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2016 Irkutsk mass methanol poisoning

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2016 Irkutsk mass methanol poisoning
Map
DateDecember 2016
LocationIrkutsk, Russia
CauseConsumption of adulterated surrogate alcohol
DeathsOver 70[A]
External images
Examples of hawthorn-scented bath oil
image icon Boyaryshnik, the surrogate alcohol brand involved in the poisoning, and the location where it was produced (via TASS)
image icon Boyaryshnik and other similar surrogate alcohols (via TASS)
image icon Images of boyaryshnik and shops that sold it (via RIA Novosti)

In December 2016, over 70 people died[A] of methanol poisoning in the Russian city of Irkutsk. Precipitated by the consumption of adulterated surrogate alcohol, it was the deadliest such incident in Russia's post-Soviet history.

Russian consumption of surrogate alcohol rose rapidly in the early 2010s amid worsening economic conditions. Surrogates cost less than government-regulated vodka and were commonly available from supermarkets, small shops, and vending machines. In the Irkutsk incident, people drank hawthorn-scented bath oil with the brand name boyaryshnik. While the product was typically made with and labeled as containing drinkable ethanol, at least one batch was made instead with a toxic amount of methanol. The resulting poisoning led to dozens of casualties and deaths among residents of the Novo-Lenino neighborhood in Irkutsk. A subsequent government investigation found that the surrogate alcohol's producer sourced the methanol from an employee of a local windshield washer fluid production facility. In response to the poisoning, in mid-2017 the Russian government increased legal punishments for illegally producing and selling alcohol and made it more difficult to acquire surrogate alcohols.

Background

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See also: Alcohol consumption in Russia

In the 2010s, Russia's economy suffered from a financial crisis, depressed oil prices, and international sanctions put into place during the Ukrainian crisis.[2][5] In Irkutsk Oblast, citizens' buying power fell from 2013 to 2017. Russians did see an increase in average salary per capita during that period, but rising prices on a number of important items—such as food, consumer goods, and housing—meant that their paychecks covered fewer essential expenses.[6] By 2016, the number of people living below the government-established poverty line of 10,000 rubles per month (about $170 at the time) had increased by over three percent over the previous four years.[2][6]

A map of the world with countries sorted by the number of liters of alcohol that were consumed per person in 2015. Russia is in the 10–12-liter range.
Average alcohol consumption per person in 2015 per World Health Organization data

At the same time, Russia remained one of the highest consumers of alcohol per capita in the world. According to the World Health Organization, Russian citizens consumed an average of 11.7 liters (3.1 U.S. gal) per person every year (as of 2016).[7][B] To continue those drinking habits amidst the declining economic situation, many Russians turned to less-regulated surrogate alcohols. Even the cheapest vodkas, carrying government-regulated prices, could not compete with surrogates that retailed for half the price.[2][8][9]

Experts estimated that surrogate alcohols made up twenty percent of the total alcohol consumed in Russia.[2][10] Other experts estimated that more than ten million Russians routinely purchased such alcohol,[11] and that its consumption had increased by as much as 65 percent since the introduction of an alcohol excise tax in 2009.[12] Such a widespread use of surrogate alcohols led to increasing amounts of alcohol poisonings,[13] adding to a problem that was already severe in Russia as of the early 21st century.[14]

The mass methanol poisoning in Irkutsk, a city of about 600,000 people near Lake Baikal in southern Siberia,[15] was caused by an adulterated batch of alcoholic hawthorn-scented bath oil.[2] It was named boyaryshnik or Боярышник, the Russian word for hawthorn,[2][16] and was also described as a lotion.[8][17] The product shared its name with a popular hawthorn-flavored tincture, and vodka historian Alexander Nikishin told the magazine Vice that was a deliberate choice to obfuscate its intended purpose:

You can buy boyaryshnik in a pharmacy, a medicinal tincture. And then there is the boyaryshnik spirit, which they call medicinal, but really it's just alcohol with the taste of boyaryshnik. It's bootlegging, pure and simple.[16]

The boyaryshnik bottles carried clear warnings that they were not intended for consumption.[18] However, many Russians knew that the product was meant to be a cheap vodka substitute and government authorities condoned its sale.[2] The oil bottles were typically half the size of vodka, but their alcohol content was so high that individuals could dilute them to a similar alcohol by volume.[2][19]

These sorts of surrogate alcohols were widely available in Russian supermarkets, shops, and vending machines. They were also not subject to any legal age requirement, alcohol excise stamps, or other restrictions introduced in the early 2010s to curb alcohol consumption in the country.[1][2][18] The vending machines were particularly problematic: they were highly profitable,[8] available 24 hours a day, and often deliberately placed near impoverished areas of Russian cities to appeal to people needing a cheap alternative to legal alcohol.[20]

Methanol and its symptoms

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Methanol is a poisonous substance.[2][21][C] It is difficult to tell apart from ethanol,[D] the substance found in vodka and other alcoholic drinks. Both are colorless and give off a similar odor, but methanol is cheaper.[22][23]

Methanol can enter the body when drunk, when placed on the skin, or when breathed in. Amounts as small as 10 milliliters (0.34 U.S. fl oz) can be fatal, although people have survived amounts as high as 400 milliliters (14 U.S. fl oz).[23][E] Symptoms occur as soon as a half hour after ingestion, and include nausea and vomiting (gastric distress) along with confusion and drowsiness (central nervous system depression). People can also fall into a coma and enter respiratory arrest. As long as 72 hours after exposure, people's vision can be negatively affected; humans break down methanol into formate metabolites, which destroys cells in the optic nerve and can leave people blind.[23]

Common methanol antidotes include fomepizole and ethanol,[23] but fomepizole was not approved for use in Russia,[2] and ethanol is difficult to administer.[23]

Incident

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A vial of methanol, the substance that caused the mass poisoning, next to a vial of ethanol, the substance found in alcoholic beverages

The bath oil involved in the December 2016 mass poisoning was made with methanol instead of the usual ethanol. It was placed into bottles that had the bath oil's typical ethanol-bearing labels.[18] The methanol was acquired from an employee of a local windshield washer fluid firm, who stole and sold the substance without the knowledge of the company's head.[25][F]

Methanol-poisoned individuals began arriving at hospitals on 17 December,[1][4] and local press reports emerged late on 18 December with the news that eight people had died and another nine were hospitalized.[26][27] By the end of the next day, a total of 57 people had been hospitalized and 49 were dead.[21][28] Because numerous residents had been overcome by poisoning symptoms before being able to call for help,[8] Irkutsk authorities searched for deceased individuals at their properties and near locations frequented by homeless individuals.[2][28] The authorities delivered the bodies straight to a morgue.[4]

Hospitalizations and deaths continued after the initial surge. On the 20th, the Irkutsk health ministry reported that casualties had risen to 52 with another 29 hospitalized.[29] Those numbers rose to 62 dead plus 40 hospitalized on the 21st;[30] 74 plus 30 on the 23rd;[31] 77 plus 16 on the 27th,[32] and finally 78 dead on 9 January.[3] Some individuals survived because they had been drinking other ethanol-based alcohol at the same time as the methanol-laced product, and the former helped counteract the latter.[2]

The total number of deaths has been reported as 74, 76, and 78. An Irkutsk medical investigation gives the lowest figure, as four deaths previously attributed to methanol were actually caused by drinking too much unadulterated ethanol-based bath oil.[1] Other scientific and media articles have supported death tolls of 76 or 78 people.[2][3][4][A] A total of 123 people were hospitalized, a number of whom died.[1][2][4] The incident was the deadliest mass methanol poisoning in Russia's post-Soviet history.[4] "Poisonings caused by cheap surrogate alcohol are a regular occurrence", a reporter for the Associated Press news agency wrote, "but the Irkutsk case was unprecedented in its scale."[28]

External images
image icon Poisoning survivors in intensive care (via TASS)
image icon The hospital where poisoned individuals were taken (via TASS)
image icon Additional images of the hospital (via RIA Novosti)

Most of those affected were residents of the Novo-Lenino neighborhood in Irkutsk. They included teachers, nurses, and drivers; The New York Times described the majority as holding "steady if low-paying jobs".[2] The Russian newspaper Komsomolskaya Pravda profiled a 34-year-old mother who bought the bath oil to share over dinner with her husband. She consumed two shots worth of the drink, and that was enough to kill her.[8][33] According to state-owned media, Irkutsk's government gave 13,325 rubles to individual families of the dead to pay for funerals (about US$200 in 2016).[34]

Aftermath

[edit]

Irkutsk's mayor Dmitry Berdnikov declared a state of emergency on 19 December.[9][35] By the next day, the Russian government said that it had seized about 2,000 liters (530 U.S. gal) of illegal alcohol, uncovered a bath oil production facility, and removed 500 liters (130 U.S. gal) of remaining bath oil from the shelves of around 100 retailers in the Irkutsk area.[28][36] On the 23rd, the state-owned TASS news agency reported that Russian police had seized over 10,000 small bath oil bottles.[37]

In the days after the poisoning, Russian authorities opened a criminal case and detained 23 people. They included local vendors who sold the product, police officers, and a senior regional government official for the greater Siberian region.[2][32][38] A further five people were arrested in January 2017 and charged with selling and publicizing surrogate alcohol.[39] In February 2020, the last of 19 individuals jailed or fined for distributing the product was sentenced to 2.5 years in prison.[40]

After the incident, a spokesperson for Russian president Vladimir Putin called it a "terrible tragedy".[28] They blamed it on a failing of "supervisory bodies".[2] Prime Minister Dmitry Medvedev called for a ban on non-traditional alcoholic liquids like bath oils, saying "it's an outrage, and we need to put an end to this".[28] Chairman of the Federation Council Valentina Matviyenko publicly supported additional regulations on alcohol-containing liquids,[36] and Deputy Prime Minister Alexander Khloponin proposed accomplishing something similar by requiring pharmaceutical prescriptions.[41] Alexei Navalny, an opposition politician, alleged that "boyaryshnik is killing more people than terrorist acts did in the whole history of Russia" each year.[9]

Putin announced on 22 December that he supported increasing regulations on products with more than 25 percent alcohol, increasing punishments for anyone who broke alcohol manufacturing and distribution laws,[42] and expanding the alcohol excise tax to alcohol-containing products in the pharmaceutical and cosmetics business sectors.[43][G] "In practice we see what such indulgences lead to: dozens of people dying like flies," Putin said.[16]

On 26 December 2016, Rospotrebnadzor, Russia's government agency devoted to consumer protection, banned all sales of most non-food items with more than 25 percent alcohol (with exceptions for window cleaning liquids and perfume).[1][46][47] Their order was scheduled to run for one month, but they extended it multiple times so that it was in effect nearly every day through 2018.[48] Nevertheless, Russian companies used the exceptions and exclusions in the measure to continue selling drinkable medicinal tinctures, antiseptics, and Eau de Cologne, even while they removed bath oils, some kinds of perfume, and other similar products.[49]

In May 2017, the Russian government pegged the minimum legal price of vodka to 205 rubles per half liter (equivalent to US$3.06 for about one pint in 2016). That was lower than a previously announced price increase to 219,[1] but it was still about 2.4 times the minimum price of vodka in 2011 and 15 rubles more than the price of vodka at the time of the Irkutsk poisoning.[50] Two months later, they strengthened legal punishments for illegally producing and selling alcohol, banned the kind of alcoholic vending machines through which the Irkutsk bath oil was sold, and prohibited online advertisements of alcoholic retailers.[1]

In December 2018, the government passed a new law that ended the ability of retailers to sell non-food items with an ethanol content of 28% or above at a price below that of the legal minimum for vodka and other liquors. The intended effect was to put an end to the ability of cheap surrogate alcohol to economically compete with their regulated alternatives.[51]

See also

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Notes

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  1. ^ a b c Secondary sources have specified the number of deaths as being 74,[1] 76,[2] and 78.[3] Supporting the 74 figure, scientists Maria Neufeld and Jürgen Rehm noted in January 2018 that a "forensic medical investigation revealed that out of the 78 deceased, 74 died because of methanol poisoning and the rest died because of consumption of large amounts of ethanol."[1] At least one source, an article in the Siberian Medical Journal, gave both 76 and 78.[4]
  2. ^ The World Health Organization said that their estimated consumption total covers "recorded and unrecorded alcohol per capital consumption" in individuals aged 15 or higher.[7]
  3. ^ Methanol is also known as methyl alcohol or wood alcohol, and it has the chemical formula CH3OH.[22]
  4. ^ Ethanol is also known as ethyl alcohol or grain alcohol, and it has the chemical formula CH3CH2OH.[22]
  5. ^ According to Human Toxicology, which gives a smaller lethal range of 30–240 milliliters (1.0–8.1 U.S. fl oz), the wide difference in toxic amounts is likely because "the contamination of the consumed liquid with ethanol or later ethanol consumption, as ethanol has a protective effect." It also cites the "notoriously poor histories reported in some of these cases and the differing folate status of patients."[24]
  6. ^ The company head had acquired the methanol illegally and made the windshield fluid with it in place of the legally required isopropanol.[1][25]
  7. ^ Some media articles referred to this as a proposal to decrease alcohol taxes.[44][45]

References

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  1. ^ a b c d e f g h i j Neufeld, Maria; Rehm, Jürgen (January 2018). "Effectiveness of policy changes to reduce harm from unrecorded alcohol in Russia between 2005 and now". International Journal of Drug Policy. 51: 1–9. doi:10.1016/j.drugpo.2017.09.006. PMID 29031132.
  2. ^ a b c d e f g h i j k l m n o p q r s MacFarquhar, Neil (18 February 2017). "Where the Booze Can Kill, and Putin Is Deemed a 'Good Czar'". The New York Times. Archived from the original on 26 February 2017. Retrieved 5 March 2017.
  3. ^ a b c "В Иркутске число жертв отравления "Боярышником" увеличилось до 78 человек" [In Irkutsk, the number of victims of the "Hawthorn" poisoning has increased to 78 people]. RIA Novosti (in Russian). 9 January 2017. Retrieved 19 August 2024.
  4. ^ a b c d e f Zobnin, Yu.V.; Vygovsky, E.L.; Degtyareva, M.A.; Lyubimov, B.M.; Malykh, A.F.; Teterina, I.P.; Tretyakov, A.B.; Lelyukh, T.D.; Ostapenko, Yu.N. (2017). "Массовое отравление метиловым спиртом в Иркутске в декабре 2016 года" [Mass poisoning with methanol in Irkutsk in December 2016]. Siberian Medical Journal (Irkutsk) (in Russian). 150 (3): 29–36. doi:10.57256/2949-0715-2017-3 (inactive 1 November 2024). ISSN 1815-7572.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  5. ^ Movchan, Andrey (2 February 2017). "Decline, Not Collapse: The Bleak Prospects for Russia's Economy". Carnegie Moscow Center. Archived from the original on 6 March 2017. Retrieved 5 March 2017.
  6. ^ a b Topilin, A. (3 June 2022). "Economic Growth and the Standard of Living in Irkutsk Oblast: A Case of Study of Regional Imbalance". Problems of Economic Transition. 63 (4–6): 212–223. doi:10.1080/10611991.2022.2141545. ISSN 1061-1991.
  7. ^ a b Poznyak, Vladimir; Rekve, Dag (2018). "Appendix I". Global status report on alcohol and health 2018 (PDF). Geneva: World Health Organization. p. 345. ISBN 978-92-4-156563-9.
  8. ^ a b c d e Connolly, Nick (25 December 2016). "A city in shock". Deutsche Welle. Archived from the original on 9 March 2023. Retrieved 9 March 2023.
  9. ^ a b c Walker, Shaun (19 December 2016). "Siberian city declares emergency as dozens die from drinking alcoholic bath tincture". The Guardian. Retrieved 15 August 2024.
  10. ^ Пузырев, Денис; Кравцов, Антон (24 November 2016). "Расследование РБК: как «аптечный алкоголизм» покоряет Россию" [RBC investigation: How "pharmacy alcoholism" is conquering Russia]. RBK Group (in Russian). Archived from the original on 25 November 2016.
  11. ^ Walker, Shaun (2018). The Long Hangover: Putin's New Russia and the Ghosts of the Past. Oxford University Press. p. 248. ISBN 978-0-19-065924-0.
  12. ^ Panin, Alexander (2 February 2015). "Russia Cuts Price of Vodka Amid Double-Digit Inflation". The Moscow Times. Retrieved 23 August 2024.
  13. ^ Andreev, Evgeny; Bogoyavlensky, Dmitri; Stickley, Andrew (11 January 2013). "Comparing Alcohol Mortality in Tsarist and Contemporary Russia: Is the Current Situation Historically Unique?". Alcohol and Alcoholism. 48 (2): 215–221. doi:10.1093/alcalc/ags132. ISSN 0735-0414. PMID 23316073.
  14. ^ Stickley, A.; Leinsalu, M.; Andreev, E.; Razvodovsky, Y.; Vagero, D.; McKee, M. (1 October 2007). "Alcohol poisoning in Russia and the countries in the European part of the former Soviet Union, 1970 2002". European Journal of Public Health. 17 (5): 444–449. doi:10.1093/eurpub/ckl275. ISSN 1101-1262. PMID 17327281.
  15. ^ "Dozens die in Russia after drinking bath oil". Deutsche Welle. 19 December 2016. Retrieved 6 September 2024.
  16. ^ a b c Luhn, Alec (22 December 2016). "72 Russians have died this week from drinking bath oil because they couldn't afford real alcohol". Vice. Retrieved 13 August 2024.
  17. ^ "Russia bath lotion poisoning: Number of dead rises to 58". BBC News. 21 December 2016. Retrieved 15 August 2024.
  18. ^ a b c Filipov, David; Schmidt, Samantha (25 October 2021). "Nearly 50 people dead from alcohol poisoning after drinking bath oil in Siberian city". The Washington Post. Retrieved 15 August 2024.
  19. ^ Nechepurenko, Ivan (22 December 2016). "After 72 Die, Putin Tightens Limits on Consumer Products High in Alcohol". The New York Times. Archived from the original on 25 December 2016. Retrieved 22 December 2016.
  20. ^ Kupfer, Matthew (25 November 2016). "Reports Show Russia's Illegal 'Pharmacy-Alcohol' Industry Is Booming". The Moscow Times. Archived from the original on 2 June 2017. Retrieved 5 March 2017.
  21. ^ a b Nechepurenko, Ivan (19 December 2016). "In Russia, Dozens Die After Drinking Alcohol Substitute". The New York Times. Archived from the original on 19 December 2016. Retrieved 19 December 2016.
  22. ^ a b c Wade, Leroy G. "Physical properties of alcohols". Britannica. Retrieved 18 August 2024.
  23. ^ a b c d e Nekoukar, Zahra; Zakariaei, Zakaria; Taghizadeh, Fatemeh; Musavi, Fatemeh; Banimostafavi, Elham Sadat; Sharifpour, Ali; Ghuchi, Nasrin Ebrahim; Fakhar, Mahdi; Tabaripour, Rabeeh; Safanavaei, Sepideh (June 2021). "Methanol poisoning as a new world challenge: A review". Annals of Medicine & Surgery. 66. doi:10.1016/j.amsu.2021.102445. ISSN 2049-0801. PMC 8187162. PMID 34141419.
  24. ^ Jacobsen, D.; McMartin, K.E. (1996). "Alcohols and glycols". Human Toxicology. Elsevier. pp. 623–648. doi:10.1016/b978-044481557-6/50026-5. ISBN 978-0-444-81557-6.
  25. ^ a b "Суд ограничился штрафом поставщику метанола для погубившего 76 иркутян "Боярышника"" [The court limited itself to a fine for the methanol supplier of the "Hawthorn" that killed 76 people in Irkutsk] (in Russian). Interfax. 31 January 2018. Retrieved 16 August 2024.
  26. ^ "Отравление «Боярышником»: хронология" [Hawthorn poisoning: a timeline]. Irk.ru/Irkutsk Online (in Russian). 19 December 2016. Retrieved 16 August 2024.
  27. ^ "Отравление метанолом в Иркутске: главное за неделю" [Methanol poisoning in Irkutsk: key events of the week]. Irk.ru/Irkutsk Online (in Russian). 24 December 2016. Retrieved 16 August 2024.
  28. ^ a b c d e f Isachenkov, Vladimir (19 December 2016). "Alcohol poisoning death toll in Russian city rises to 49". Associated Press. Archived from the original on 20 December 2016. Retrieved 19 December 2016.
  29. ^ "Death toll in Siberian mass alcohol poisoning case rises to 52". Reuters. 20 December 2016. Retrieved 18 August 2024.
  30. ^ Reevell, Patrick (21 December 2016). "62 Die in Siberia After Drinking Counterfeit Bath Oil". ABC News. Retrieved 18 August 2024.
  31. ^ "Death Toll From Alcohol Poisoning Rises To 74 In Irkutsk". Radio Free Europe/Radio Liberty. 23 December 2016. Retrieved 18 August 2024.
  32. ^ a b Hobson, Peter (27 December 2016). Roche, Andrew (ed.). "Russia opens criminal case into official after 77 die of alcohol poisoning". Reuters. Archived from the original on 19 July 2017. Retrieved 27 December 2016.
  33. ^ Синьков, Андрей (22 December 2016). "Отец погибшей от суррогата иркутянки: «Моя дочь не была алкоголичкой, она стала жертвой преступников»" [Father of Irkutsk woman who died from surrogate alcohol: "My daughter was not an alcoholic; she became a victim of criminals"]. Komsomolskaya Pravda (in Russian).
  34. ^ "Семьи погибших от «Боярышника» получат компенсации от иркутских властей" [The families of those who died from "Hawthorn" will receive compensation from the Irkutsk authorities]. Argumenty i Fakty (in Russian). 23 December 2016. Retrieved 16 August 2024.
  35. ^ "Dozens Dead In Siberia After Drinking Body Lotion; Seven Arrested". Radio Free Europe/Radio Liberty. 19 December 2016. Retrieved 15 August 2024.
  36. ^ a b "Продавцы убившего 26 человек в Иркутске "Боярышника" задержаны" [The sellers of the "Hawthorn" that killed 26 people in Irkutsk have been detained]. BBC News Русская служба (in Russian). 20 December 2016. Retrieved 15 August 2024.
  37. ^ "Some 10,000 bottles of poisonous bath lotion seized in Siberia's Irkutsk". TASS. 22 December 2016. Retrieved 13 August 2024.
  38. ^ "Suspected Surrogate Alcohol Supplier Arrested in Irkutsk". The Moscow Times. 23 December 2016. Archived from the original on 15 July 2018. Retrieved 5 March 2017.
  39. ^ "Counterfeit Alcohol Producers Arrested in Siberia". The Moscow Times. 31 January 2017. Archived from the original on 4 October 2023. Retrieved 5 March 2017.
  40. ^ "Supplier Of Deadly Bath Lotion In Siberia Jailed". Radio Free Europe/Radio Liberty. 28 February 2020. Archived from the original on 9 March 2023. Retrieved 9 March 2023.
  41. ^ "Alcohol-Based Medicines to Need Prescriptions After Siberian Poisoning Tragedy". The Moscow Times. 22 December 2016. Archived from the original on 22 December 2016. Retrieved 5 March 2017.
  42. ^ Walker, Shaun (21 December 2016). "Vladimir Putin orders clampdown on 'surrogate' alcohol as deaths rise". The Guardian. Archived from the original on 10 October 2022. Retrieved 21 December 2016.
  43. ^ "Путин: нужно повышать акцизы, а не продавать флакончики за три копейки" [Putin: we need to raise excise taxes, not sell bottles for three kopecks]. RIA Novosti (in Russian). 21 December 2016. Retrieved 16 August 2024.
  44. ^ Kottasova, Ivana (22 December 2016). "Putin cracks down on moonshine amid poisoning crisis". CNN Business. Retrieved 16 August 2024.
  45. ^ "Putin Plans Alcohol Tax Cuts After Siberian Poisoning Tragedy". The Moscow Times. 21 December 2016. Retrieved 16 August 2024.
  46. ^ "Russia Suspends Sale of Non-Food Products Containing Alcohol". The Moscow Times. 26 December 2016. Archived from the original on 11 July 2018. Retrieved 5 March 2017.
  47. ^ "Russia Extends Restrictions on Sale of Alcohol Products After Mass Poisoning". The Moscow Times. 25 January 2017. Archived from the original on 2 October 2018. Retrieved 5 March 2017.
  48. ^ Neufeld, Maria; Rehm, Jürgen (April 2018). "Newest policy developments regarding surrogate alcohol consumption in Russia". International Journal of Drug Policy. 54: 58–59. doi:10.1016/j.drugpo.2017.11.013. PMID 29414486.
  49. ^ Gil, Artyom; Savchuk, Sergey; Appolonova, Svetlana; Allenov, Andrey; Khalfin, Ruslan (20 April 2021). "Availability of non-beverage alcohols in Russia in 2015–2020: Were control policies implemented since 2005 effective?". Journal of Law, Public Policies, and Human Sciences. 2 (2): 08–34. doi:10.52571/JLPPHS.v02.n02.pgi.08.2021.
  50. ^ Neufeld, Maria; Rehm, Jürgen (January 2018). "Effectiveness of policy changes to reduce harm from unrecorded alcohol in Russia between 2005 and now". International Journal of Drug Policy. 51: Appendix A/Web supplementary data. doi:10.1016/j.drugpo.2017.09.006. PMID 29031132.
  51. ^ Neufeld, Maria; Bobrova, Anastacia; Davletov, Kairat; Štelemėkas, Mindaugas; Stoppel, Relika; Ferreira-Borges, Carina; Breda, João; Rehm, Jürgen (March 2021). "Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects". Drug and Alcohol Review. 40 (3): 350–367. doi:10.1111/dar.13204. ISSN 0959-5236. PMC 7936953. PMID 33155370.

Further reading

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