Alcohol and Alcoholism in Russia: An Update

The problem of excessive alcohol consumption in Russia is well known; but there is a tendency to exaggerate it. In this way, responsibility for enhanced mortality is shifted onto the people, that is, self-inflicted diseases caused by excessive alcohol consumption. The overestimation of the cause-effect relationship between alcohol consumption and cardiovascular disease has been used for the same purpose. The quality of alcoholic beverages is uneven. Instances of mass poisoning are discussed here. The concept of unrecorded alcohol is not directly applicable to Russia without a comment that ethanol from non-edible sources, diverted from the industry or imported, has been used for production of beverages sold through legally operating shops and eateries. Furthermore, heavy binge drinking has contributed to mortality. Fortunately, this hazardous pattern of alcohol consumption has been declining since the last two decades. Vodka and fortified wine have been partly replaced by a moderate consumption of beer. In a separate section, invasive and medicinal treatments without sufficient clinical indications are discussed. The attitude to persons supposed to have an alcohol use disorder is less responsible with lower procedural quality assurance than for other patients. Some ethical and legal aspects of compulsory treatments are briefly delineated. Efficiency of public policies in the discussed area has been limited. Considering shortcomings of medical practice, research and education, the directives and increase in funding are unlikely to be sufficient for a solution of existing problems. Measures should include participation of authorized foreign advisors.