MOSCOW, March 30, 2006 (RFE/RL) -- Sasha is only 13, but he already has two years of hard drinking behind him.
He remembers well trying his first alcoholic drink, at age 11.
"The first time I drank it was a can of Jaguar -- it's a big can of cocktail that costs 33 rubles [$1.20]," Sasha said. "I liked it, the feeling alcohol gave me."
Now, Sasha is getting help for alcohol abuse at Kvartal (Quarter).
In that sense, he is luckier than child alcoholics receiving treatment in Russia's overcrowded, cash-strapped state hospitals.
Kvartal is a modern, friendly treatment center sited in a leafy courtyard in southern Moscow. It can house up to 25 children. Founded three years ago, this is Russia's only rehabilitation center for minors with alcohol and drug problems.
Despite being a state-run structure, Kvartal works closely with several humanitarian organizations -- including Doctors Without Borders -- and receives consistent financial aid from UNICEF, the United Nations Children's Fund.
Sasha says he likes it at the clinic.
But that does not mean he necessarily wants to overcome his drinking problem.
Reluctance Of Youth
The clinic's director, Veronika Gotlieb, says most child alcoholics are in denial about their addiction.
"The majority of these children do not want to change anything," Gotlieb said. "Children who have been sent by the police or by narcologists, for example, think they're doing just fine: 'Everyone drinks, it's normal, I don't have any problems. I drink until I'm half dead, but everyone does that.' What can you do with people who have no problems? Telling them 'this is bad, you can get sick, you can die,' does not work with teenagers, because they are not afraid of death, they don't fear for their lives."
Once the six-week treatment is over, the young patients all too often relapse into alcohol abuse.
This is why Kvartal focuses on psychological treatment. Besides receiving medical care, children can consult psychologists on the spot and are encouraged to take part in a range of creative activities like face painting, drawing, and acting.
Drinking is, of course, strictly prohibited at the clinic. But once the six-week treatment is over, the young patients all too often relapse into alcohol abuse. Gotlieb says the aim of the treatment program is therefore to provoke a change of attitude in the children that will help them acknowledge their addiction and develop a long-term alternative to alcohol and drugs.
The success of the recovery then depends as much on their own determination as on their family's support.
In Gotlieb's experience, however, rehabilitation efforts tend to be hampered precisely by the parents.
Face painting is one of the therapeutic activities for children at Kvartal (RFE/RL)
"Rare are the parents who are interested and, what's even more important, who understand that the efficiency of the change in the child depends directly on the family's readiness to change in such a way that the atmosphere within the family does not push the child out of the home," Gotlieb said. "Parents act as though they were at the dry cleaner's: they come here, [they say] 'Here's my girl, or my boy, you repair him and everything will be fine.' I would say that children are much saner than their parents."
According to the Health Ministry, the number of children diagnosed with alcohol, drug, and substance abuse in Russia has more than tripled since the early 1990s.
Official statistics show that in 2004 more than 100,000 children and teenagers under 18 received treatment in state hospitals for alcohol abuse and alcoholism. This represents roughly 1.3 percent of this age group. Alcoholism is also hitting increasingly younger children -- Kvartal has patients as young as eight. Advertising To Blame?
Yevgenia Koshkina, an expert at the Health Ministry's National Drug Research Center, says aggressive beer advertising is largely to blame for this trend.
"We had very aggressive advertisements that targeted young people," Koshkina said. "Beer consumption has considerably risen -- 40 percent of young people drink beer on a regular basis. Then they develop tolerance, they don't get satisfaction, the desired stress removal, from this quantity. So they start consuming vodka."
"There's an expression: 'Show me your friend and I'll tell you who you are.'"
Gotlieb says her clinic has treated teenagers who consumed as much as 10 liters of beer a day.
So what causes children to turn to alcohol?
Orphans and children from impoverished or dysfunctional backgrounds are certainly more at risk than others. But Gotlieb says children and young teenagers usually drift into alcohol abuse not out of despair, but simply out of boredom, bravado, or peer pressure.
Ivan, a smiley, outgoing 13-year-old boy, shares a room with Sasha at Kvartal. He says his older brother and his friends prompted him to taste alcohol about a year ago. And like his roommate Sasha, he liked it -- until social services sent him to the clinic last week, he had been drinking about 1 1/2 liters of vodka every day.
Ivan says he has long wanted to abandon alcohol, but he says his friends' pressure to drink was a constant obstacle.
"I hang out with people who drink and smoke," Ivan said. "There's an expression: 'Show me your friend and I'll tell you who you are.' Give up? I used to say that I wasn't home, that I didn't want to go out, I didn't see them [friends] for several weeks. Then I decided it would be better to come here, get treated, and then I won't drink anymore."
But even Ivan, despite his determination, still finds it impossible to picture his life without alcohol once he leaves the clinic.
"I will drink, but not much," he says with a guilty smile. "Just in smaller doses."