United 24 TV channel presents report about our clinic and ketamine therapy. Translation by specialists of our clinic.
Now there is a lot of talk about the reconstruction of 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 of recovery that has a much more complex road map to recovery.
"I got 5 concussions. The last one was very serious," Oleg Kazantsev, a former junior sergeant of the Armed Forces of Ukraine, tells me while we are sitting 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 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 injury in everyday life, these statistics paint a stark picture, as a fifth of the population could potentially fall into the casualty category.
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, could treat millions with an unconventional form of therapy: ketamine-assisted therapy (KAT).
KAT has been successful under close supervision in treating Ukrainian veterans and civilians with PTSD symptoms since the outbreak of the war in 2014. Now that Ukraine's mental health resources are at risk of being stretched beyond capacity due to a full-scale Russian invasion, swift action is being taken to expand and train KAT.
Psychedelic past
Although classified as a dissociative drug, ketamine is also used for psychedelic adjunct 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 not new. Dr. Humphrey Osmond, an English psychiatrist, used LSD to treat alcoholism in the 1950s. His discoveries inspired MI6 and the CIA to use this drug as a "truth serum."
In the 1960s, drugs such as LSD, MDMA, and psilocybin (mushrooms) became popular alternatives 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 hippie movement of the 1960s and the psychedelic drugs they used.
A new US 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 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. The strain on the country's mental health resources was greatly increased by the full-scale invasion of Russia in 2022.
Meanwhile, there is a promising approach to solving the looming problem, and it is already showing results that are faster and more effective than traditional therapeutic solutions. This approach is called ketamine [psycho]therapy (KAT).
The anesthetic, commonly referred to by partygoers as "horse tranquilizer" and turned into a recreational drug, has sparked the interest of the Ukrainian state, which is preparing a comprehensive strategy to tackle the looming mental health crisis stemming from 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 experts interviewed, ketamine can be used as a great tool to allow a subject to enter a state of neuroplasticity—where the brain can reorganize its functioning.
In an effort to offer safe and regulated treatment for mental disorders, the Ministry of Health of Ukraine approved ketamine therapy for clinical use in 2017. KAT, combined with various talk therapy techniques, is considered by many members of the psychedelic therapy (PAT) community to be a very effective alternative for those who experience little success with traditional treatments such as cognitive behavioral therapy, SSRIs (serotonin reuptake inhibitors), electroconvulsive therapy, antipsychotics, mood stabilizers, etc.
Case studies and clinical success
One notable case [of recovery] is that of Igor Kholodylo, a military psychologist and medic who suffered severe injuries and post-traumatic stress disorder after a shell from a Russian tank hit his car during an evacuation. Hodilo, who was fortunate enough to have adequate training, fought the disease with conventional treatment methods, but his symptoms persisted, including problems with pronunciation.
Kholodylo turned to Dr. Vladyslav Matrenytskyi, a pioneer of [legal] psychedelic psychotherapy in Ukraine. In his clinic, Matrenytskyi treated many patients, among whom now more and more are military personnel. His private clinic is the first in Ukraine to receive a license for ketamine therapy.
Speaking to me on Zoom, Cool talks about a very powerful KAT session, going back to a moment he painfully carried inside. The injection of ketamine created a sense of relaxation and euphoria, the clinic a sense of safety, and the therapist guided Holodil through a sleep-like state.
Ihor Kholodylo visited many "hot zones" on the front lines. He specialized in medical evacuation — taking the wounded out of danger to a safe area for treatment. He remembered one moment very well: the death of a fellow soldier who was under his care.
A recovered Cooler recalls that in this dream-like state he experienced the moments that led to the soldier's death. Kholodil's first instinct as a military medic was to administer first aid to a wounded soldier, but later his training as a psychologist came to the fore when he realized the terrible state the soldier was in.
The refrigerator prepared the fighter for the inevitability of his death, while doing everything possible to buy the fighter precious time for a life-saving procedure. [During the CAT session], under the guidance of his psychotherapist, Chill met the soldier in his memories and received what he needed to hear: assurance that Chill had done everything to keep the soldier alive.
The refrigerator continues the story, describing his return to consciousness. The therapists immediately talked to him about his breakouts and the emotions he was going through, but this time something was different. Everyone present had tears in their eyes. Moreover, although the Cooler himself did not notice this, he spoke without difficulty.
Remarkably, after only a few sessions, Cold says that his stuttering has improved significantly and his most critical PTSD symptoms have subsided. He claims that after about ten sessions of KAT, he regained a sense of normalcy. Now Holodylo is in Japan, where he is being treated for an eye damaged by an explosion.
American Veterans Studies
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 to administer PAT. Dr. Skiles also works in the Portland Veterans Administration's Social Neuroscience and Psychotherapy (SNaP) Laboratory, where he conducts and researches PAT and its therapeutic effects on US veterans with problems ranging from substance abuse to PTSD.
Dr. Skiles has done extensive work with the American veterans community. In a Zoom conversation, he reveals a little-known secret in the SWAT community: He says they're all "trippy." Yes, warriors, known around the world for their toughness and tough looks, veterans are experimenting with psychedelics in their communities, "turning into teddy bears" - as they process the traumas associated with their professional military experience.
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 withdraw 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 for mental relief, relief of psychological pressure and stress. KAT helps patients achieve a state of mind where they can effectively manage and subsequently cope with their trauma.
This effect is said to be able to immediately help reduce the intensity of PTSD symptoms and improve overall mental health. The therapeutic process should include sessions with a psychotherapist in which patients are encouraged to explore their subconscious traumas, transforming them into metaphorical journeys that are easier to manage and understand.
Broader 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. Matrenytskyi and others advocate for the inclusion of other psychedelics, such as MDMA and psilocybin, in treatment protocols, even though these substances are still banned in Ukraine. Proponents say these treatments could further speed up the recovery process for soldiers with drug-resistant PTSD.
Однак використання психоделіків у лікуванні діючих солдатів викликає етичні та моральні питання. Потенціал неправильного використання, залежність і психологічний вплив такого лікування на бойову готовність викликають серйозне занепокоєння.
JAMA, рецензований медичний журнал, опублікував свій системний огляд психоделічної терапії та звернув увагу на ризики, пов’язані з «недослідженим терапевтичним компонентом». Але 8 осіб, опитаних у цьому звіті, коли їх запитали про можливість неправильного використання або зловживань, стверджували, що чистий і регульований препарат, призначений кваліфікованими фахівцями з питань психічного здоров’я, є безпечним. PAT, хоча ще в зародковому стані; багатьма вважається безпечнішою альтернативою самолікуванню, якому часто сприяють незаконні та небезпечні засоби.
На запитання до доктора Матреницького про потенційну залежність, у тому числі і у пацієнтів — чи не приходить дехто до його клініки, щоб зловживати наявністю легального кетаміну — він пояснює, що після завершення сеансу пацієнти матимуть високу ймовірність асоціювати терапію кетаміном із важкою роботою. Він уточнює, що сеанси пов’язані не з елементами ейфорії, а з їхньою здатністю провести пацієнтів через травматичні події та дозволити їм обробити їх у безпечному середовищі.
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. Mental health professional education and KAT training are vital to large-scale success.
Міністерство оборони України та Міністерство охорони здоров’я продемонстрували відкритість до вирішення проблеми психічного здоров’я, що насувається на країну, за допомогою експериментальних підходів. Лісова Поляна – це медичний центр Міністерства охорони здоров’я, який спеціалізується на лікуванні важких психотравм. у військових. За словами їхнього директора Ксенії Возніциної, державний заклад буде отримувати ліцензію на адміністрування КАТ.
Возніцина також передбачає розширення програм PAT у своєму закладі, включаючи можливе використання MDMA та псилоцибіну, хоча вона визнає, що це далека мета. Тим не менш, перехід від приватних закладів, таких як Експіо, до державних закладів, таких як Лісова Поляна і SNaP, де практикує доктор Скайлз, знаменує значний крок у прийнятті та дестигматизації PAT, відхід від його минулих асоціацій із табуйованими та підпільними практиками.
Non-profit organizations such as Healing Ukraine's Trauma and the Ukrainian Psychedelic Research Association must ensure that all sections of society are informed and prepared for this transformation. These organizations work tirelessly to provide resources, research and training to ensure that [mental health] professionals are well prepared to use KAT effectively. They also work with international organizations to standardize protocols and ensure 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 various stakeholders, Ukraine is poised to make significant progress in mental health care.
Фото: United24