A personal invitation provided the author with a rare opportunity to study and reside at one of only a handful of residential treatment centers in the former Soviet Union. The center, Durakovo, is located in Durakovo, Russia, approximately 100 kilometers southwest of Moscow.

The “new,” post-communist Russia has seen a painful rise in addictions, including alcoholism and drug addiction. Russian government statistics show that 40 percent of men and 17 percent of women are alcoholics (Russian Ministry of Health, 1999), with Russian youth experiencing a rise in related family dysfunction and lacking adequate provision for their daily needs (Brunson, 2002).

Social customs have contributed to the rise of alcoholism in Russia. Drinking alcohol hardly carries negative connotations. Beer is readily available — incredibly, it is considered a soft drink. The few prevention and early intervention efforts have lacked scientific basis. In the early 1990s, Russia reported its population of drug addicts in the thousands, but today the country has an estimated 3 million drug addicts who support an illegal drug trade worth some $2 billion each year (Reuters & Kommersant, 2002).

In Russia, the links between drinking and death, as well as drinking and disease, are clear. A recent report states that most deaths among Russian men occurred on Mondays after a weekend of heavy drinking; further, heart disease, accidents, and suicides account for nearly 75 percent of all deaths, but these men are seldom sober when they die (Reuters & Kommersant, 2002).

Treatment in Russia
Russian addiction treatment is still in its infancy, born in several urban centers in the early 1990s after the demise of the former Soviet Union. A striking characteristic is the lack of support for twelve-step based treatment from the medical community, despite significant support from Christian and specific Russian Orthodox religious communities. The growth of the twelve-step recovery movement in Russia can be likened to the early stages of growth in the country in the 1940s and 1950s. In Soviet times, alcoholics were committed to psychiatric hospitals, where they could spend several months, or could be locked up in special prisons for two years, forced to work without pay. Treatment was not voluntarily sought; those who made it to a hospital were often subjected to non-medical treatments including herbal baths, mudpacks, surgical implantation of slow-release Antabuse (disulfiram), aversion therapy, and other punitive methods of treatment (Ivlev, 2002).

Treatment in Russia is, in most cases, free of charge, through hospital-based programs. Only approximately 36 Alcoholics Anonymous (AA) meetings per week are held in all of Moscow. There are now about 300 AA groups in more than 100 towns in mainland Russia — almost nothing compared to the extent of the disease. Grassroots American-based outreach efforts for the past 12 years have documented 2,000 twelve-step family member/Al-Anon-based groups in Russia (Webb, 2002).

The primary considerations when screening and admitting clients for treatment in Russia are motivation and readiness for change. Not everyone — even those with severe needs — is able to receive addiction treatment at this time.

One treatment center’s story
Durakovo is a 400-acre agricultural settlement that developed on a foundation of state farming of beets and cabbage. The village was named, according to local legend, when one aristocrat won it from another in a card game called “Fools.”

The Durakovo region is home to artists, priests, businessmen, and farmers — all who recently have witnessed the birth and growth of human industry, prosperity, and sobriety due to the creation of a residential treatment center for alcoholic men. The center, also named Durakovo, is a twelve-step focused vocational and residential treatment program for individuals with alcohol and drug addictions; residents’ ages range from 15 to 67.

Durakovo director Mikhail Morosov’s own recovery story includes an alcoholic low point on the streets of Moscow and successful completion of a 28-day program called “Russian/American Center for Treat-ment of Alcoholics and Drug Addicts.” At a hospital-based program in Moscow (staffed, in part, with clinicians from Pennsylvania), Mr. Morosov, 47, was introduced to twelve-step based recovery (The Baltimore Sun, 2002).

Durakovo’s history includes Mr. Morosov’s own painful family addictions, including trauma at the age of 24 from witnessing the death of his uncle, who drowned in the Moscow River while intoxicated. Unfortun-ately, Mr. Morosov followed in the pathway of using alcohol as an assistant, in friendships, in business, in life, in everything.

Once visiting a friend in early recovery in 1993, Mr. Morosov drove through the fields of Durakovo and found an Orthodox shrine, its cupola smashed and filled with a stork’s nest. He took it as a sign from God, built a small cottage, and launched a business in a nearby town, building a factory to mass-produce Russian Orthodox icons.

As he brought friends and acquaintances with alcohol problems to the cottage for increasingly longer visits, he transformed the place into an informal treatment center. “Rumors spread,” he says. “That’s how people learned about us.”

Treatment at Durakovo
The screening and admission process at Durakovo begins in an office on the grounds of one of the oldest monasteries in Moscow. Here, the primary referral sources are priests of the Russian Ortho-dox Church. The interview assesses spiritual connectedness and readiness for change to an abstinent lifestyle, due to the director’s strong stance toward total abstinence as the initial and primary goal. For him, God, the church, and AA are one. Without a firm allegiance to God, as seen through the Russian Orthodox belief system, one cannot obtain and maintain sobriety. Durakovo provides a startling glimpse of the doctrine of the early founders of AA, the doctrine of the Oxford Groups, and the strong influencs of the Oxford Group forefathers who led AA recruits to a task-centered personal connection with a higher source of being, their God.

The specific steps of Durakovo clients include the following spiritual tasks:

• Submission: resembles Step One
• Confession: a strong theme in the Russian Orthodox faith
• Spiritual Release/Altruism: giving back to one’s community

Upon admission, Durakovo’s residents are transported via one of a fleet of Land Rovers® to a facility situated on dirt roads near Obelisk, the center of Russian Orthodox and scientific study. The length of stay at this rehabilitation center is variable, anywhere from one to seven years. Alcohol use is forbidden, and while clients are free to discharge themselves, few do.

Relapse episodes are rare, but if they occur, are dealt with on an individual basis. The motivation of the client is assessed and is key to decisions regarding future care. A medical doctor is part of the treatment team, specifically a narcologist, from Volgograd, who resides on the premises and is available 24 hours a day, 7 days a week. AA meetings are held on the premises, with two “outside” meetings on Tuesdays and Thursdays at the monastery in Moscow. These are typical meetings with a mix of Durakovo clients and outside AA members with various lengths of sobriety.

Strong recovery rates at Durakovo
Perhaps the strong recovery rates and incredible increase in Durakovo clients’ quality of life have to do with the strong spiritual connection and the assignment of a “role” or job description upon entry. Each resident is actively involved in the day–to–day running of this farm community. All hold positions of responsibility, such as cook, gardener, sheepherder, stable hand, painter, bricklayer, or driver.

“You work hard to save yourself and glorify God,” says Alexei, 27, who lived seven years as an active heroin addict before coming to the village in 1999.

Mr. Morosov is the village’s principal landowner, organizer, and guiding spirit. His enthusiasm is contagious. Stopping in one of his 10 stables, he examines the hooves of a big white stallion, and then gives the animal a kiss on the nose. He leads the way to the town’s stone banya, or sauna, used by residents each week for purification ceremonies.

Village residents and newly admitted clients revere him. “Mikhail is not only a serious friend, he’s like a mother and father to me,” says Andrei, 32, a client from the city of Kursk. For two years, Andrei has worked in the cattle barn. When he arrived, he craved a drink and considered running away.

“At first, it was hard to live by the rules,” Andrei says. “Don’t go here. Don’t do that. It was hard to stand. But later you come to understand that all these restrictions do you a lot of good.”

Durakovo days and nights
Treatment at Durakovo is free, yet not easy. Recovering individuals are expected to work in the village from 8:30 a.m. to 6:00 p.m. without pay, doing tasks such as building a new church or grooming horses or feeding sheep. There are no radios, stereos, or television. Smoking is prohibited outside a single room. Communication is limited; Mr. Morosov reads everyone’s outgoing mail. The aim, residents say, is to banish anything that might tempt them or distract them from abstinence or religious studies.

Each night in Durakovo’s communal dining hall, which resembles a great hall of an Arthurian castle, more than 30 men gather to atone for their sins. Their shoulders are slumped, their eyes filled with sadness. It starts as AA meetings do, with a ritual of confessions.

“Andrei is an alcoholic.”

“Alexander is an alcoholic.”

“Vasily is an alcoholic.”

One more resident, Artyom, 22, is recovering from heroin addiction. He speaks of early withdrawal as being difficult, filled with nausea and depression. Then one day, he says, he was overcome with a wave of euphoria. “You develop a completely new relation with the world,” he says. Study and use of AA principles has allowed him to embrace a new personal spirituality, embracing Russian Orthodoxy in a way that has led to a spiritual awakening. Mr. Morosov once told him something he has never forgotten: “Alcoholics and drug addicts will save the world.”

Originally not understanding the depth of this concept, Artyom has, in the two years he has lived there, helped make the village a showcase of Russian craftsmanship and ingenuity. He saw the deep spiritual changes in the people around him and in himself. It became clear that the people of Durakovo seem more focused, more responsible and determined than many people who are not alcoholics.

“At first, I laughed,” he says. “Now, I understand.”

A final reflection
A decade ago, Durakovo was like any other Russian village, an island of farm life that hadn’t changed in hundreds of years. Today, the Durakovo treatment facility stands on its grounds, which have a fresh, almost fairytale-like look. The architecture is exquisite.

Mr. Morosov hosted our party of five North Americans with true Russian hospitality. One of the primary goals of this charismatic “Russian Bill W.” is to bring Western addiction counselors and professionals in the field of addiction treatment to his center for firsthand experience and ongoing support and involvement. Barriers of distance and language seem small in comparison to the strength and resilience of members of the recovering community in Russia, where the seeds of treatment and twelve-step methodology are being planted and nurtured daily in places like Durakovo.

Jane L. Emery, MS, LADC ( This e-mail address is being protected from spam bots, you need JavaScript enabled to view it ) can be reached at 13 Manwaring Street, New London, CT 06320; by telephone 860-437-3429; and by fax 860-443-8940.

References
Brunson, P. (2002, January 6). Condensed Proposal Overview. The Baltimore Sun.
Ivlev, A. (2002). “House of Hope Combats Alcoholism Through Time-Tested Methods.” http//www.isar.org/isar/
archive/GT/GT14ivlev.html.
Reuters & Kommersant (2002, January 2). Reprinted by CNN.
Russian Ministry of Health (1999, August 13). Article in the London Times.
Webb, T. (2002, Spring/Summer). “The Legacy.” Goal Ministries Publications.
Weir, F. (2001, March 3). Christian Science Monitor (Special Edition). Boston, Mass.

This article is published in Counselor, The Magazine for Addiction Professionals, August 2003, v.4, n.3, pp. 34-39.

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Greg Mathew   |202.63.118.xxx |2008-08-22 01:48:04 The raise of alcoholism and addiction is some how reduced after establishing rehab organizations.Many counselors help's the drug addicts to quit. --------------------------------------------  Greg Mathew link:http://www.addictiontherapy.com Reply 0   0

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