Psychedelics can help them overcome their trauma and possibly fight back
Ihor Kholodylo was probably not supposed to survive. A military psychologist and medic was evacuating his comrades in early 2023 when his jeep was hit by a Russian tank shell. He remained barely able to communicate. The operation saved his heart and eyesight. But doctors were unable to correct his speech problem and stuttering. He tried all kinds of radical therapy, but nothing helped. Then he met Vladyslav Matrenytskyi, a pioneer of psychedelic psychotherapy, who asked an unexpected question. Would he try ketamine?
Mr. Cold did not expect much, but the result was amazing. After one session, his stuttering was almost gone. Five more and he was almost back to normal. Gone are the nightmares and fears about everyday life. Ketamine therapy wasn't easy, he said, but it allowed him to resolve the trauma that was causing his symptoms: "I was back to what you could call life ... I felt light, just blessed."
Ketamine has been legalized in Ukraine for the treatment of mental illnesses since 2017. The therapeutic use of psychedelics has a long history and was explored in America in the 1950s and 60s. After the hippie movement, it lost political popularity, and for a time psychedelics were equated with drugs such as heroin. But in the last decade or so, they've had a renaissance.
Now the war is bringing Ukraine to the forefront of treatment. Dr. Matrenytskyi, who runs the country's only clinic offering ketamine therapy, says he has treated nearly 300 patients suffering from depression, post-traumatic stress disorder (PTSD) or anxiety. The proportion of soldiers is increasing.
A 40-minute session at Dr. Matrenytskyi's clinic, on the top floor of a gray children's hospital in northern Kyiv, costs just 4,000 hryvnias ($105), although the clinic provides free treatment to some soldiers. A typical course lasts from two to six sessions. The dose of ketamine — 0.5 mg per kilogram of body weight — is administered by drip. The therapist guides the patient through their journey. The goal, according to Dr. Matrenytskyi, is to tap into subconscious traumas: "We turn the memories into a metaphorical journey." He says that about a third of his ketamine patients have "extremely good" results, and another third have "fairly good" results. Adverse reactions, usually panic attacks, are rare. This is the signal to stop the drip.
The doctor says that most of the soldiers on the front line will benefit from his treatment. He blames stigma and a "Soviet" approach to military medicine for slowing access, and is lobbying to make it more common. Another goal is to expand the treatment to include banned substances such as MDMA and psilocybin (the active molecule in magic mushrooms).
Deputies and officials in the Ministry of Health mostly support it. Ksenia Voznitsyna, director of the Lisovo Polyana State Military Rehabilitation Center, believes that a pilot project using MDMA and psilocybin can be approved within six months. In May, her center sponsored a conference on the use of psychedelics in psychotherapy. But Ms. Voznitsyna believes that psychedelics should be used with caution, and never for active soldiers. "It's a therapy for complex situations, drug-resistant PTSD, when conventional methods don't work."
Others disagree. Mr. Kholodylo says that Ukraine should use psychedelics to improve combat performance. He sees two uses. The first he calls "decompression" to prevent depression from developing in frontline fighters in the first place. The second would be a ritual to prepare warriors for the possibility of death. "This is the most important thing for every soldier going to the front line. It paralyzes some of them." According to him, a soldier who accepts the risk of death is a much more effective warrior and has a better chance of survival.
The idea of using psychotropic drugs to help soldiers fight raises serious moral issues. The military is still a long way from officially implementing ketamine therapy, let alone providing it to serving soldiers. But the armed forces of Ukraine are very decentralized, and some units are obviously experimenting. Mr. Kholodylo says that he has already sent one elite special forces for treatment. "The soldiers were surprised that they were able to get back to the front line so quickly," he says. "They just didn't think it was possible."
Original: https://www.economist.com/europe/2024/01/15/a-new-therapy-for-ukraines-scarred-soldiers-ketamine
Translation of the Expo center
Photo: The Economist