Russia's 1-Step Program: Scaring Alcoholics Dry

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By Peter Finn
Washington Post Foreign Service
Sunday, October 2, 2005

MOSCOW -- Svetlana, a 32-year-old self-described alcoholic, had managed to stay off the booze, but one day two years ago she just had to have a drink. This time she sat down by the phone so she could call an ambulance, then took a sip from a bottle of beer.

"I was very afraid," said Svetlana, who fully expected to asphyxiate when just one swig of alcohol hit her bloodstream. She only hoped that she would have time to make the call and that the ambulance crew would be able to revive her.

"I was absolutely sure something terrible would happen to me," she recalled.

Three months earlier, Svetlana had been "coded" -- a catchall term for a Russian method of treating alcoholism that essentially involves scaring the living daylights out of the alcoholic. Dating to the former Soviet Union, it involves the manipulation of the alcoholic's psyche to create the belief that alcohol equals death.

In Svetlana's case, that was induced by mild hypnosis followed by injection of a temporary but powerful drug that could attack her respiratory system. Before the drug kicked in, the doctor gave her a little vodka to taste. She became dizzy and had difficulty breathing before the doctor stepped in with some oxygen to revive her.

The injected medicine, the doctor said, would stay in her system. "I've coded you for a year," he said, according to Svetlana. "And if you drink in that time, you will die." He insisted that she sign a release form saying he would bear no responsibility for her death should she drink within 12 months.

"I believed him, because we had all heard stories about people who were coded and died when they drank," said Svetlana, who didn't want her last name published because she said her co-workers didn't know she was an alcoholic.

In the last 20 years, hundreds of thousands of people in Russia and other countries of the former Soviet Union have been coded against the desire to drink. But some doctors fear that the increasing sophistication of the population and the use of the technique against other addictions, such as gambling, are draining the method of its essential ingredient: the power of suggestion.

Russian chat rooms now buzz with discussions about its fallibility, and Web sites offer methods to test whether a coded alcoholic has been administered a placebo or a real drug that can cause violent illness when mixed with alcohol. "Knowledge about unsuccessful coding is spreading, and faster than it ever has before," said Alexander Nemtsov, a psychiatrist at the Moscow State Scientific and Research Institute of Psychiatry. "But we still don't have the alternatives to replace it."

Alcohol abuse, marked by binge drinking, has soared to all-time highs in Russia. More than 50,000 people die annually from alcohol poisoning, compared with about 400 annually in the United States, according to Russian researchers. It is not unusual for Russians to consume one or more bottles of vodka at a single sitting. There is little available to alcoholics in the way of long-term counseling; 12-step programs, such as Alcoholics Anonymous, are still in their infancy here.

For many Russians, the only available treatment is coding.

After 30 minutes of waiting for a medical crisis that never came, Svetlana said, she drained the bottle of beer and then cracked open another. By the next day, she was deep into a binge that would last four months. Now two years later, she attends Alcoholics Anonymous and has been sober for 16 months.


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