Thursday, November 17, 2016

Living and Dying in the Arms of Mother Russia

by Nomad


Here's a peek into some of the reasons why Russians, men, in particular, have a hard time surviving until what we consider middle-age. Sadly for the Russian government, there's not a single reason but a multitude of them. 

Russia is no country for old men. And it's not all that great for old women either. That's not an opinion but a fact.
According to a recent report by the Organization for Economic Cooperation and Development (OECD), most Russian citizens will not see their 71st birthday. But how does that stack up against other countries, you ask?

The life expectancy in the former Communist country lags nearly ten years behind the average in developed countries. That's also lower than countries with similar income levels such as Turkey, Mexico or Chile.

Russia ranked 43rd out of the 45 countries surveyed. The average life expectancy in Russia in 2013 was 70.7 years. but the life expectancy for Russian men is just 64 years. (For U.S. men, the average life expectancy is 76.)
Experts have made some conjectures on why Russians have such a hard time staying alive past their seventh decade.

Up in Smoke

Lifestyle choices are blamed for the poor showing, namely high rates of alcohol abuse, and smoking.
Back in 2013, Putin signed legislation that placed an increased tax on cigarettes raising the price to approximately $1.50 a pack.
(A smoker's paradise compared to most Western countries.)

Smoking in RussiaThe law also banned smoking in public indoor places. Tha included bars, restaurants, offices, and public transportation, in recreational areas like parks and beaches, outside subway stations, and inside jails and hospitals. 
It's one thing to make laws, it's quite another to enforce them. 

Nevertheless, these laws ambitiously aim at reducing smoking in Russia- where nearly half the population smokes- by 15 percent by 2020.
Russia was among the countries with the highest percentage of male tobacco consumption, with roughly 45 percent of the male adult population smokers — roughly 20 percent above the OECD average. Russian women, in contrast, smoked less than the OECD average, according to the report.
Because of the prevalence of smoking, cancer mortality rates in Russia greatly exceed those in Europe and the United States. In Russia, the overall risk of dying from cancer is about 60%. Lung cancer rates among men are ten times higher than that of women.

Down the Hatch

If that gender difference is striking when it comes to lung cancer rates, then consider too that liver disease and other alcohol-related mortality is three times higher for Russian males.
That said, reducing alcohol consumption, ranked among the highest in the world, may be more difficult.

Back in 2009- before Russia's economic woes really began- there were 2.5 million alcoholics in the country according to Russia's health authorities. Those are estimates only; the actual number is impossible to calculate in a country with poor health infrastructure. Hard times have, in all likelihood, made that number soar even higher. 

One research study showed that men that drank three or more half-litre bottles of vodka a week  ran a 35% greater risk of  dying before age 55. At this time, a quarter of Russian men die before that age.   

Yet, it is fair to ask how many men actually drink that much vodka?
The answer is a lot.
According to one researcher from Oxford, the average Russian drank about drank 20 liters of vodka per year. That, keep in mind, is the average.
"Russian death rates have fluctuated wildly over the last 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka."
Peto added:
"The rate of men dying prematurely in Russia is totally out of line with the rest of Europe. There's also a heavy drinking culture in Finland and Poland but they still have nothing like Russia's risk of death."
In 2007, Gennadi Onishenko, the country's chief public health official, pointed out that Russian alcohol consumption over the past 16 years has nearly tripled. With one in eight death directly related to alcohol, Onishenko also claimed that this has played a major role in population decline. 

Despite the fact that most people understand that there is something seriously wrong with the alcohol-driven way of life, most also realize that change is next to impossible.

Why Russians are Dying for a Drink 

Vodka is not merely a drink of choice, but a cultural artifact that is unlikely to be easily retired.
While recent laws have had some success in reducing the amounts of consumed alcohol, critics warn that attempts in the Gorbachev days were deeply unpopular and unsuccessful. 

It's true that vodka sales have reportedly fallen since the government-imposed price increase but there have been negative consequences for low-earning Russians in the poverty-stricken provincial towns.
Combating alcoholism by instituting a legal minimum price for vodka has led to an increase in the sale of illegal substitutes. an even greater danger to public health.
Those who can no longer afford store-bought drinks are turning to "under the counter" alternatives that can cause serious damage, even death.
The rise in prices has lead to a corresponding rise in the consumption of potentially lethal moonshine, medical alcohol, perfume, aftershave or even cleaning products. 
In March of last year, at least 14 people in a village in the Far East have died of apparent methanol poisoning after drinking counterfeit liquor in the region of Krasnokamensk.

It was for this reason that Prime Minister Dmitry Medvedev ordered a crackdown on counterfeit alcohol products and equipment for their production in recent months.
Instead of public education or treatment programs, it seems like the only recourse the government has to keep Russians from killing themselves is to outlaw things. 

Russian Drug problem
More Reasons for a Short Life
Smoking and alcohol abuse are really tips of the iceberg when it comes to premature death in Russia.
There were other problems not specifically mentioned in the report: drug addiction and the related rise of HIV.

One authoritative source notes:
The Russian Ministry of the Interior estimates that 2.5-3 million people regularly or occasionally use illegal drugs in the Russian Federation, representing 2.1 percent of the whole population.
Besides the damage drug addiction does to the social cohesion of any nation, there's also the negative effects (especially combined with alcohol abuse) on the workforce and productivity.

With drug abuse comes a host of health-related problems too. In 2012, the Lancet, a prestigious medical journal reported:
"Russia has the largest population of injecting drug users (IDUs) in the world — an estimated 1·8 million people. More than a third have HIV; in some regions, the proportion is nearer to three-quarters. Astonishingly, an estimated 90% of Russian IDUs have hepatitis C, and most patients co-infected with HIV and tuberculosis in Russia are drug-dependent."
As of 2007, the Russian Federation has become one of the top three centers for drug-resistant tuberculosis. Progressive TB became the direct cause of death in 66.5% cases among deceased patients with HIV.

The results are predictable: an estimated 100,000 people die from drug overdoses in Russia every year. This does not include deaths from Hepatitis C, other liver diseases, and many other infectious diseases. The social groups that are the most vulnerable to narcotics are young people and teenagers.

Explains one source, Russia's heroin epidemic is in many ways similar to the rise in Post-Traumatic Stress Disorder (PTSD) in the US. Namely, a consequence of war.
Russia’s heroin problem has snowballed since the end of the Cold War and collapse of the old Soviet Union. In the 1990s, traffickers made inroads across the former Soviet states, particularly along the Silk Road from Afghanistan via Russia’s vast southern border with Kazakhstan. At the same time, Russia was seeing a rise in unemployment and poverty, and for some, heroin became a way of dealing with life.
Since the war in Afghanistan, the illicit drug trade has been prospering again after a decline under Taliban rule. According to the U.N. Office on Drugs and Crime, nearly all of the world's illegal opium which is the raw material for heroin comes from Afghanistan. 
"Russia remains a major destination country for Afghan opiates and other illicit drugs. According to a major Russian media report that cited official sources, Russia consumes between 75 and 80 metric tons (MT) of heroin each year."
None of this can be good news in Russia.
However, the authorities in Moscow would rather blame the US failure to stop the flow of opium than to deal with the problem at home.

Russian Mafia

The Human Toll from Organized Crime

Critics charge this is simply prevarication on the part of Russian officials. The government officials choose to ignore that the flood of opium is facilitated by organized crime. Although in the past, illegal drugs were used as a transit point on their way to Western Europe, according to research, "the domestic market absorbs today a growing and overwhelming portion of the illegal drugs that are produced, smuggled and sold in the country."
Call it karma or blow back but that's something that Russia could do something about without help from the outside.

There are other reasons that Russian officials are unable to deal with the serious drug problem.

Firstly, organized crime, the sponsor of Russia's drug culture, exists - has always existed- as a result of the corruption of public officials and law enforcement. Unfortunately, Russia is clearly unable to deal with political corruption in any meaningful way mainly because it is, like vodka drinking, too deeply woven into the culture.
There is a widespread public tolerance for corrupt practices going back centuries. Manabu Suhara, a professor of Economics at Japan's Nihon University points out in an analysis of corruption in Russia:
...Laws and regulations as formal rules obviously do exist in Russia, they seem to be easily violated, because a substantial part of them is not necessarily consistent with the natural feelings of the populace.
Without that outrage, there is no mandate for change. Without a means, mandate or motive for tackling organized crime in Russia, the social problems mentioned above can never be addressed. Putting a high tax on cigarettes or alcohol only encourages the expansion of a black market run by elements of the Russian mafia.  

What it Means to be An Addict in Russia

Yet another obstacle to addressing the drug addiction problem is the attitudes that run deep in the society. Facing up to the scale of the drug problem requires some serious soul searching, as opposed to blaming the West.

In practical terms, this requires a major overhaul in how drug addiction- as a disease, rather than a crime- is dealt with. The treatment available to a Russian drug addict is, to say the least, appallingly inadequate. And that has much to do with the Soviet era and its present-day crippling effects on Russia.

Critics of Russian government policy note that the science and practice of drug treatment in Russia – narcology – developed out of psychiatry in close collaboration with other state mechanisms of social control, including police agencies.  

Russia's solutions to its widening drug problem, say critics, "remain couched in Soviet-era repressive psychiatry, propaganda and willful ignorance of widely accepted scientific truths."

According to unverified claims by the Eurasian Harm Reduction Network (EHRN),  some treatment methods include  |
flogging, beatings, punishment by starvation, long-term handcuffing to bed frames, 'coding' (hypnotherapy aimed at persuading the patient that drug use leads to death), electric shock, burying patients in the ground and xenoimplantation of guinea pig brains.
For the overly-curious, this xeno-implantation treatment involves the injecting of animal tissue into the brains of addicts.  (How common that actually is debatable.)

Needless to say, these practices (and the official acceptance of this kind of treatment) demonstrate a lack of legitimacy in the Russian government's approach to this social problem. 
Not only are these methods barbaric, but they are also ineffective. As the Russian Federal Drug Control Service has acknowledged, over 90% of drug treatment patients return to using illegal drugs within one year. 

And that's really no surprise since released addicts are distrustful of returning to the authorities for further "treatment" and doubtless, seek solace from the only relief available, returning to drugs. Some might say, it is the outward manifestation of a society unable to deal with its problems in any other way besides passing new laws and imposing fines and flogging addicts.
 *   *   *   *
The shortened life expectancy in Russia is a symptom of deeper problems in the country. This statistic reflects problems that will require a new kind of thinking and a new kind of leadership and that's something that Russia has shown to be highly resistant to.