Can AA Survive in Russia?

Can the AA 12-Step Program Thrive in Russia?

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.

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Teens & Alcohol Shops

Alcohol Shops Affect Teen Drinking

Alcohol outlets lead to specific problems among youth and young adults

Alcohol research has clearly demonstrated a connection between alcohol outlets and alcohol-related problems.

A new study focuses on the effects of alcohol outlets on underage youth and young adults.

Findings show that alcohol-related injuries among underage youth and young adults are shaped by the density and types of alcohol outlets in neighbourhoods.

Prior studies have not only demonstrated a clear connection between alcohol outlets and alcohol-related problems, they have also shown that certain types of outlets are associated with different types of problem outcomes. A new study shows that a particular group, underage youth and young adults, have specific problems – injury accidents, traffic crashes, and assaults that are related to specific types of alcohol outlets – off-premise outlets, bars and restaurants.

Results will be published in the March 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“Over the past four decades, public health researchers have come to recognize that although most drinkers safely purchase and enjoy alcohol from alcohol outlets, these places are also associated with serious alcohol-related problems among young people and adults,” said Paul J. Gruenewald, senior research scientist at the Prevention Research Center and corresponding author for the study.

“In the early studies, researchers believed associations were due to increased alcohol consumption related to higher alcohol outlet densities,” added Richard Scribner, D’Angelo Professor of Alcohol Research at the LSU School of Public Health. “However, as the research area has matured, the relations appear to be far more complex. It seems that alcohol outlets represent an important social institution within a neighbourhood. As a result, their effects are not limited to merely the consequences of the sale of alcohol.”

For this study, researchers obtained non-public hospital discharge data from the California Office of Statewide Health Planning and Development, including residential zip code and patient age for all patients discharged. Ninety-nine percent of the injury records were successfully mapped to zip codes. Population demographics, place characteristics, and data related to alcohol outlets were also collected from various sources, and modelled in relation to two age groups: underage youth between 18 and 20 years of age, and of-age young adults 21 to 29 years of age.

“Greater numbers of off-premise outlets such as take-out establishments were associated with greater injuries from accidents, assaults, and traffic crashes for both underage and of-age young adults,” said Gruenewald. “But only among of-age young adults were greater number of restaurants related to traffic crash injuries and greater numbers of bars related to assault injuries. These findings confirm previous observations that drinking at bars may be a particular risk for aggression and alcohol-related assaults while drinking at restaurants may be a particular risk for drunken driving and alcohol-related traffic crashes. The findings also confirm prior studies that indicate underage risks are uniquely associated with off-premise establishments.”

“In other words,” said Scribner, “the pattern of alcohol-related injuries among underage youth and young adults is not random; their occurrence is shaped by the density and type of alcohol outlets in a neighbourhood. For example, when young adults reach the minimum legal drinking age, they begin legally drinking in bars where events such as bar fights are relatively common, and more likely when the density of bars increases. A little more complex is the strong association between an increasing density of off-premise outlets such as convenience stores and liquor stores, and higher rates of all injury outcomes among both underage youth and young adults. The authors indicate this association may be related to broader social factors where the concentration of these types of alcohol outlets in a neighbourhood influences the social networks of both youth and young adults by reinforcing high-risk drinking practices. Clearly this type of research can help to develop informed policy in areas where high rates of youth injuries are considered a problem.”

The key message, said both Gruenewald and Scribner, is that a neighbourhood’s alcohol environment plays a role in regulating the risks that youth and young adults will be exposed to as they mature.

“From a prevention perspective, this represents an important refocusing of priorities, away from targeting the individual to targeting the community,” said Scribner. “This is hopeful because a community-based approach that addresses the over concentration of alcohol outlets in a neighbourhood where youth injuries are a problem is relatively easy compared with interventions targeting each youth individually.”

Chronic Illness Often a Taboo Conversation


Along with taboo topics such as politics and religion, many people are reluctant to discuss managing a chronic illness with family or friends, according to a new survey of more than 1,000 adults.

The survey found that 82 percent of respondents said they knew someone with a chronic illness, but only 34 percent were likely to suggest ways for this person to better manage their care. That’s about the same number who said they’d debate politics (37 percent) or religion (33 percent) with a loved one or friend.

only 34 percent were likely to suggest ways for this person to better manage their care

Respondents were more likely to;

  • discourage friends or loved ones from buying the wrong house (65 percent),
  • loan them a large amount of money (56 percent),
  • advise them against taking a job they didn’t think was right for the person (48 percent), and
  • tell them their spouse was unfaithful (41 percent).

The reasons why many Americans are reluctant to offer advice to chronically-ill friends or family include:

  • They think the person has the situation under control (66 percent);
  • they are not a health care professional (31 percent);
  • they don’t want to seem like a nag (31 percent) or
  • rude (29 percent);
  • they don’t believe the person would listen to them (27 percent); or
  • they didn’t think the matter was that important (15 percent).

Other findings:

  • Twenty percent of respondents said their spouse was the easiest person to give advice to about health, followed by a child (20 percent), mother (13 percent), and father (5 percent).
  • Most respondents said they’d prefer to receive advice about managing a chronic illness from a health care professional (67 percent), followed by a spouse (10 percent) or parent (7 percent). Men were twice as likely as women (14 percent versus 7 percent) to have their spouse give them such advice.
  • Men have an easier time offering health advice to their spouse (28 percent) than women (19 percent). Women have an easier time offering health advice to their children (24 percent) than men (16 percent).
  • Thirty-four percent of respondents said the person closest to them with a chronic illness is a parent (34 percent), followed by another relative (16 percent), spouse (14 percent), friend (11 percent), sibling (8 percent), and child (6 percent).

Tips on how to help family or friends, or even patients with a chronic illness:

  • Talk to them in order to get an understanding of their goals. Get the conversation started by discussing events or activities they used to enjoy or future events they want to be part of, such as a family reunion. Once you understand their goals, you can help them achieve them along with health care providers, doctors or community service agencies.
  • Appoint an “ambassador” — a friend or loved one feels comfortable talking with and respects enough to heed his or her advice. This person can help the ill person manage their condition.
  • If you don’t already know, increase your comfort levels by educating yourself about the person’s chronic illness. This will make you feel more comfortable speaking with them about the condition and reinforcing professional advice.

Everybody wins when ex-addicts learn to live again

A great failing of current strategies to solve the problem of drug addiction in B.C. is the near-absence of any long-term programs catering to the needs of patients in recovery.

It is doubly disappointing then, that when a private initiative is put forward offering such a program, it should encounter resistance from within the community.

There is a danger of this happening in Surrey, where, as Kent Spencer reported in The Province yesterday, former business tycoon John Volken is proposing to build a $20-million “campus” in the Newton area designed to teach life and job skills to recovering addicts.

Volken, 66, who sold his United Furniture Warehouse chain three years ago, has since invested more than $100 million in pursuing his grand scheme of social philanthropy.

More of this story at the Province.

Life-long druggie says prison’s no answer

Vancouver granddad says jail turns addicts into hardened criminals

Prison, Terry McKinney tells me, screws up your head so badly that when you’re on the outside, it’s payback time: A confused and off-track kid goes in, a slick, seasoned felon comes out.

So if Prime Minister Stephen Harper thinks users and traffickers like him will rush to change their stripes — spooked by a $64-million anti-drug plan that imposes must-do jail time — he can forget it.

McKinney, a 59-year-old Vancouver granddad, has been a junkie for the past 37 years; a regular in B.C.’s prisons after numerous convictions for peddling heroin to bankroll what was a $1,000-a-day habit at the peak of his intake.

The inmate who has done time is 10 times smarter, 10 times more vicious and 10 times bigger, he says. They have nothing better to do than form alliances, pump iron and plan more sophisticated crimes. The first to befriend an offender when he’s sprung are his jail buddies.

More of this story by Joey Thompson, at The Province

Treatment Benefits Inmates

Long Term Treatment Benefits Inmates

The Residential Substance Abuse and Treatment (RSAT) Program at the Wicomico County Detention Center in Salisbury, Md. provides repeat offenders with six months to two years of holistic rehabilitation services to promote permanent lifestyle changes, the Delmarva Daily Times reported on July 5.

’Substance abuse is more of a symptom than a cause — something else is going on that they’re either trying to self-medicate or ease a difficult situation,’ said Doug Devenyns, founder of the program and director of the detention center.

’When you couple the addictions treatment with the … other treatment that addresses that underlying cause, then we get into a pretty effective scenario. The success rate starts going off the map.’

The RSAT program has graduated 20 offenders since its formation two years ago, and only 4 have relapsed.

While up to 75 percent of offenders commit additional crimes after their release, only 2 of the RSAT graduates have been re-arrested.

RSAT participants live apart from the general inmate population, attending counseling and classes in such subjects as parenting, conflict resolution and hygiene for a total of 10 hours a day.

Those without a high school diploma are also required to complete a GED program to maximize the effectiveness of their rehabilitation.

The program can only admit 34 residents due to limited resources and a strict screening process.

RSAT costs $300,000 a year, 75 percent of which is provided by the governor’s office, while the remainder is paid by the city of Salisbury.

’There is so much talent with that group alone that the world hasn’t yet seen, that is hidden behind addiction,’ said RSAT lead counselor Lynn Schofer. ’They deserve an opportunity to show it and live it.’

Friends Can & Do Help

Mental health study shows friends can help

The study by the Mental Health Foundation discovered almost 80% of people know at least two friends who have experienced mental distress, yet many don’t want to admit their problems for fear of what their friends might think.

The charity surveyed people across the UK looking at the experiences of both people with mental health problems and those of people who have supported friends during a period of mental illness.

Half of all people who did not want friends to know about their mental health problem said it was because they felt ashamed and two in three were worried their friends would not understand.

A total of 49% of those who responded said they did not feel able to talk to their friends about their mental health problem.

Reassuringly, 60% of people with mental health problems reported that when their friends did find out, they were concerned and 47% offered support.

Two in three people said their friend’s mental health problem did not put their friendship under strain, and almost half (41%) declared that it actually made their friendship stronger.

A total of 62% of people with mental health problems said it helped to have friends around and 41% revealed they received more help from their friends than their GP or own family.

Almost half of the respondents who knew a friend with a mental health problem felt that they did not know enough about mental health to give advice and a further 48% said better information would have helped them to support their friends.

Nearly three quarters of people admitted feeling frustrated because there was no simple solution to their friend’s mental health problem.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said: “Friendships are very important for good mental well-being, yet people can feel ashamed or embarrassed to tell their friends about how they feel.

“We know it can be hard for a person who feels depressed or anxious to discuss how they’re feeling but it is often friends who can provide the most support.”

Based on the findings of the new survey the Mental Health Foundation has developed a number of recommendations for people to support a friend.

Included in the suggestions are for friends to:

  • keep in contact through regular phone calls, visits or emails;
  • give emotional support through listening and talking;
  • try to provide practical support, such as offering to accompany them shopping or on a visit to their GP;
  • just be around; and
  • try and understand your friend’s mental health problem.