Jargin S2*, Robertson S1
1 Rhodes University, Grahamstown, South Africa
2 Peoples’ Friendship University of Russia (RUDN), Moscow, Russia
*Correspondence: Jargin S, RUDN, 117198 Moscow, Russia. E-mail: sjargin@mail.ru
Received: 11 Nov, 2025; Accepted: 24 Nov, 2025; Published: 02 Dec, 2025.
Citation: Jargin S & Robertson S. “Alcohol and Alcoholism in Russia with Special Reference to Toxicology.” J Environ Toxicol Res (2025):119. DOI:doi.org/10.59462/3068-3505.2.2.119
Copyright: © 2025 Jargin S. This is an open-ac cess article distributed under the terms of the Cre ative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Abstract
This review is focused on alcohol and alcoholism in Russia since 1970, but the subject matter is significant in a global context. The article may be of interest for experts in medicine and toxicology, social workers and psychologists. There has been a tendency to exaggerate the topic in order to veil shortcomings of the health care system, with responsibility for the comparatively low life expectancy especially in males shifted onto people, that is, self-inflicted diseases caused by the alcohol abuse. Besides, the purpose of this review is to draw attention to the unstable quality of legally sold beverages, which have caused poisonings up to lethality, even after consumption of moderate doses, offenses against alcoholics and people with alcohol-related dementia, aimed at appropriation of their immobile and other property, and overtreatment of alcoholics in medical institutions. Some invasive procedures have been used without sufficient indications. Instead of warmongering, the Russian government should provide public assistance to citizens in need, including those suffering from alcoholism and alcohol-related dementia.
Keywords
Alcohol, Alcoholism, Russia, Alcohol Surrogates, Toxicology
Introduction
This review is an update of some parts of the book “Alco hol and Alcoholism in Russia: Recent History” and other publications [1,2]. The topic is relevant for the former So viet Union (SU) and some other countries. In the Russian Federation (RF), the problem has sometimes been exag gerated in order to shift responsibility for the comparatively low life expectancy, especially among men, onto citizens. Alcohol is often discussed in the context of domestic vio lence. It is straightforward to denounce a drunken trouble maker. Perpetrators from the privileged milieu know how to avoid responsibility, accuse the victim of slander, and force her or him to remain silent. Drunkenness is a well known criminogenic factor; but focusing on drunken trou blemakers distracts attention from corruption and orga nized crime. The fight against drunk driving is necessary, but when intoxicated drivers are held generally responsi ble for traffic injuries and the declared goal is zero blood alcohol content [3], insufficient attention is paid to the con dition of roads, vehicles and other causes of accidents. Of note, alcohol-related violence and other misbehavior is common among young and working-age people [4]. Many older alcohol consumers know their maximal dose and do not violate public order.
Recent History
The Anti-Alcohol Campaign (AAC), launched in 1985, was initially effective, but after 1987 the consumption started to increase, with fortified, dry and sparkling wines giving way to low-quality vodka [5]. Alcohol-related mortality declined during the AAC; but there was an increase in poisonings by technical fluids. Inexpensive perfumes and other ethanol-containing liquids were sold en masse, e.g. window cleaner in Krasnoyarsk province in 1988 [6]. During the AAC, the quality of legally sold beverages declined. Mass drinking after the AAC facilitated the economic reforms. It is known that alcohol-dependent people are prone to emo tions of guilt and shame, have low self-esteem [7], so they are easier to control and to manipulate. Workers and in telligentsia did not interfere with the privatization of state enterprises due to drunkenness and participation in illegal activities: theft in the workplace, use of equipment for per sonal purposes, to which the administration often turned a blind eye before the economic reforms of the 1990s. After the abolition of the state monopoly on alcohol, the country was flooded with low-quality drinks made from eth anol produced by chemical synthesis or by hydrolysis of cellulose (Sawdust) with subsequent fermentation. In the 1990s, the turnover of non-beverage ethanol in the retail trade reached 60%, while the mortality rate from alcohol poisonings in RF was reported to be 65 times higher than the European average [8]. In the 1990s and early 2000s, ethanol was supplied in large quantities from Georgia. The author observed a line of tanker trucks queuing at the border. This ethanol was used to produce vodka, beer and wine. The North Caucasus was known as a source of low-quality alcohol throughout the country [9]. Drinks sold in shops and kiosks caused poisoning. The following quantities of fatal poisonings from alcohol-con taining liquids were reported by year: 1998 - 21,800, 1999 - 24,100, 2000 - 27,200 [10]. Real figures were probably greater. In many patients the onset of severe poisoning was related to the consumption of vodka purchased in a legal shop [11]. The concentration of ethanol in blood was often not excessively high. Mass poisonings by legally sold beverages have been discussed in detail previously [1,2]. The role of organochlorine compounds as the cause of fatal poisonings was assumed [11,12]. It seems likely that the bottles with vodka labels contained admixtures of tetrachloromethane, dichloroethane or other solvents used in dry cleaning of clothes [9,13]. Even alcohol-depen dent persons will not drink the named liquids because they have a characteristic smell. However, liquid from a labeled vodka bottle can be gulped without smelling it; such cas es, ending up in death, are known. Low-quality, counterfeit vodka was sold in stores, kiosks and snack bars. Industrial alcohol was added to beer and wine. Consumers recog nized the taste of non-beverage ethanol, which had been habitually stolen from factories and scientific institutions [14]. These facts were camouflaged by some authors, creating the impression that surrogates were deliberately purchased for drinking (from Russian): “The outbreak was caused by the use of antiseptics with chloride compounds due to a shortage of other non-potable alcohol” [15]. In fact, in 2006 there was not the “shortage of non-potable al cohol” but a temporary dearth of vodka in some places as a result of increased excise taxes and tightening of regula tions with the closure of kiosks and many small shops [10]. The temporary gap in the market was filled by surrogates sold in vodka bottles [15].
The exaggeration of the issue of unrecorded or non-com mercial alcohol shifts the responsibility for poisonings onto consumers alleged to intentionally drink toxic surrogates [16]. The concept of unrecorded alcohol is not direct ly applicable to RF without a comment that ethanol from non-edible sources has been used for production of bev erages sold through legal shops, generally with the knowl edge of the authorities [17-19]. The concept of unrecorded alcohol is not applicable to RF without the comment that technical ethanol, redirected from industry or imported, was used to produce legally sold drinks [13,14,17,19,20]. Without opening the bottle, a consumer cannot distinguish the authentic beverage from a counterfeit. In the 1990s, crooked labels and loose caps were known as features of falsified beverages. Today, bottles of genuine and counter feit products are indistinguishable by sight [21]. After the aforementioned mass poisonings, there was an improving tendency; however, vodka and beer sometimes smell of industrial alcohol now as before.The use of technical ethanol for beverage production can be interpreted as concealment of information about facts that pose a health risk. Citizens have the right to expect that government will ensure quality control. Modern methods such as chromatography and spectrometry must be used to control the quality of drinks and detect impurities. In particular, the following should be applied more widely by supervising authorities: gas chromatography with flame ionization detection (GC-FID), using a column separating admixtures, and gas chromatography - mass spectrometry (GC-MS) [22,23]. Spectrophotometry using chromotropic acid has been proposed by the Organization of Vine and Wine (OIV) as a low-cost alternative for methanol analysis in wines and spirits. Recent studies have improved this method; referenced in [24].
The decrease of heavy binge drinking is visible with the naked eye. Compared to the 20th century, heavy intoxi cation is less common today, even among marginalized individuals. In this regard, it is necessary to mention the Siberian bichi. In populated areas and temporary shelters in the taiga forest live homeless citizens without docu ments, called bichi; they worked in tree tapping and oth er jobs. The alcohol abuse sometimes interfered with the working safety. During the AAC, they massively consumed non-beverage alcohol such as window cleaner [6]. Soci ety’s attitude has not always been humane. The state must take care of them, as well as of homeless people in gener al, provide them with hostels; they need help in obtaining documents and housing. Quality control of alcoholic prod ucts is also necessary, including confiscation of surrogates and counterfeits containing industrial ethanol sold in vodka bottles through legally operating shops.
Anti-Alcohol Policy
After the Anti-Alcohol Campaign (AAC), ended in failure by 1989, the average life expectancy in Russia decreased especially in men. For the period 1993-2001, this figure was estimated to be around 58-59 years [14,25]. The life expectancy has increased since then; but there are doubts about reliability of official statistics. Among the causes of the increased mortality has been limited availability of modern health care, late detection of malignancies, offences against alcohol-depended people resulting in homeless ness and premature death.
Some authors exaggerate the effectiveness of governmen tal anti-alcohol measures. The policies’ impact on public health is sometimes discussed as if vodka were the main factor determining mortality: “The relatively high mortality rate in Russia is associated with the consumption of strong alcoholic beverages, mainly vodka” (translated from Rus sian) [26]; “Alcohol is the most important factor of male mortality in industrialized countries; and the strength of the alcoholic beverages consumed is of great importance” [27]. In this way, other factors are ignored: availability and quality of medical care, toxicity of drinks on sale, offenses against alcoholics and people with alcohol-related demen tia. In fact, vodka, beer and other drinks have remained af fordable since the AAC: sales in supermarkets, no queues, ratio of the average income to vodka price higher and selling time longer than prior to the AAC [1]. The mono graph [28] discusses the “crisis of medicine”, denying its significant impact on mortality. However, the arguments are unconvincing, for example, the stable level of mortality from strokes, despite the growth of morbidity. The tenden cy to overdiagnose cardio- and cerebrovascular diseases in unclear postmortem cases is known. The frequency of unfounded diagnoses is inversely proportional to the qual ity of diagnostics and the healthcare in general [29]. The decline in infant and maternal mortality since 1999, cited by the authors as evidence of improved healthcare quali ty [28], may reflect priorities in governmental policies, but has no relation to drunkenness and alcoholism. Recent anti-alcohol measures have been superficial com pared to those of the Soviet era. Taking inflation into ac count, vodka prices fluctuated moderately [1]. The avail ability of alcohol did not really decrease. As in the Soviet era, some restrictions encouraged the consumption of higher doses: disappearance of beer in 0.33 l cans, ab sence of vodka in 150-200 ml bottles. Inside observers rec ollect that disappearance of 250 ml vodka bottles after the anti-alcohol measures of 1972 led to consolidation of the stereotype “pollitra-na-troikh - half a liter for three”, which appeared after the ban of selling by the glass in stores and canteens in 1960. For many aged alcohol-dependent people, even 250 ml is too much; they would prefer to buy after work a 100-150 ml of vodka plus 1-2 bottles of beer and go home. Instead, between 1972 and 1985, they con sumed half a liter for three persons, then sometimes added fortified wine (vodka was sold until 7 p.m.). Consumption in high doses was contributed by queues, after standing in which more alcohol was purchased and consumed. During the AAC (1985-1989), many elderly people and veterans were forced to stand in hours-long lines and/or to drink surrogates. Certainly, it is better not to drink, but this does not justify selling of counterfeit beverages in regularly la beled bottles, deceit of alcohol-dependent citizens, depri vation of quality healthcare, of apartments and houses. The author of this review agrees to the opinion that “the anti-alcohol measures implemented in Belarus and Rus sia coincided with decrease in alcohol-related mortality which originated in the past” [30], caused by different fac tors. Apparently, the main reason for the decline in alcohol consumption has been a responsible lifestyle in a market economy. This pertains to workers and intelligentsia in the first place. As a result of economic reforms of the 1990s, confidence in the future has been lost by many people. Factories and scientific institutions closed or reduced their personnel. At the same time, property crime has increased, leaving many alcoholics and people with dementia home less. Finally, the immigration from less drinking regions has contributed to a decrease in alcohol consumption.
Epidemiology and Statistics
“There is no doubt that alcohol is an important cause of mortality in Eastern Europe and globally. It remains uncer tain, however, whether the high long-term mortality rates of middle aged and older persons in Russia are caused predominantly by alcohol and what is the contribution of other factors” [31]. Those “other factors” are evident for in side observers: deterioration of the healthcare after 1990, toxicity of some drinks on sale, external causes of death [3]. Related factors have been mooted as being respon sible for the fluctuations in life expectancy and mortality since 1990: stress associated with the transition to capi talism, quality and availability of food, cigarette smoking, insufficient social care [32]. In addition, heavy binge drink ing after the failure of AAC has been discussed as a cause of increased mortality. Without denying the harm from this style of alcohol consumption, it should be stressed that the heavy binge drinking has been declining since the early 2000s [33]. Over the period 2003-2017, the positive life expectancy trend was statistically independent of alcohol poisonings [34].
For 2021, the age-standardized death rates of heart dis eases per 100,000 were as follows: Russia 403, China 290, United States 151, Germany 142, France 84, Japan 76 [35]. The reasons for the high cardiovascular mortal ity in RF and of its increase after 1990 are obvious for pathologists. Cardiovascular Diseases (CVD) are often diagnosed in unclear cases, both at postmortem examina tions and in people dying at home without autopsy. If the cause of death is unclear, one of the standard diagnoses is “IHD with heart failure” or other similar formulations [29]. It is not surprising that an increase in registered mortality from CVD coincided with the quality decline of post mor tem diagnostics and of the healthcare in general during the 1990s and early 2000s [36,37]. The topic of insufficient healthcare quality as a cause of low life expectancy in RF is generally avoided these days.
The overdiagnosis is confirmed by an increase in the reg istered mortality from CVD, but not from Myocardial In farction (MI), the share of which in the Russian mortality is small [25]. The reason is obvious for pathologists: the diagnosis of MI is usually based on clinical or morpholog ic criteria, while IHD with heart failure is sometimes used postmortem without sufficient evidence. The overdiagno sis of CVD has occurred along with “the absence of any significant differences in mortality rates from neoplasms, including those associated with alcohol, in the period 1984-1994” [38], since tumors are rarely diagnosed with out evidence. Remarkably, deaths from lung cancer (X-ray or autopsy are necessary for the diagnosis) in men de creased by 17% between 1998 and 2007; while deaths from breast cancer, which rarely goes undetected, in creased [25]. “Changes in Russian mortality over the past few decades are unprecedented for industrialized coun tries in peacetime” [39]. Indeed, mortality fell rapidly with the onset of the AAC, and then increased significantly. The fluctuations were so sharp that the possibility of an artifact was discussed [38]. The above seems to be indicative of unreliable and possibly manipulated statistics. The decline in mortality after 1985 was probably overstated in order to highlight the success of AAC, which was counterbalanced by an overestimation after 1990. Some writers have exag gerated the causal relationship between alcohol and CVD, seeking to portray increased mortality as a result of alco hol abuse, e.g. [40], commented in [1,2]. The “outstanding puzzle” that “the risk of dying from IHD (excluding MI) is associated with heavy alcohol consumption” [41] has anal ogous explanations. It can be reasonably assumed that official statistics is unreliable now as before. The comparatively high mortality rate from strokes [42] together with low mortality from myocardial infarction has an explanation: unlike myocardium, the macroscopic pic ture of cerebral infarction can be imitated artificially e.g. by a junior pathologist, destroying brain tissue at autopsy in case of impossibility (lack of toxicological tests) or unwill ingness to look for the true cause of death. The unreliabil ity of stroke diagnosis is indirectly confirmed by the report that in 2002, “the death rate from stroke among Russian men aged 45-54 was ~10 times higher than in Germany, France or Italy” [42]. The article [42] contains a reference to international statistics from 2004, according to which the registered stroke mortality in RF, without taking into ac count gender and age, was 4-8 times higher than in many developed countries [43].
Alcoholic cardiomyopathy has been diagnosed more fre quently in RF than in other countries, sometimes without sufficient grounds. It was estimated that registered mortali ty from alcoholic cardiomyopathy in RF is ~100 times high er than in the United States, Finland and France [8]. The diagnosis of cardiomyopathy has been widely used post mortem in alcohol consumers [40], while the true cause of death sometimes remained unknown. Clinically significant cardiomyopathy usually develops after long-term abuse, especially in genetically predisposed individuals. There is an opinion that moderate alcohol consumption is not associated with the risk of CVD, and some epidemio logical studies show that the risk is reduced among mod erate consumers [44-46]. However, the cardioprotective effect of low doses has not been confirmed by a number of studies [47,48]. There is a controversy in the literature about the risks of moderate alcohol consumption. This is beyond the scope of this review. Theoretically, a protective effect is not excluded due to the thousands-years’ adap tation of some ethnic groups to alcohol and by-products of natural fermentation. Even if the cardioprotective effect of moderate doses exists, in advanced age it is largely counterbalanced by the toxic impact of ethanol on the liv er, nervous system, skeletal muscles and immunity. It is important to emphasize that new methods of ethanol man ufacturing are accompanied by new by-products, to which no adaptation has developed. In animal experiments, eth anol obtained both synthetically and by hydrolysis turned out to be more toxic than that from edible raw materials [17]. Experiments may overestimate the toxicity of bev erages produced using traditional technologies, because animals lack adaptation.
In conclusion of the section, the downward trend in alcohol consumption and alcohol-related mortality in RF should be pointed out. According to estimates by the World Health Organization (WHO) and some Russian authors, the alcohol consumption in RF reached its maximum around 2001- 2004, then fluctuated with a downward trend until 2010, after which the decline has continued [49-52]. The period 2003-2017 saw the prevalence of alcohol dependence in patients registered in state-run services fall by 38%, that of harmful use of alcohol - by 54%, and the prevalence of alcoholic psychosis - by 64% [32]. From 2005 to 2016, the consumption in terms of pure ethanol decreased from 18.7 to 11.7 liters per person per year [52]. According to our observations, in the fourth year of the Ukraine war (2025), alcohol consumption is increasing again, which has been confirmed for certain regions [53,54].
Invasive Treatments with Questionable Indi cations
Among others, the following treatments were applied to supposed alcoholics: prolonged intravenous infusions,sorbent hemoperfusion, endolymphatic, endobronchial and rectal drug delivery, sometimes without clear indi cations. Intravenous infusions were recommended for patients with alcohol use disorder including moderately severe withdrawal syndrome: 7-10 infusions daily, some times combined with intramuscular injections; details and references are in the books [1,55]. The intravenous de toxification was deemed indicated to nearly all alcohol-de pended patients. Many cases with symptoms of excessive infusions, fluid overload, pulmonary or generalized edema have been reported [56]. Besides, various intramuscular injections have been applied and recommended: mag nesium sulphate, sodium bromide and thiosulphate, sub cutaneous infusions of saline and insufflations of oxygen (300-500 ml); Unithiol, Dimercaprol, cranio-cerebral hypo thermia (1-1.5 hours); extracorporeal ultraviolet irradiation of blood, sorbent hemo- and lymphoperfusion [1,55]. The recommended duration of the intravenous detoxification was up to 30 days; references are in [1,2]. A more recent publication recommended 2-3 days [57]. This is generally at variance with the international practice. Alcohol and its metabolites are eliminated spontaneously while rehydra tion can be usually achieved per os. Repeated infusions, endovascular and endoscopic manipulations were known to transmit viral hepatitis.
Furthermore, antipsychotic drugs have been applied in adults and adolescents diagnosed with alcohol depen dence in the absence of psychosis. The alcohol craving has been interpreted as an altered state of consciousness, as a paranoid or delusional phenomenon [58-60]. Accord ingly, the anti-psychotic medication has been recommend ed by the most authoritative handbooks [60,61]. Apart from other potential side effects, a synergism between some antipsychotics and alcohol, possibly aggravating liver injury, should be taken into account [62]. With regard to alcohol-related dementia (and other dementia in alcohol consumers) it should be stressed that antipsychotic use compared with non-use is associated with increased risks of stroke, venous thromboembolism, myocardial infarc tion, heart failure, fracture, pneumonia and acute kidney injury [63].
Among patients with supposed alcoholism, biopsies were taken from kidneys, pancreas, liver, lung, salivary glands, stomach and skin, repeatedly in some cases. Intraoper ative lung biopsies were taken at surgeries for suppura tive lung diseases; details and references are in the books[1,55]. Some biopsies were collected according to clinical indications but in many cases the specimens from different organs were taken for research. The attitude to patients with alcohol use disorders tended to be less responsible. Other invasive procedures (angiography, endoscopic cholangiopancreatography) were applied in persons diag nosed with alcohol use disorder without clear indications [64].
The overuse of surgery in patients with comorbidity of al coholism and tuberculosis should be briefly commented. According to official instructions and textbooks, indications for surgery (lobectomy or others) have been broader in alcohol-dependent than in other patients; details and ref erences are in the books [1,55]. In case of alcoholism, thoracic surgeries have been recommended earlier, after a short course of medical therapy. Perelman insisted on early surgery in Tb patients with alcohol use disorder, and operated them also in the absence of demonstrable Tb in fection, including stable solitary tuberculoma. At the same time, he noticed that patients with alcoholism have more frequent post-surgery complications [65].
Furthermore, bronchoscopy was applied in cases with bronchitis, the latter being frequent among alcoholics in Russia due to cigarette smoking and the risk to fall asleep in a cold place. Along with other complications, vocal cord injuries were observed after repeated bronchoscopies sometimes performed in conditions of suboptimal procedural quality [64]. It was noticed that vomiting, triggered by apomorphine as aversive therapy, provoked hemopty sis and pneumothorax in patients with tuberculosis. A case was reported when ~60% of patients from a “phthisio-nar cological” institution for compulsory treatment broke out; over 50% of them were returned by the police [66]. The implementation of compulsory examinations and treat ments is increasingly efficient these days, which can be seen by the example of tuberculosis. Reportedly, 100% of M. tuberculosis excretors in the Moscow region had been hospitalized since 2019 [67].
The ultra-rapid (one session) treatment of alcoholism, known in the former SU as “coding”, should be comment ed briefly. The method was started during the AAC; it was criticized because of mystification, verbal intimidation and unpleasant manipulations associated with health risks. The following has been applied: spraying of the throat with ethyl chloride or infusion of 3-5 ml ethyl chloride into the pharynx with forced swallowing, pressure with therapist’s thumbs on the trigeminal and occipital nerve branch es, pressure on the carotid sinus areas and the patient’s eyeballs, intralingual injections, forceful turning and back wards movements of the patient’s head [68-75]. The latter is associated with a risk of injury for patients with vertebral abnormalities. Nevertheless, it continues to be used.
Aged Alcohol Consumers: Vulnerable Mem bers of Society
The focus on alcohol distracts from other causes of rel atively high mortality in RF. In this regard, it is necessary to give more attention to the individuals with alcohol use disorder, their protection from fraud and violence, from disdainful attitude in employment centers and medical in stitutions, from harassment in the workplace and at home. It is known that older people are sometimes bullied to quit their jobs or change the place of residence. Even moder ate alcohol consumption can serve as a pretext. The topic of elder abuse is scarcely covered in Russian literature [76,77]; it does not pertain to drinkers only, although al cohol abuse occurs among both perpetrators and victims. On the one hand, alcohol-dependent individuals have less real possibilities to protect their rights; on the other hand, maltreatment can cause stress and depression in the vic tim, predisposing to alcohol consumption. Elder abuse can take many forms and often goes unrecognized. Victims of abuse may have low self-esteem, blame themselves for what is happening, and do not want to “betray” their relatives. Bringing death of an elderly person nearer may be a consciously implemented strategy that includes in volvement in binge drinking, failure to provide assistance, manipulation in the direction of social risks and auto-ag gression. People with alcohol use disorder and dementia are known to have been victims of property-related crimes, which resulted in an increase in homelessness [78]. In the 1990s, extortion and violence were usual in the housing market; later on the fraud and threats have prevailed. Disabled, lonely, aged people, including alcohol abusers, have been convenient victims [79].
The attitude in governmental polyclinics, especially to wards middle-aged and elderly men, is sometimes dis missive. Real or supposed alcohol abuse can serve as a pretext. Aged men are visibly underrepresented among patients. For that reason, along with the marketing of pla cebos under the guise of evidence-based medicine, high prices, low quality and falsification of some drugs [80,81], chronic diseases often remain untreated. Mention should also be made of the employment service, where a dismis sive attitude towards the unemployed has been noticed. Personnel of homes for the aged are not always friendly to residents. Some of such homes prohibit exit from their territory and beer drinking, or leave the permission with paying relatives, which is a violation of the elderly persons’ rights. It is known that alcohol consumption is contrain dicated in some diseases and incompatible with certain drugs. This necessitates qualified advice rather than pro hibitions.
Conclusion
Of great importance is the strengthening of measures to prevent alcohol addiction, in particular, effective anti-alco hol propaganda aimed primarily at young people. The me dia often present people with alcohol addiction in a pitiful light. Apparently, this kind of propaganda has contributed to the fact that young people today drink less than in the 1980s, and that heavy binge drinking is visibly in decline. This approach has a drawback: criminals including mi grants sometimes subdivide citizens into “krutye” (cool or tough) and those socially vulnerable. Many aged alcohol consumers find themselves in the latter category. The care of war veterans is showcased today. There are, however, misgivings that the veteran status has been awarded gratuitously to individuals from the privileged milieu. Some real or fictive participants of the Ukraine war will occupy leading positions without sufficient professional qualities [82]. In fact, many real veterans had been mal treated in the period 1985-2005. It is known that percent age of alcohol consumers is relatively high among military veterans. During the AAC (1985-1989), they had to stand hours-long queues at retail outlets and/or to drink surro gates. After AAC, the country was flooded by poor-quality beverages and surrogates sold in vodka bottles through legally operating shops and kiosks, leading to mass poi sonings. As discussed above, the healthcare deteriorated at that time while the average life expectancy in men decreased to 58-59 years in the 1990s and early 2000s. The labor productivity is increasing, but unemployment remains; there are not enough prestigious jobs for every one. Older drinkers can be considered voluntary outsiders, giving up their social positions to more proactive fellow citizens. Following the example of some countries, they should be given a possibility to spend time in pubs and then go home, provided that public order is maintained. It might be a good idea to bring back inexpensive pubs of the Soviet era, with one difference: there should be enough seats. It is unhealthy for aged people to stand on their feet for a long time. The same applies to workers after their shift. Instead of the warmongering, the Russian govern ment should provide public assistance to citizens in need, including those suffering from alcohol use disorders.
Conflicts of interest: The authors have no conflicts of in terest to declare.
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