On the verge of collective breakdown?

This commentary says yes.

http://www.japantimes.co.jp/opinion/2013/05/31/commentary/alcohol-addi ction-could-doom-putins-dreams/#.UalDj0BJOAg

Alcohol addiction could doom Putin’s dreams
BY CESAR CHELALA
MAY 31, 2013 ARTICLE HISTORY PRINT SHARE
NEW YORK – Russians’ love for vodka has a long history. Legend holds that vodka arrived in Moscow in the 14th century, brought by Genovese merchants to Prince Dmitry Ivanovich.

Legend also says that the monk Isidore, of the Chudov Monastery inside the Kremlin, made a recipe for Russian vodka around 1430. He could not have anticipated the devastating effect that alcohol addiction, mainly to vodka, would have on Russians’ health and quality of life, and on the country’s economy and social fabric.

When the Bolshevik Party came to power its leaders tried — without much success — to reduce alcohol consumption in the Soviet Union. Josef Stalin re-established the state monopoly to generate revenue.

Mikhail Gorbachev, in 1985, increased controls on alcohol consumption and imposed a partial prohibition through a massive anti-alcohol campaign. That campaign, which included severe penalties against public drunkenness and alcohol consumption, as well as restrictions on liquor sales, was temporarily successful. It reduced per capita consumption and improved quality-of-life measures such as life expectancy and reduced hospital admissions. But the population disliked the policy and it had to be abandoned, its consequences felt again soon afterward.

Periodically reports surface on the great number of people who die as a result of consuming fake vodka and other alcohol substitutes. It is estimated that more than 40,000 Russians die every year after drinking toxic liquids that include medical disinfectants, after-shave lotions and other dangerous substances.

Today, the average Russian drinks the equivalent of 18 liters of pure alcohol a year, mostly as vodka and other black market moonshine called samogon. According to the World Health Organization, this consumption is far above what is considered safe to drink and greater than in any other nation in the world.

Russia has now one of the highest rates of alcohol-related illness, including long-term neurological, cardiovascular, psychiatric and liver problems.

In the short term, and generally as a result of binge drinking, several kinds of injuries and conditions follow: violence, risky sexual behavior (including unprotected sex), alcohol poisoning as well as miscarriages and stillbirths.

The connection between excessive drinking and interpersonal violence cannot be overstated. But due to social tolerance of violent behavior and incomplete or inaccurate information, official statistics record only a small percentage of violence. Some, however, are worrying. Among male perpetrators of spousal homicide, 60 to 75 percent of offenders had been drinking heavily before the incident.

Among young men, the risk of suicide is five times higher for heavy drinkers and nine times higher for alcoholics. Although men drink more than women, excessive alcohol consumption during pregnancy can result in the child developing fetal alcohol syndrome or showing fetal alcohol effects that are associated with delinquent and violent behavior later in life.

Russians’ poor health status has translated in a short life expectancy. According to the United Nations Department of Economic and Social Affairs (UNDESA) Population Division, life expectancy for males in Russia is 61.56; for females it is 74.03. These figures are 17 years lower than in the Western European population. By contrast, for Japan the figures are 79.29 and 86.96, respectively.

In June 2009, the Public Chamber of Russia estimated 500,000 alcohol-related deaths in the country annually. This figure highlights a very serious situation particularly taking into consideration that the country is going through a severe demographic crisis: It is estimated that its population will drop 20 percent by 2050.

Although no precise figures are available, the direct and indirect costs of alcohol abuse in Russia can be considerable. Unless stronger measures are taken soon, Vladimir Putin’s dreams of a greater Russia will not be realized. The situation was aptly described by Oliver Bullough in his book “The Last Man in Russia”: “One man’s alcoholism is his own tragedy. A whole nation’s alcoholism is a tragedy too, but also a symptom of something far larger, of a collective breakdown.”

Cesar Chelala, M.D. and Ph.D., is an international public health consultant and a co-winner of the Overseas Press Club of America award.