One-time Russian prisoner Andrei tried to quit drinking 22 times, going for cures that lasted from one to six months. But each time, he went back to the bottle.
Then 14 years ago, the 58-year-old tried Alcoholics Anonymous, attracted by the different approach, which was not about doctors reprimanding the drinker, but taking personal responsibility.
And after going through the 12-step programme five times, the Muscovite with deeply-furrowed face and intense dark eyes, said he felt confident he could stay dry.
The Alcoholics Anonymous method of treating alcoholism first came to Russia from the United States more than 20 years ago, but is still not mainstream in a country where hard drinking is often viewed as inevitable and ingrained in the national psyche.
The AA movement of “mutual aid” groups created in the United States in the 1930s first came to Russia at the end of the 1980s during the perestroika era, as the country opened up under the last Soviet leader Mikhail Gorbachev.
Yet more than 20 years later, Russia has just 400 AA groups with 10,000 members — a tiny number for a population of 143 million where alcohol abuse and its social effects are a national scourge.
“The AA groups do not have much success in Russia, while 2.5 million Russians are registered as addicted to alcohol, and almost one in two Russian men regularly abuse alcohol,” said Alexander Nemtsov, an expert on alcoholism at the Institute of Psychiatry in Moscow.
“The Russians’ mentality opposes this American programme, which is based on extremely extrovert behaviour within a group,” said Nemtsov.
“Besides that, going through the AA cycle demands working with one’s self, while Russians prefer a passive role during their treatment.”
Russian alcoholics often choose treatments such as hypnosis, used by doctors to make them develop an aversion to alcohol and lose the urge to drink.
Another treatment involves under-the-skin implants of capsules containing a substance that allegedly produces negative physical effects if the patient drinks alcohol.
— ‘An illness, not a sin’ —
Andrei, who has spent nine years in jail for robbery, said that Russian methods were based on making him feel guilt and repentance, “which prevented me from stopping.”
He said he was attracted by the AA programme because it portrays alcoholism as an illness, not a sin.
But it was not smooth sailing.
“To start off, I found it horrible to tell my life story in front of 20 other alcoholics,” said Andrei.
“Everything about it, like the meetings where you buy tea and biscuits for everyone and then you tidy up the room together… made me think of our subbotniks,” he said, referring to a Soviet custom of making people volunteer to do community service on Saturday.
Today, though, he said he no longer felt guilty and was comfortable in his group, which meets two or three times a week in a basement in central Moscow.
The tight-knit atmosphere of such groups is viewed with suspicion by some in the Russian medical establishment, who perceive it as “foreign.”
“With its pragmatism, rationalism, individualism, its cult of material success, the AA is hard pushed to take root in Russia,” said Andrei Igonin, head of the alcohol dependency department of the Serbsky Centre, the country’s best known psychiatric hospital.
Russians “are more emotional, open and confident, and at the same time they are more turned towards authority. They are altruists in search of spiritual protection,” the scientist claimed in an article in Toxicology journal.
Some Russians are more inclined to turn for spiritual help to the Russian Orthodox Church.
“I went to the AA and I couldn’t believe my ears. They have no God and they say that they conquer alcoholism themselves. That fills them with pride,” one Orthodox believer wrote in a blog.
“I went back to the Church. There, they conquer it with prayer and fasting. Why reinvent the bicycle?” he asked.
Nevertheless, some AA groups meet on premises owned by the Church, which in 2010 described the AA as an “effective instrument in rehabilitating drug and alcohol addicts”, while stressing the need to develop its own anti-alcohol programme.
A 2011 WHO report found that every fifth male death in Russia was attributable to the effects of alcohol, with the average male drinker knocking back 35.40 litres of pure alcohol per year.
Many Russians take a fatalistic attitude to this, or half-admire it as something suffered by people who also have great talents.
Russian literature from 19th-century novelist Fyodor Dostoevsky to Venedikt Yerofeyev — who wrote a cult Soviet “prose poem” about an alcoholic’s meditations on a Moscow suburban train — overflows with memorable characters who are drinkers.
“It has always been that the Russian drinks to be able to bear the unfairness of existence,” said Vladimir, an AA activist who quit drinking 18 years ago.
“In Russia, alcoholics have traditionally been an object of sympathy… and that is also a killer.”