Medical, moral, and political treatment of alcoholics in late Soviet psychiatry, 1970-1991

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Christian Werkmeister, History, Martin Luther University, Halle Wittenberg, Germany

“ ‘Doctor, now from face to face, answer quick: Will there be a diagnosis, or rather a verdict?’ Medical, moral, and political treatment of alcoholics in late Soviet psychiatry, 1970-1991”


Presented to the conference:

Alcohol, Psychiatry and Society

St Anne’s College, Oxford, 29-30 June 2017

See: All ‘Alcohol, Psychiatry and Society’ conference podcasts

Abstract: Although Muscovite historical sources in the sixteenth century referred to alcoholism as the „drinker’s disease“, it was considered predominantly as a sin or as immoral behaviour. Alcoholics were sometimes severely punished for what was considered as non-acceptable behaviour, but on the whole problematic drinking was widely accepted. After the Bolshevik Revolution of 1917, the new Soviet order triggered ground-breaking changes in the field of clinical psychiatry. Western medical ideas were introduced and alcoholism was officially recognized as a disease. The progressive scientific climate of the early Soviet years was short lived. The so-called Stalin constitution of 1936 stated: "He who does not work, shall not eat." This allowed the persecution of anyone who was suspected to be socially problematic – especially heavy drinkers. Alcoholism therefore was considered, once again, a moral imperfection. In the 1970s, the abuse of psychiatry for political reasons additionally hardened the regime for Soviet alcoholics.


During this time, forced hospitalization became the twin of penal incarceration; Michel Foucault has commented on this. In the Soviet medical field, physical (fetters) and chemical (sedatives) immobilization, and moral re-education went hand in hand. Although Soviet professionals stressed the meaning of socially useful labour and “work-therapy”, these measures were simply taken in order to subsidize the under-funded institutions. Alcoholics were not treated as patients, but either as a cheap work-force, or as criminals, to be punished for the “crime” of excessive drinking. They were also deprived of their citizens’ rights and the disease became a life-long stigma. Even after their release, alcoholics remained subject to repeated, forced hospitalization, involuntary treatment and were set to work in their former clinics.


The aim of the paper is to show the connection between society’s norms, political convictions, and the treatment of alcoholics from the 1970s until the end of the Soviet Union. It therefore links the devastatingly high number of alcoholics in Russian, Soviet, and post-Soviet times to the political, legal, and moral framework in the politicized medical field. It evaluates not only official documents, such as Soviet textbooks and medical papers, but also considers dissident underground publications and other sources to present a more accurate picture of the peculiarity of Soviet Russian alcoholism and its clinical treatment.



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