"Our discussions with Russian colleagues suggest that [surrogate alcohols construe] a major issue," added McKee. "Samogon has been part of Russian life for centuries. The so-called aftershaves are sold in brightly coloured quarter-litre bottles and it seems very difficult to believe that those making them do not know that they are being drunk. The bottles seem to be produced in a few places and distributed widely across Russia. So although we need to do more work, we believe they are being drunk widely. It also seems very likely that these substances are playing an important role in the high level of alcohol-related deaths in Russia."
McKee said that he also suspects that the same types of substances are being consumed in many other parts of the world. "These are products that are often consumed by people living on the margins of society, who are difficult to conduct research upon," he said. "This is consistent with historical lessons which show that substance abuse is often widespread during periods of rapid transition, such as the industrial revolution."
Shkolnikov concurs. "When thinking about the Russian health crisis, one should not overlook certain societal forces operating in the post-Soviet era," he said. "These include a totalitarian legacy of neglect of individual values and interests, substantial poverty and underdevelopment, growing unemployment and income inequality, long-lasting underfunding of the social sector, and an insufficient health-care system. Alcohol is used as a means of escape from reality."
McKee is hopeful that the Russian government has become aware of the seriousness of the problem. "Following a meeting that we had with President Putin's advisors," he said, "the president specifically mentioned the need to tackle surrogate alcohols in hi