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Alcoholism treatment in Russia in transition

MOSCOW—The treatment of alcoholism in Russia—like the economy and the Russian version of democracy—is very much in transition.

By far the most widespread treatment for alcoholism is "coding," a practice that began in the Soviet era as a one-day program based on hypnosis.

Coding was developed by the late physician Alexander Dovzhenko, who became a god-like figure to his patients and disciples.

He had such a hold over his patients that when he told them that any sip of alcohol could be deadly, they believed him, said Dr. Alexey Magalif, a Moscow psychiatrist who runs a private clinic specializing in alcohol treatment.

Patients were given a code word to repeat to themselves as a kind of preventive mantra, hence the name "coding."

Magalif said he rejects coding as "morally obsolete" and not effective for all patients.

"Dovzhenko's patients were actually afraid they'd be paralyzed, so he had some successes," Magalif said.

Another form of coding involved injecting a mixture of drugs under the skin, a kind of implant that was called a "torpedo."

After the injection, patients were then given a small amount of vodka, which, in interaction with the torpedo, made them violently ill. They were warned that they could die if they consumed any alcohol at all, including alcohol-based medicines or even certain candies.

Magalif also said that most Russians don't consider alcoholism a disease; they still see it as a weakness or a character flaw. Most also believe that one-day treatments should work.

"Unfortunately, the attitude toward the problem is quite superficial and not very serious, so most patients are not willing to do the hard psychotherapeutic work," he said. "They think the doctor should fix them in one visit."

Some private clinics have opened in Russia's major cities, and some of them use Western treatment models, including psychotherapy, pharmacology and group counseling.

The Salvation Army and many churches offer treatment programs, and Alcoholics Anonymous meetings, while mostly limited to urban areas, are increasingly popular.

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(c) 2005, Knight Ridder/Tribune Information Services.

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