Psychedelics can help them overcome trauma and possibly fight
Ihor Kholodilo was probably not supposed to survive. The military psychologist and medic was evacuating his comrades in early 2023 when his jeep was hit by a Russian tank shell. He was left barely able to communicate. Surgery saved his heart and eyesight. But doctors were unable to fix his speech and stuttering problems. He tried all kinds of radical therapy, but nothing worked. Then he met Vladislav Matrenitsky, a pioneer of psychedelic psychotherapy, who asked him an unexpected question. Would he try ketamine?
Mr. Kholodilo didn't expect much, but the result was amazing. After one session, his stuttering almost disappeared. Five more and he was almost back to normal. His nightmares and fears about everyday life disappeared. According to him, ketamine therapy was not easy, but it allowed him to resolve the trauma that caused his symptoms: "I got back to what you could call life... I felt light, just blessed."
Ketamine has been legalized in Ukraine for the treatment of mental illness since 2017. The therapeutic use of psychedelics has a long history, and it was explored in America in the 1950s and 60s. After the hippie movement, it lost its political popularity, and for a while psychedelics were equated with drugs like heroin. But in the last decade or so, they have experienced a renaissance.
Now the war is bringing Ukraine to the front lines of treatment. Dr. Matrenytsky, 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. A growing proportion are soldiers.
A 40-minute session at Dr. Matrenytsky'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 some soldiers with free treatment. 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. Matrenytsky, is to address subconscious traumas: "We turn memories into a metaphorical journey." He says that about a third of his patients who take ketamine have "extremely good" results, and another third have "good enough" results. Bad reactions, usually panic attacks, are rare. This is a signal to stop the drip.
The doctor says that most soldiers on the front line would benefit from his treatment. He blames stigma and a "Soviet" approach to military medicine for slowing access, and is lobbying to make it more widespread. Another goal is to expand treatment to include illicit substances such as MDMA and psilocybin (the active molecule in magic mushrooms).
MPs and officials in the health ministry are largely supportive. Ksenia Voznitsyna, director of the state military rehabilitation center Lisova Polyana, believes that a pilot project using mdma and psilocybin could 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 cautiously, and never for active soldiers. "It is a therapy for difficult situations, for drug-resistant PTSD, when conventional methods do not work."
Others disagree. Mr. Kholodilo says that Ukraine should use psychedelics to improve combat performance. He sees two applications. The first he calls "decompression" to prevent depression from developing in the first place in soldiers on the front lines. The second would be a ritual to prepare soldiers for the possibility of death. "This is the main thing for every soldier who goes to the front line. Some of them are paralyzed by it." 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 army is still far from officially introducing ketamine therapy, let alone providing it to soldiers who are serving. But Ukraine's armed forces are highly decentralized, and some units are apparently experimenting. Mr. Kholodilo says he has already sent one elite special forces unit for treatment. "The soldiers were surprised that they were able to return to the front line so quickly," he says. "They just didn't think it was possible."
Translation by the Experio Center
Photo: The Economist
