A fascinating piece in the Boston Globe:
(via Marginal Revolution)The country’s leaders have tried over the years to stanch the problem by making alcohol harder to buy, most recently in 2009, when then-president Dmitry Medvedev declared alcoholism a “national disaster” and ordered a raft of new regulations. But historically, nothing has really worked. ...
Why has Russia proven so inhospitable to AA’s ideas? Certainly, the history of distrust between our two countries hasn’t helped. But there have been other obstacles as well—some religious, some medical, some cultural. It turns out that what looks like a benign and effective social movement in one country can start to look very different when it arrives on a new shore. Together, the difficulties AA has faced in Russia point to a fundamental obstacle to transplanting ideas across borders: Some solutions, even successful ones, may not be nearly as universal as the problems they are supposed to solve. ...
The reasons why, according to people who have devoted years to understanding alcoholism in Russia, are multiple and complex. The most important, perhaps, is that the Russian idea of “alcoholism” is very different from the American one: According to medical anthropologist Eugene Raikhel, the popular definition of a “drinking problem” in Russia is what happens at “the endpoint of chronic alcohol use,” not the drinking itself, which is considered perfectly normal. “They think alcoholism is when a person is homeless, lying in a ditch,” said Moseeva. “That’s an alcoholic. That a person can be more or less successful and still be an alcoholic doesn’t really register.” ...
Russians do get treated for alcohol abuse—but it tends to happen when someone is trying to dry out after an acute bender, and usually just means seeing a doctor, going through detox, and submitting to so-called coding, during which the patient is hypnotized into believing he can never drink again. There are also drugs, like Antabuse, designed to induce headaches and nausea if the patient drinks; not long ago, it was much more common for Russian doctors to implant such substances under people’s skin with so-called torpedoes than to refer them to AA.
A further obstacle to AA’s growth in Russia is something more philosophical: At a basic level, its premise of sobriety through mutual support just doesn’t make sense to a lot of Russians. In the past, this has taken the form of anti-Western suspicion—“What are the Americans trying to get out of this?” is a question Moseeva used to hear regularly. But more fundamentally, the group-therapy dynamic collides with a skepticism about the possibility of ordinary people curing each other of anything. “The idea that another drunk can help you is asinine to most Russians,” said Alexandre Laudet, a social psychologist who has researched Russian alcoholism.
Then there’s the problem of opening up to strangers. The AA method works in part through trust in people you’ve never met before, and coming clean to them about one’s most shameful secrets. “It is much harder for a Russian person to talk about himself than it is for an American,” said a Russian AA member named Mikhail. “And there are a lot of reasons why, including that the generation of my parents—and my own, I’m 55—couldn’t speak the truth at all, because it was possible to get arrested for it.
