the U.S.S.R. was by the mid-1980s facing an alcohol problem of truly crisis proportions." The Economist (1989) reported that a decrease in life expectancy for Soviet males, from 66 years in 1965 to 62 years in 1984, was largely attributed to heavy alcohol consumption, and that studies from the West suggested that alcoholism was the third leading cause of death in the Soviet Union, after heart disease and cancer.

It has also been estimated that in the early 1980s one-fifth of all deaths in the Soviet Union were either directly or indirectly caused by alcohol (Treml 1987); two-thirds of murders and violent crimes were committed by intoxicated persons; and drunk drivers were responsible for 14,000 traffic deaths and 60,000 serious traffic injuries (Ivanets and Lukomskaya 1990).

PERESTROIKA AND THE ALCOHOL-RELATED REFORMS OF 1985

In April 1985, shortly after Mikhail Gorbachev became leader of the Soviet Union, the Soviet government, in the spirit of perestroika--which is based on reasoned argument, openness, and a flexible approach to problems--approved a major "new" antidrinking campaign.

The campaign included a multidisciplinary approach to alcohol-related problems. Ivanets and Lukomskaya (1990) describe in detail the two major components of the program--the regulation of the availability of alcoholic beverages, and the establishment of prevention programs focusing on decreasing the demand for alcohol.