Mark R. Elliott
Editor’s note: Edited excerpts of this article were published under the title, “Quenching the Spirits; How Faith-based Rehab Programs Are Doing Battle with Russia’s Drinking Problem,” Christianity Today 57 (November 2013): 60-64. The unabridged study from which the present East-West Church and Ministry Report article is taken may be accessed via the online journal, Occasional Papers on Religion in Eastern Europe 34 (January 2014): 1-47, at www.georgefox.edu/academics/undergrad/departments/soc-swk/ree.
Drunk Driving Deaths
The toll was seven dead: five special needs orphans, their teacher, and her husband, returning home from a crafts fair. On 22 September 2012 a drunk driver on a two-day binge had plowed into a Moscow bus stop at an estimated 125 miles per hour. Following his arrest, 29-year-old Alexander Maximov, with a previous DUI and other traffic violations, told investigators, “I always do what I want.”
Russian leaders Vladimir Putin and Dimitry Medvedev and the state Duma are all on record calling for stiffer DUI penalties in an attempt to reduce the nation’s troubling rate of alcohol-related traffic fatalities. Looking at the larger picture, the World Health Organization maintains Russia has “by far the highest proportion of alcohol-attributable mortality” worldwide. In Lenin’s famous phrase, taken out of context, “What is to be done?” Now that the post-Soviet church is free to exercise compassion, can it be some part of a solution to Russia’s epidemic alcoholism? Perhaps so, but first, what are the actual dimensions of the crisis?
Russia’s Demographic Decline
Russia today is facing a serious demographic shortfall. Since the Soviet breakup, the country’s population has fallen from 149 million to 142 million. With an excess of 12.5 million deaths over births in these years, the decline would have been even greater but for in-migration from Central Asia. At fault are deteriorating health care, an unhealthy diet, smoking, declining birth rates, emigration, and social trauma stemming from economic upheaval and persistant unemployment. The ultimate cause of demographic decline is an elevated mortality rate unprecedented in a highly educated, industrialized nation in peacetime. A host of Russian and Western analysts, in turn, argue that alcohol abuse plays a leading role in Russia’s unsustainably high mortality rate.
Russia’s High Rate of Alcohol Consumption
Europe has the world’s highest rate of alcohol consumption; and in Europe, Russia’s annual consumption rate of 15.8 liters of pure alcohol per capita is exceeded only by Moldova (18.2), the Czech Republic (16.5), and Hungary (16.3), while the annual male alcohol consumption rate of 35.4 liters is eclipsed only by Ukraine (37.4) and Estonia (36). Working-age Russian males down an average of more than 155 bottles of vodka per year.
Alcohol Poisoning and Binge Drinking
Compounding the problem of increasing quantities of alcohol consumed has been the decreasing quality of spirits. Drinking often unsafe, homebrewed samogon has increased deaths from alcohol poisoning, as has the consumption of such lethal liquids as industrial alcohol, antifreeze, perfume, and cleaning solutions. Whereas fewer than 1,500 Americans die from alcohol poisoning annually, the figure for Russia in a recent year was 23,000. Russia, in addition, has the misfortune of Europe’s second highest rate of consumption of strong spirits (63 percent). Binge drinking (the case for about one-third of Russian males at least monthly), heavy consumption apart from meals, and Russian cultural tolerance for heavy drinking also contribute to Russian alcoholism.
Alcohol-Related Mortality
The unhealthy quantity, quality, and pattern of Russia’s alcohol consumption provide the explanation for alcohol-related deaths of half a million Russians annually. Out-of-control consumption of vodka and other distilled spirits results in marked increases in alcohol-related homicide, suicide, traffic fatalities, drownings, fatalities from industrial accidents, fires, and falls, and terminal medical conditions including cancer of the mouth and cardiovascular, liver, kidney, and respiratory diseases. As examples, 75 percent of murders committed in Russia and 42 percent of suicides occur under the influence of alcohol, and in one Russian urban investigation, 83 percent of those who died in fires, 63 percent who drowned, and 62 percent who fell to their death were inebriated. Thus, in the midst of Russia’s demographic free fall, an increasing body of evidence suggests that alcoholrelated deaths are especially to blame.
Social Costs of Alcohol Abuse
In addition to deaths, the social costs of Russian alcohol abuse include increased rates of theft, assault, rape, domestic violence, divorce, child neglect, and orphaned children. Misuse of alcohol is also responsible for fetal alcohol syndrome births and as much as a 15 to 30 percent shortfall in worker productivity. Russian émigré Harvard scholar Boris Segal estimates economic losses from alcoholism at one-third of Russian GNP.
Church-Based Rehab
Since the demise of the Soviet Union churchbased rehab programs have proliferated, now totaling approximately 100 Russian Orthodox and some 600 to 800 Protestant. A Pentecostal church in Kyiv opened the first Protestant residential alcohol rehab center in the former Soviet Union in 1994, with the second, New Life, in St. Petersburg in 1995. The charismatic New Life Center in the Leningrad Region, with a residential population fluctuating between 170 and 400, may be the largest churchbased program in Russia. Most church-sponsored rehab centers, however, are modest in size, typically working at any one time with 20 to 25 recovering alcoholics.
Detox
Those who enter church rehab programs undergo withdrawal “cold turkey” since church centers cannot afford drug regimens and prefer instead to rely on spiritual intervention. Christian rehab worker Alison Giblett credits, in particular, the “healing power of prayer” for sparing alcoholics withdrawal at its worst. Many program participants, for their part, report detoxification less severe or non-existent compared to previous withdrawals they have experienced.
Rehab Routine
At the heart of Russian church-based rehabilitation is the conviction that only God can reform alcoholics and that Bible study, prayer, worship, and Christian community are the practical, spiritual means of their deliverance. The usual rehab routine involving exercise, regular hours, regular meals, and regular work is naturally conducive to better health. Program participants regain appetites, regain weight and strength, and regain a sense of normalcy, in contrast to lives and bodies previously taxed by alcohol.
Follow-up Care
Residents who successfully complete rehabilitation programs and make their way back into society face the danger of relapse unless they take great care. Rehab centers therefore encourage their graduates to steer clear of old drinking friends and old haunts and, instead, to live four to twelve months in halfway houses, transition apartments, and in the case of Orthodox, in monasteries, nunneries, or remote parishes. Centers also try to arrange employment, stress the importance of permanent vows of total abstinence, and encourage attendance at periodic reunions. Former Alcoholics and Church Growth Journalist William Yoder, visiting Baptist and Pentecostal churches in Siberia, reports a common sight: “rows of silent men between the ages of 20 and 50 unaccompanied by women or children”— rehab residents and graduates. Moscow Pentecostal pastor and rehab director Andrei Blinkov has observed that former alcoholics who stay active in church are the rehab program graduates most likely to stay sober. Churches are both organizing agents of recovery and products of rehab programs; churches start rehab programs and rehab programs start churches. Alison Giblett explains, “Drug and alcohol rehab ministry in Russia and Ukraine is the strongest determining factor of church growth.”
Church-Based Rehab Success
Four features of church-based alcohol rehabilitation programs have contributed to their success. First, recovered alcoholics very frequently serve as directors and staff in church-based rehab centers. Time and time again, as I interviewed directors and sponsors of programs across vast distances I found this point confirmed—from Khabarovsk to Novosibirsk to Almaty to Moscow to Kostroma. Fourteen of 20 rehab center directors interviewed by Alison Giblett were themselves graduates of recovery programs, as is the case with all 40 leaders of Evangelical Christian-Baptist Good Samaritan rehab centers. Rehab graduates who stay on to staff recovery centers serve as role models. In The Mill, Father Maxim and his workers urge residents to look to Christ and the saints for lives to emulate, but residents view ex-alcoholic staff members as the best examples of what they can become.
A second key to success has been the residential nature of recovery centers. The trouble with day programs, Alison Giblett argues, is that addicts “are still surrounded by all the same temptations.” Great value comes from community living with staff and residents eating, sleeping, working, and worshiping together, all of which fosters a healthy, sober lifestyle.
Third, churches almost always locate their rehab programs in the remote countryside where temptations prove harder to indulge. Alison Giblett recalls, “It was often in the small ‘family-run’ isolated homes located far from the cities and modern life where I sensed the strongest commitment to change and joy in their transformed lives.”
Finally, church-based rehab centers operate on remarkably modest budgets. Post-Soviet branches of such transnational rehab programs as Teen Challenge and Betel have sometimes received help with startup costs. However, most church-based rehab centers have received little or no operating support from clients, the government, or Christian sources abroad. That may be changing as Putin and Medvedev recognize the increasing threat that substance abuse poses for the nation. On 22 November 2012 the Russian Federal Drug Control Service announced funding of one billion rubles ($32.2 million) for 2013 in support of rehab centers, apparently including church-based programs.
Measuring Success
he self-sufficiency that characterizes most church-based rehab programs stems from low-cost rural residence, volunteer staffing, drug-free detox, and a remarkably wide range of small business ventures.New Life and The Mill near St. Petersburg, Pastor Andrei Danilov’s center near Kostroma, an Operation Mobilization center near Novosibirsk, and three rehab programs near Almaty illustrate the dizzying array of possibilities: electrical, plumbing, and construction work, auto repair, carpentry, making furniture, marketing honey, making bricks, and operating a sawmill, fishery, taxi service, and guest house. As for agricultural pursuits, these centers grow and consume or sell vegetables, fruits, flowers, and ornamental plants, raise livestock, breed bulls for sale, engage in potato truck farming, and make and market peanut butter, salsa, jams, and preserves.
Post-Soviet church-based alcohol rehabilitation programs are unquestionably prolific and give every appearance of success. However, measuring results, even defining success, proves to be a difficult task. Lack of agreement on what length of sobriety constitutes success makes for widely diverging estimates of effectiveness. “In Soviet times,” University of Chicago Professor Eugene Raikhel notes, “a remission was considered effective if the patient didn’t drink for two months,” whereas today in church-based rehab programs, total abstinence for life is the yardstick for success.
On average, post-Soviet government-run and commercial alcohol rehab centers have success rates of less than 10 percent. Indicative of the poor showing of secular programs is the admission of one narcologist with 50 years’ experience: “I know how to get a man out of drunkenness, but to teach him how to live sober, I am powerless.” By way of contrast, the average success rate for church-based alcohol rehabilitation in Russia and Ukraine is 61 percent.
Positive, non-quantitative outcomes of churchbased programs reinforce the point: widespread employment of rehab graduates as treatment directors and staff, numerous reformed alcoholics in new church leadership positions, and recovered alcoholics marrying and raising families in churches connected to rehab programs. A medical doctor in Ukraine with nearly 30 years of employment in state rehab programs came to the painful conclusion that her past efforts had been “hopeless and senseless.” As a retiree, she now volunteers in a successful churchbased program in Kyiv.
Also in Ukraine, state ministries, after evaluating various drug and alcohol rehabilitation programs, designated the church-based “Know the Truth” curriculum as one of four approved resources for substance-abuse treatment. In Russia an outside specialist judged the success of the church-based New Life Center near St. Petersburg “on a par with…the very best Russian centers for addiction treatment.” In 2005 in a Kremlin ceremony President Putin awarded a medal to New Life’s director.
Rehab Shortfalls
While acknowledging the positive results of church-based recovery programs, a balanced perspective still requires examination of marginal and unsuccessful rehab efforts. In November 2010, on charges of unsanitary conditions, forced detention, and the mistreatment and death of a client, the Ministry of Justice ordered the closure of the Protestant “Transformation of Russia,” which reportedly administered almost 400 rehab centers. While some Russian Orthodox churches host Alcoholics Anonymous meetings, especially conservative, nationalistic Orthodox are suspicious of AA because of its Western and Protestant roots. Also troubling is the calculation of a priest at Moscow’s Danilovsky Monastery who runs AA meetings for Orthodox clergy, that perhaps one quarter of all Orthodox priests are themselves battling alcoholism.
Orthodox Criticism of Protestant Rehab
In addition, some Orthodox priests, for example, Father Maxim (Pletnev) who directs a St. Petersburg rehab center, dismiss Protestant rehab programs as the replacement of one addiction for another: “They may be saving people from drugs, but these people display a dependency on the sect very similar to narcotic dependency.” Similarly, Father Alexander (Novopashin) in Novosibirsk warns against “sectarian” rehab centers as “scams that hide behind good intentions.”
It is true that successful church-based residential rehab programs—in Russia and elsewhere—rely heavily upon strict and demanding house rules. However, since spiritual disciplines and rigorous daily routines characterize Orthodox as much as Protestant rehab programs, both could be said to be fostering new dependencies—and, in fact, neither would care to disavow fostering dependence upon God. Conversely, on a positive note, Orthodox sociologist Sergei Filatov of the Russian Academy of Sciences contends that Protestant rehab work in Siberia and the Russian Far East serves as a positive incentive for greater Orthodox efforts to aid alcoholics.
Primitive Conditions
Many church-based treatment centers must also cope with primitive accommodations. Centers often sleep six to ten persons per room and lack modern utilities, forcing residents and staff to make do without running water, indoor bathrooms, washing machines, or central heating. Such dire conditions would hardly seem conducive to successful recovery, but in rural Russia at least, such rudimentary living conditions are not unusual.
Relapse
Father Georgi (Edelstein) has successfully assisted recovering alcoholics in his parish outside Kostroma, but other alcoholics have failed to make good on his help. On occasion this enterprising priest has offered recovering alcoholics housing in newly constructed cabins, with the promise of deeding their quarters to them outright if they stay sober for a year. One morning in June 2004 I remember arriving in the village of Karabanovo to visit Father Georgi, only to see smoke rising from the ashes of an izba that had burned overnight. An alcoholic under Father Georgi’s tutelage had squandered his chance: In a drunken state he had smoked in bed, catching fire to his home.
Ambitious Social Outreach
In spite of its hindrances and handicaps, churchbased alcohol rehabilitation in Russia and Ukraine constitutes perhaps the most ambitious social outreach undertaken by Protestants in the wake of the Soviet Union’s demise. Together the rehabilitation work of Protestant and Orthodox churches marks a dramatic departure from Soviet marginalization of religion. Since the advent of glasnost, the word miloserdie (charity) has no longer been obsolete as Soviet dictionaries previously had designated it. The church-based rehab movement is also part of the post-Soviet reemergence of civil society. Whether or not current state harassment and suppression of Russian secular NGOs will undermine church-based rehab as well is an open question. Only time will tell if the November 2012 announcement of state funding for private rehab programs might signal a more favorable climate for at least this category of NGOs.
Grassroot Initiatives
A striking feature of the post-Soviet, church-based rehab movement is the spontaneous character of its emergence without direction from, foreknowledge of, or approval from the state—or even church leaders for that matter. Pentecostals on the local level, who have launched the greatest number of church-based rehab programs, have undertaken the recovery of alcoholics without any appreciable Western influence, direction, or funding. What makes the indigenous character of the post-Soviet Pentecostal (and Baptist) rehab story all the more remarkable is that church-based rehab centers first emerged in the 1990s in the very same years as the dramatic influx of missionaries with their multi-faceted support for Russian Protestantism. While Western and Korean missionaries took substantive roles in shaping post-Soviet Protestant evangelism, church planting, theological education, publishing, and ministry to children at risk, Protestant rehab centers have managed to proliferate mostly on their own with, initially, minimal overseas involvement.
What Is To Be Done?
In sum, alcohol abuse inflicts widespread damage upon Russia, undermining the nation’s health, safety, family integrity, economic productivity, demographic viability, and political stability. The question remains: What is to be done? Efforts in combatting alcoholism in Russia, government measures have proven ineffective in good measure because the public is little exercised by its own pandemic inebriation. “The difficulty,” according to leading alcoholism researcher Alexander Nemtsov, “is that the alcohol problem in this large and heavily drinking country evokes almost no reflection in the national consciousness. Millions of personal tragedies attributable to drinking do not coalesce into a public sentiment against alcohol; heavy consumption has become a part of daily life.”
Probably no less than a sea change in Russian culture would be required to effectively rein in alcohol abuse. That, in turn, would be possible only as a result of a newfound respect for human life that has been cheapened by devastating revolutions, wars, and famines. Patriarch Kyrill has argued that “Freedom is truly possible only when society and every individual respects the God-given dignity of every other person.” Similarly, lasting freedom from alcoholism requires a deep-rooted respect for one’s own person, a belief church-based rehab advocates derive from St. Paul’s admonition that the body deserves care because it is God’s temple (I Corinthians 6: 19-20).
Given the extent of Russia’s abuse of alcohol, it seems unlikely that its population would adopt abstinence as practiced by most Russian Protestants and some Old Believers (traditionalists who split from the Orthodox Church in the 17th century). Still, it might be plausible to imagine that out of self-interest the Russian state and the Russian public might come to better appreciate and make allowances for its various religious and ethnic minorities who either abstain from or better hold their liquor, including Old Believers, Protestants, Muslims, and Jews. By some miracle, should that come to pass, sober graduates of church-based alcohol rehabilitation programs would stand ready as models for the nation of the possibility of a healthier existence free from enslavement to alcohol.
Mark R. Elliott, retired professor of history, is founding editor of the East-West Church and Ministry Report, Asbury University, Wilmore, KY