United 24 TV channel presents a report about our clinic and ketamine therapy. Translation by the specialists of our clinic.
There is a lot of talk about rebuilding Ukraine, and most of the talk is about infrastructure, inanimate objects that can be destroyed to make way for something new. However, there is an underestimated human element to recovery that has a much more complex roadmap.
"I received five contusions. The last one was very serious," Oleh 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 the changes began. PTSD started. I didn't want to leave my house."
It is believed 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 being traumatized in their daily lives, this statistic paints 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 health 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 succeeding 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, swift action is underway to expand and train KAT.
Psychedelic past
Although ketamine is classified as a dissociative drug, it is also used for psychedelic assisted therapy. It has dissociative and hallucinogenic properties that can induce altered states of consciousness similar to those of 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 discoveries 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 a popular alternative to traditional treatments, especially for treatment-resistant disorders. However, no real breakthroughs in research were made because the Nixon administration passed the Controlled Substances Act, a response to the 1960s hippie movement and the psychedelic drugs they used.
The new American law classified LSD, psilocybin, and other psychedelics as Schedule I substances, "indicating a high potential for abuse and unacceptable medical use." This effectively ended most legal research and clinical use of psychedelics in the United States, as well as around the world. Those who refused to recognize their research went underground and remained there until the 1990s.
Legal ketamine
Ukraine has been at war with Russia since 2014, and the consequences of the prolonged war have led to significant mental health problems for soldiers and civilians. The strain on the country's mental health resources has been greatly exacerbated by Russia's full-scale invasion in 2022.
In the meantime, there is a promising approach to addressing the looming problem, and it is already showing results that are faster and more effective than traditional therapeutic solutions. This approach is called ketamine assisted therapy (KAT).
The anesthetic, commonly referred to by partygoers as a "horse tranquilizer" and turned recreational drug, has attracted the interest of the Ukrainian state, which is preparing a comprehensive strategy to address the mental health crisis that is looming as a result of the 10-year war.
Experts say that the therapeutic potential of ketamine lies in its ability to produce a rapid antidepressant effect and facilitate the processing of traumatic memories. According to the interviewed experts, ketamine can be used as an excellent tool to allow the subject to enter a state of neuroplasticity - when the brain can reorganize its functioning.
In an effort to offer a safe and regulated treatment for mental disorders, the Ministry of Health of Ukraine supported ketamine assisted 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 very effective alternative for those who face little effectiveness of traditional treatments such as cognitive behavioral therapy, SSRIs (serotonin reuptake inhibitors), electroconvulsive therapy, antipsychotics, mood stabilizers, etc.
Case studies and clinical success
One well-known case [of recovery] is that of Ihor Kholodilo, a military psychologist and medic who was severely injured and suffered post-traumatic stress disorder after a Russian tank shell hit his vehicle during an evacuation. Kholodilo, who was fortunate enough to have proper training, fought the disease with conventional treatments, but his symptoms persisted, including problems with speech.
Kholodilo turned to Dr. Vladyslav Matrenytskyi, a pioneer of [legal] psychedelic psychotherapy in Ukraine. In his clinic, Matrenytsky has treated many patients, including an increasing number of military personnel. His private clinic is the first in Ukraine to be licensed to provide ketamine therapy.
During a conversation with me on Zoom, Kholodilo talks about a very powerful KAT session, returning to a moment he had been carrying painfully within himself. The injection of ketamine created a feeling of relaxation and euphoria, the clinic created a sense of safety, and the therapist guided Kholodilo through a dream-like state.
Ihor Kholodilo visited many "hot zones" on the front line. He specialized in medical evacuation - taking the wounded out of danger to a safe area for treatment. He remembers one moment in particular: the death of a fellow soldier who was under his care.
The recovered Kholodilo recalls that in this dream-like state he relived the moments that led to the soldier's death. Kholodilo's first instinct as a military medic was to provide first aid to the wounded soldier, but later his training as a psychologist came into play when he realized the terrible condition the soldier was in.
Kholodilo was preparing the soldier for the inevitability of his death, while doing everything possible 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 he could to keep the soldier alive.
Kholodilo continues his story, describing his recovery. 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.
Notably, after just a few sessions, Kholodilo says that his stuttering improved significantly, and the most critical symptoms of post-traumatic stress disorder subsided. He claims that after about ten KAT sessions, he regained a sense of normalcy. Now Kholodilo is in Japan, where he is undergoing treatment for his eye damaged by the explosion.
Research on American veterans
Dr. Zachary Skiles is a psychologist with Heal Ukraine Trauma (HUT), a non-profit organization based in the United States that focuses on (among other things) training mental health professionals to conduct PAT. Dr. Skiles also works at the Portland Veterans Administration's Social Neuroscience and Psychotherapy (SNaP) Laboratory, where he conducts and researches PAT and its therapeutic impact on U.S. veterans with issues ranging from substance abuse to post-traumatic stress disorder.
Dr. Skiles has done a lot of work with the American veteran community. In a conversation via Zoom, he reveals a little-known secret in the Special Forces community: he says they all "trip". Yes, warriors known around the world for their toughness and tough exterior, veterans experiment with psychedelics in their communities, "turning into teddy bears" as they process the trauma associated with their professional military experience.
The benefits of psychedelic therapy, in particular ketamine therapy, which is currently legal in Ukraine, seem to be significant. The dissociative properties of ketamine allow patients to detach from their immediate environment 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 for mental relief, alleviating psychological pressure and stress. KAT helps patients reach a mental state where they can effectively cope with their trauma and subsequently manage it.
It is said that this effect can immediately help reduce the intensity of PTSD symptoms and improve overall mental health. The therapeutic process should include sessions with a therapist during which patients are encouraged to explore their subconscious traumas, turning them into metaphorical journeys that are easier to manage and understand.
Wider implications and ethical considerations
According to Dr. Skiles, the success of ketamine therapy in Ukraine could have broader implications for mental health treatment in military settings. Dr. Matrenitsky and others advocate for the inclusion of other psychedelics such as MDMA and psilocybin in therapeutic protocols, although these substances are still banned in Ukraine. Proponents argue that these treatments can further speed up the recovery process for soldiers with drug-resistant PTSD.
However, the use of psychedelics in the treatment of active soldiers raises ethical and moral questions. The potential for misuse, addiction, and the psychological impact of such treatment on combat readiness are of serious concern.
JAMA, a peer-reviewed medical journal, published its systematic review of psychedelic therapy and drew attention to the risks associated with the "unexplored therapeutic component". But the 8 people interviewed in this report, when asked about the possibility of misuse or abuse, argued that a clean and 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 means.
When asked about potential addiction, including among patients - whether some come to his clinic to abuse the availability of legal ketamine - Dr. Matrenytsky explains that after a session, patients are highly likely to associate ketamine therapy with hard work. He clarifies that the sessions are not about the euphoric elements, but about 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 medications into mainstream PTSD treatment has the potential to revolutionize mental health care in both the military and civilian sectors. Education of mental health professionals and training in KAT are vital to large-scale success.
The Ministry of Defense of Ukraine and the Ministry of Health have demonstrated an openness to addressing the looming mental health problem in the country through experimental approaches. Lesnaya Polyana is a medical center of the Ministry of Health that specializes in treating severe psychological trauma in the military. According to their director, Ksenia Voznitsyna, the state institution will receive a license to administer CAT.
Voznitsyna also envisions expanding PAT programs at her facility to include the possible use of MDMA and psilocybin, although she admits that this is a distant goal. Nevertheless, the move from private facilities like Experio 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.
Non-profit organizations such as Healing Ukraine's Trauma and the Ukrainian Association for Psychedelic Research need to ensure that all segments of society are informed and prepared to make this transformation. These organizations are working tirelessly to provide resources, research, and training to ensure that [mental health] professionals are well prepared to use KAT effectively. They are also working 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 different stakeholders, Ukraine is poised to make significant strides in mental health care.
Photo: United24
