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Ukraine: A New 12-Step Therapy Combats Alcoholism

Kyiv, 16 September 1998 (RFE/RL) -- An American organization, First Light Partners, has embarked on a novel program to combat alcoholism in Ukraine.

It is estimated that there are more than five million alcoholics in Ukraine. They are usually being treated with contempt by health professionals and psychiatrists. Some of them are repeatedly arrested by the police, locked up in prison-like drying-out centers and subjected to humiliating and ineffective treatment.

In contrast, the therapy suggested by First Light Partners sounds a civilized, humane and effective option. It invites alcoholics, with the help of therapists, to come to terms with their addiction personally and fight it as a disease of which they do not have to be ashamed.

The program envisages 12 steps to overcome total addiction to alcohol and setting one's life to rights. There's no medication involved, it is cheap, and the instructions can fit on a small scrap of paper. Developed from the principles of Alcoholics Anonymous (AA), it is in use around the world, and it has been shown to work.

Anatoly Viyevsky, chief narcologist for Ukraine and director of the Kyiv services for addicts, says the therapy is now available in 100 centers, throughout Ukraine.

Set up by American Ted Hicks in 1992, First Light Partners has provided annual three-month training courses since last year, teaching theory as well as practical skills practiced on groups of patients. It says it has professionals throughout the country.

Hicks, a reformed alcoholic, first came to Ukraine to set up AA groups, and was so horrified with the options open to Ukrainian alcoholics that in 1992 he founded First Light Partners to try to change the whole concept of alcoholism and its treatment.

Alcohol and drug detoxification has long received low priority in Ukraine. "There's an unofficial opinion among most of the professionals working with alcohol abuse that alcoholics, like drug addicts, are hopeless and not worth bothering with," said Tatiana Rodenova, a graduate of First Light Partner's first training course.

Traditional treatments including implantation of slow release chemicals which patients are told react fatally to alcohol and aversion therapy have not worked. "There's no peace. You really want to drink but at the same time you can't because you're scared you'll die," said Marta Makarushka, training director and country representative with First Light Partners. . "What kind of an existence is that?" Viyevsky agreed. "These are commercial and amateur methods," he said. "But there are people who want to get rid of their addictions quickly, and so some practitioners propose these treatments."

The 12 step program recognizes that there is no such thing as a medical cure for alcoholism. "The basic concept is that alcoholism is an illness which is incurable, chronic, progressive and fatal," said Rodenova. The therapy then requires great responsibility on the part of the patient, who basically has to make the decision to drink or not to drink. But "you have to say you are an alcoholic, and a lot of people don't want this stigma," said Viyevsky.

The 12 steps, as outlined in AA literature, have a distinctly spiritual tinge. Patients are asked to call on a "higher power" for help, admitting that they can no longer control their use of alcohol and asking for forgiveness for the harm they have done themselves and others through their alcohol abuse.

Makarushka insists that the therapy, though clearly spiritual, is not religious, as the '"higher power" can be whatever seems appropriate to the individual. Its religious overtones however hindered earlier introduction of the therapy into Ukraine, Viyevsky said.

But the main reason professionals and patients alike have been wary of the therapy is the emphasis it places on the patient and not the therapist or doctor. "Alcoholics here are convinced that if they go for treatment, the doctor will cure them," said Makarushka. "And because 12 step therapy involves some responsibility it's not so attractive to people." Those who follow the 12 step program have to accept that they will never be able to control their drinking or be able to drink socially and in moderation. The therapy envisages no time limits; alcoholics are told to think only a day at a time. They learn to recognize risk situations, avoid people who many encourage them to drink, and seek out company that will support abstinence.

In Ukraine, where drinking is an intrinsic part of social interaction, that can be difficult. Families and friends often inadvertently reinforce alcoholism by urging the "chut-chut", the little drink that is required for a toast at any celebration.

Most Ukrainians still regard alcoholism as a vice, or a weakness of character, said Rodenova. "Most hospitals where patients pay are trying to focus on quantity rather than quality, they just try to get as many people through as possible," she said.

Viyevsky and First Light Partners do not see eye to eye on how 12 step therapy should be introduced into Ukraine, but they agree that it is the way forward. So apparently does the Ministry of Health. The program has been included in the ministry's plans for the months to come.