Reform policies aggravate Russia's drinking problems

BY 8 a.m., the bustling Belorussky train station in downtown Moscow is a showcase for Russia's massive drinking problem.

Before entering the nearby subway or boarding a bus to work, hundreds of commuters have a bottle or two of beer, available in any of the numerous kiosks that have sprung up near the station in recent years. An increasing number of homeless alcoholics, who spend the night on scattered patches of grass near the station, slug down a shot of vodka or beg for change to buy themselves a bottle.

In the old days of the Soviet Union, Russians rarely abstained from drinking. But they usually kept their habit to themselves, fearful of being arrested on the spot and spending up to two years in one of 171 special ``labor camps'' for alcoholics.

But on July 1, the last of 35,000 inmates of the labor therapy prevention centers (LTPs) made their way back into society.

The centers were conceived in 1968, officially to cure alcoholics. In reality, they did little more than provide cheap labor to the state and hide a major embarrassment to the Communist leadership.

The camps, located in most major cities and provincial capitals in Russia, received a large influx of men and women in 1985, when the country's new leader, Mikhail Gorbachev, started his widely publicized campaign against alcoholism. Most inmates were repeat offenders picked up on the streets for disorderly conduct or reported to authorities by relatives and neighbors, but some landed in the camps simply for refusing to undergo treatment for alcoholism.

Few programs available

With the closing of the camps, Russian health officials warn that few alternatives are available to battle the spread of alcoholism.

``After the closure, the addicts will just end up on the street. Where can they go? Nobody has considered that question,'' says Nikolai Shutov, chief physician at Hospital 19, a clinic for 800 alcoholics and drug addicts in Moscow. ``You need to change the system, not destroy it,'' he adds. ``You can close them, but the social problem remains.''

The problem is intensifying as Russia struggles to reform its economy. Unemployment is growing as state enterprises go bankrupt, and soaring crime and political instability are creating a nationwide sense of insecurity.

A recent study shows that Russians have overtaken the French as the world's heaviest drinkers, consuming 14 liters of pure alcohol per capita each year. The average Russian man drinks almost half a liter of vodka every two days, the Izvestia newspaper reported recently.

The state is ill-equipped to cope. State-run rehabilitation clinics have cut capacity in half to meet rising costs. The number of overnight ``drunk tanks'' has also declined. According to Interior Ministry statistics, 320 people died last year in the country's 900 sobering-up stations, mainly due to medical negligence.

Moscow, a city of 10 million people has only two state-run drug and alcohol rehabilitation clinics. While a growing number of private firms offer clinics or home care, few can afford it.

Western religious groups help fund some charitable clinics. The Catholic Church finances House of Mary, a walk-in facility, and the Church of Scientology has opened a small clinic targeted mainly at drug addicts. The NAN (No to Alcoholism and Drug Addiction) organization runs an out-patient clinic modeled on Alcoholics Anonymous that brings in Western consultants on a regular basis. And the Russian Orthodox Church is hoping to set up its own assistance programs soon.

But most clinics are private businesses that cater to the rich, and in today's inflationary society even many nonprofit clinics are forced to charge fees.

Vozvrashcheniye, or Recovery, has helped more than one third of its patients stay off the bottle by using the AA program, center deputy director Alexander Krivenko says. It can accommodate 30 patients, but only eight are presently enrolled because inflation has put the program out of most people's reach.

``We are a serious alternative, but we can only help a very limited number of people,'' Mr. Krivenko says.

A solution needed

Keeping the labor camps open would have kept some alcoholics off the street. But few think it would have helped solve Russia's drinking problem.

``How can you be cured if you don't want to be?'' grumbled Anatoly Puzhakov, as he waited for his release in June from Labor Therapy Prevention Center No. 1 in a Moscow suburb. ``It's useless. I can't quit drinking. I can't live any other way.''

Outside the gate, another former inmate celebrated his release with his wife and a bottle of vodka.

Chief physician Leonid Stanev says the camp provided a comprehensive rehabilitation program. But in interviews, inmates say they were forced to work nine-hour days and received no care at all. And although alcohol was in principle strictly banned, Mr. Puzhakov says he often bought alcohol from the guards.

Camp Warden Nikolai Sheptalov says the closure was a mistake. ``Here, they are protected by the state,'' he says. ``There, they have to find a way to live. Not everyone is able to do so.''

Col. Rudolf Volzhanin, head of the Interior Ministry correctional department, says that former inmates may resort to stealing and end up in a regular prison. Alcohol is a factor in 70 percent of all crimes, government statistics say, and figures prominently in incidents of domestic abuse.

But there are no plans or funds for any new state-run clinics to take the place of the labor camps. And the number of beds in state-run drug-rehabilitation clinics, set up by large enterprises that employ the patients as cheap laborers, has been cut in half since 1989 because of low funding, Health Ministry rehabilitation expert Anatoly Shevchenko says.

Dr. Shutov of Hospital 19 says alcoholics receive various kinds of treatment in his program, including mandatory work therapy reminiscent of the camps. But he claims no significant success in weaning his patients from the bottle. ``For a few months,'' he says, ``there are 800 fewer battered wives, 800 fewer drunks on the street.''