United 24 TV channel presents a report about our clinic and ketamine therapy. Translation by specialists from our clinic.
There is a lot of talk about rebuilding Ukraine right now, and most of the talk revolves around infrastructure, inanimate objects that can be destroyed to make way for something new. However, there is an underappreciated human element to recovery, which has a much more complex recovery roadmap.
“I had five concussions. The last one was very serious,” Oleg Kazantsev, a former junior sergeant in the Ukrainian Armed Forces, tells me as we sit in a clinic in Kyiv. “After recovering in the hospital, I returned home, and that’s when things started to change. PTSD started. I didn’t want to leave my house.”
It is estimated that 12-20% of people who have experienced or witnessed traumatic events may develop post-traumatic stress disorder, which occurs after experiencing a traumatic event. In war-torn Ukraine, where everyone is at risk of trauma in their daily lives, these statistics paint a stark picture, as one fifth of the population could potentially fall into the category of victims.
Now, in the face of a looming mental illness epidemic, the global mental health community has rallied around Ukrainians, who are now preparing a solution that, if scaled up, could treat millions with an unconventional form of therapy: ketamine-assisted therapy (KAT).
KAT has been successful under close supervision, treating Ukrainian veterans and civilians with symptoms of post-traumatic stress disorder that emerged at the start of the war in 2014. Now, with mental health resources in Ukraine at risk of being stretched beyond their capacity by a full-scale Russian invasion, rapid action is underway to expand and train KAT.
Psychedelic past
Although ketamine is classified as a dissociative drug, it is also used for psychedelic adjunctive therapy. It has dissociative and hallucinogenic properties that can induce altered states of consciousness similar to those produced by classic psychedelics such as psilocybin and LSD.
The use of psychedelics in clinical treatment is nothing new. Dr. Humphrey Osmond, an English psychiatrist, used LSD to treat alcoholism in the 1950s. His findings inspired MI6 and the CIA to use the drug as a “truth serum.”
In the 1960s, drugs such as LSD, MDMA, and psilocybin (mushrooms) became popular alternatives to conventional treatments, especially for treatment-resistant disorders. However, real breakthroughs in research failed to materialize because the Nixon administration passed the Controlled Substances Act, a response to the 1960s hippie movement and the psychedelic drugs they were using.
The new U.S. law classified LSD, psilocybin, and other psychedelics as Schedule I substances, “indicating a high potential for abuse and an unacceptable medical use.” This effectively ended most legal research and clinical use of psychedelics in the United States, and around the world. Those who refused to acknowledge their research went underground and remained there until the 1990s.
Legal ketamine
Ukraine has been at war with Russia since 2014, and the effects of the prolonged war have led to significant mental health problems for soldiers and civilians alike. The strain on the country's mental health resources was greatly exacerbated by the full-scale Russian invasion in 2022.
Meanwhile, there is a promising approach to solving the looming problem that is already showing results that come faster and more effectively than traditional therapeutic solutions. This approach is called ketamine [psycho]therapy (KAT).
The anesthetic, which partygoers commonly call “horse tranquilizer” and has become a recreational drug, has piqued the interest of the Ukrainian state, which is preparing a comprehensive strategy to overcome the looming mental health crisis resulting from the 10-year war.
Experts say that ketamine's therapeutic potential lies in its ability to produce a rapid antidepressant effect and facilitate the processing of traumatic memories. According to the experts interviewed, ketamine can be used as a great tool to allow a subject to enter a state of neuroplasticity - when the brain can reorganize its functioning.
In an effort to offer safe and regulated treatment for mental disorders, the Ministry of Health of Ukraine supported ketamine therapy for clinical use in 2017. KAT, which is combined with various talk therapy methods, is considered by many members of the psychedelic therapy (PAT) community to be a highly effective alternative for those who experience low efficacy from traditional treatments such as cognitive behavioral therapy, SSRIs (selective serotonin reuptake inhibitors), electroconvulsive therapy, antipsychotics, mood stabilizers, etc.
Case studies and clinical success
One famous case [of recovery] is that of Igor Kholodylo, a military psychologist and medic who suffered severe injuries and post-traumatic stress disorder after a Russian tank shell hit his car during an evacuation. Kholodylo, who was fortunate enough to have received proper training, fought the illness with conventional treatments, but his symptoms persisted, including problems with pronunciation.
Kholodylo turned to Dr. Vladislav Matrenytsky, a pioneer of [legal] psychedelic psychotherapy in Ukraine. Matrenytsky has treated many patients in his clinic, including an increasing number of military personnel. His private clinic is the first in Ukraine to receive a license to provide ketamine therapy.
Speaking with me on Zoom, Kholodilo recounts a very powerful KAT session, revisiting a moment he had been carrying painfully inside. The ketamine injection created a sense of relaxation and euphoria, the clinic a sense of safety, and the therapist guided Kholodilo through a dream-like state.
Ihor Kholodylo has been to many "hot zones" on the front lines. He specialized in medical evacuation - taking the wounded out of danger to a safe area for treatment. One moment stands out in his memory: the death of a fellow soldier under his care.
The recovered Kholodylo recalls that in this dream-like state he experienced the moments that led to the soldier's death. Kholodylo's first instinct as a military medic was to administer first aid to the wounded soldier, but his training as a psychologist later came to the fore when he realized the soldier's dire condition.
Kholodilo prepared the soldier for the inevitability of his death, while doing everything he could to buy the soldier precious time for a life-saving procedure. [During the CAT session], under the guidance of his therapist, Kholodilo met the soldier in his memories and received what he needed to hear: assurances that Kholodilo had done everything to keep the soldier alive.
Kholodilo continues his story, describing his awakening. The therapists immediately discussed with him his breakthroughs and the emotions he had experienced, but this time something was different. Everyone present had tears in their eyes. Moreover, although Kholodilo himself did not notice it, he spoke without difficulty.
Remarkably, after just a few sessions, Kholodilo says his stuttering has improved significantly, and the most critical symptoms of post-traumatic stress disorder have subsided. He claims that after about ten KAT sessions, he has regained a sense of normality. Kholodilo is currently in Japan, where he is receiving treatment for an eye damaged in the explosion.
American Veterans Research
Dr. Zachary Skiles is a psychologist at Heal Ukraine Trauma (HUT), a non-profit organization in the United States that focuses on (among other things) training mental health professionals in the delivery of PAT. Dr. Skiles also works at the Veterans Administration Portland’s Social Neuroscience and Psychotherapy (SNaP) Laboratory, where he conducts and researches PAT and its therapeutic impact on American veterans with issues ranging from substance abuse to post-traumatic stress disorder.
Dr. Skiles has done extensive work with the American veteran community. In a Zoom conversation, he reveals a little-known secret in the Special Forces community: he says they all “trip.” Yes, the warriors, known worldwide for their toughness and tough looks, are experimenting with psychedelics in their communities, “turning into teddy bears” — as they process the traumas associated with their professional military experiences.
The benefits of psychedelic therapy, particularly ketamine therapy, which is currently legal in Ukraine, appear to be significant. Ketamine’s dissociative properties allow patients to detach from their immediate surroundings and emotions, creating a state in which they can confront and process traumatic experiences without feeling overwhelmed.
This therapeutic approach promotes deep emotional exploration and healing. The patient gets a chance to mentally decompress, relieve psychological pressure and stress. KAT helps patients reach a mental state where they can effectively deal with their trauma and subsequently cope with it.
This effect is said to immediately help reduce the intensity of PTSD symptoms and improve overall mental health. The therapeutic process should include sessions with a psychotherapist, during which patients are encouraged to explore their subconscious traumas, transforming them into metaphorical journeys that are easier to manage and understand.
Wider implications and ethical considerations
The success of ketamine therapy in Ukraine could have broader implications for mental health treatment in military settings, Dr. Skiles said. Dr. Matrenytsky and others are advocating for the inclusion of other psychedelics, such as MDMA and psilocybin, in treatment protocols, even though these substances are still banned in Ukraine. Proponents argue that these treatments could further accelerate the recovery process for soldiers with medication-resistant PTSD.
However, the use of psychedelics in the treatment of active-duty soldiers raises ethical and moral questions. The potential for misuse, addiction, and psychological effects of such treatment on combat readiness are of serious concern.
JAMA, a peer-reviewed medical journal, published its own systematic review of psychedelic therapy and drew attention to the risks associated with an “unresearched therapeutic component.” But the eight people interviewed for the report, when asked about the potential for misuse or abuse, maintained that a clean, regulated drug prescribed by qualified mental health professionals is safe. PAT, although still in its infancy, is considered by many to be a safer alternative to self-medication, which is often facilitated by illegal and dangerous drugs.
When asked about the potential for addiction, including among patients — whether some people come to his clinic to abuse the availability of legal ketamine — he explains that after a session, patients are more likely to associate ketamine therapy with hard work. He clarifies that the sessions are not about the euphoric elements, but rather their ability to guide patients through traumatic events and allow them to process them in a safe environment.
Future directions
All eyes will be on Ukraine as the integration of KAT and potentially other drugs into mainstream treatment for PTSD could revolutionize mental health in both the military and civilian sectors. The education of mental health professionals and the training of KAT are vital for large-scale success.
The Ministry of Defense of Ukraine and the Ministry of Health have demonstrated openness to addressing the mental health problem facing the country through experimental approaches. Lisova Polyana is a medical center of the Ministry of Health that specializes in the treatment of severe psychological trauma. in the military. According to their director Ksenia Voznitsyna, the state institution will receive a license to administer CAT.
Woznitsyna also envisions expanding PAT programs at her facility, including the possible use of MDMA and psilocybin, although she acknowledges that this is a long shot. Still, the move from private facilities like Expio to public facilities like Lisova Polyana and SNaP, where Dr. Skiles practices, marks a significant step in the acceptance and destigmatization of PAT, moving away from its past associations with taboo and underground practices.
Nonprofit organizations such as Healing Ukraine's Trauma and the Ukrainian Association for Psychedelic Research must ensure that all segments of society are informed and prepared to make this transformation happen. These organizations are working tirelessly to provide resources, conduct research, and conduct training sessions to ensure that [mental health] professionals are well-prepared to use KAT effectively. They are also collaborating with international organizations to standardize protocols and ensure that best practices are followed. The success of these efforts can serve as a model for other countries facing similar challenges, demonstrating the potential of innovative treatments to address complex mental health issues. By encouraging a collaborative approach and leveraging the strengths of diverse stakeholders, Ukraine is poised to make significant strides in mental health care.
Photo: United24
