Drinking Games: Can Russia Admit It Has a Problem?

Soviet-era joke: Brezhnev gets a telegram from Siberia—"Quick, send two train cars of vodka. The people have sobered up and are asking where the Tsar is."

Moscow—Visitors to Russia are often shocked at the ubiquity of inebriated people. It's easy to spot the dirty, red-faced men of indeterminate age stumbling down the street, cigarettes drooping from their mouths. Teens hang out in small groups in city parks, nonchalantly passing bottles of beer back and forth. On the crowded subway, the smell of alcohol on commuters' breaths is noticeable—even in the morning.

Of course, Russia doesn't have an exclusive claim to alcoholism or drug addiction. In the United States, there are 56,000 chapters of Alcoholics Anonymous. Americans spend $20 billion a year at private treatment centers. But there is a specific eeriness about the problem in Russia. It is widespread, it is socially accepted, and it has transcended regimes—from the tsars, to the communists, to today's hybrid of democracy and authoritarianism. Increasingly, however, officials are admitting that it poses a threat to the survival of the country itself. In 2009, advocating stepped-up efforts to reduce alcohol abuse, the former Soviet leader, Mikhail Gorbachev, observed that "we are destroying ourselves, and then we will look for who destroyed our country, who made us drink."

The idea that alcohol is destroying Russia is not sheer hyperbole. Russia's population, 150 million at its peak in 1991, has been on a steady decline since the Soviet collapse. It now stands at just 140 million. Many factors account for the drop. The health system has deteriorated, hundreds of thousands have emigrated, and birth rates have dropped. But it's the stubbornly low life expectancy that is obstructing Russia's chances of survival. A Russian boy born today will likely live about 60 years, fewer than any of his West European counterparts—or even boys in Yemen. According to a recent report in the British medical journal The Lancet, the staggeringly high level of recorded alcohol consumption—nearly 8 gallons annually per adult male, double the figure in the United States—is a major factor in this demographic disparity. A 35-year-old Russian man has a 27 percent chance of dying before age 55; the probability for a Western European male of the same age is 6 percent. The magazine's researchers found that half the deaths among Russian males ages 15 to 54—whether from car accidents, heart attacks or suicides—are alcohol-related. Even the Russian government acknowledges this grim toll, reporting that excessive alcohol consumption plays a role in 500,000 deaths a year. The government also notes that 23,000 Russians die of alcohol poisoning every year. Fewer than 1,500 Americans meet that fate annually.

"Alcohol—Enemy of Production" (1985)

In May 2010, Russia's Ministry of Healthcare and Social Development reported that a recent survey had found that there are 2.7 million alcoholics in the country. The World Health Organization tells a different story. In the United States, it says, 5 percent of the male adult population has an "alcoholic use disorder;" in Russia, it's 16 percent, or about 7 million people. The proportion of those who are "heavy episodic drinkers," those who consume 2.1 ounces or more of pure alcohol at least once a week, is 13 percent in the United States and 22 percent in Russia — at least 10 million men over the age of 15.

The epidemic's tentacles reach into the lives of children, particularly those from disadvantaged backgrounds. A 2006 study by a Tufts University team in the northern city of Murmansk, a city of 300,000, found that more than half the children in its orphanages suffer from fetal alcohol syndrome. FAS distorts facial features, producing a flat nose bridge and a flat upper lip, and can cause severe learning disabilities and behavioral problems like hyperactivity. But the high rates of FAS do not appear to stem...