- 1 day ago
As Russia's war in Ukraine drags on, addiction and self-medication are becoming a growing but largely unspoken problem. One that authorities are only starting to address, and one many fear will outlast the war itself.
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00:06War, that means torn-off arms, torn-off legs, its intestines, stench and filth on the body.
00:12You've wet yourself, you've soiled yourself.
00:14It's an extremely hard emotional state.
00:17A person who has never used anything in their entire life ends up using there.
00:23When you're on methadone, you can forget a little.
00:26Somehow there is, how should I put it?
00:29It's not that you gain strength.
00:31It's more that you can distance yourself from those horrors and from that constant anxiety there.
00:40In recent history, no army has fought for four years without rotation.
00:47And these people come back with their biochemistry changed.
00:50And they're not interested in anything anymore.
00:52Not family, not home, not work, not career.
00:57And they've become used to danger.
01:01And the drug dampens this part.
01:03And then that becomes a problem.
01:12Drugs have long been a part of warfare.
01:14During World War II, Nazi Germany distributed millions of methamphetamine tablets to troops.
01:20U.S. forces issued stimulants like Dexedrine to pilots from World War II through the wars in Iraq and Afghanistan.
01:32During the Vietnam War, up to 15% of American soldiers used heroin, not to enhance performance, but to cope
01:40with the effects of war.
01:44Four years into Russia's full-scale invasion of Ukraine, reports suggest the use of both stimulants and opioids is rising
01:52to stay in the fight and to cope with its consequences.
01:56The cases of using, sometimes occasionally, or more regularly, are quite widespread.
02:04And we could talk about that probably more than half of people who are in the active duty, meaning on
02:10the front line, have some sort of experience of using.
02:13That could be drugs, but also alcohol, and sometimes combination of both, or even combination of several active substances and
02:23alcohol.
02:30It all started after my first injury.
02:33I was wounded in the arm.
02:36Dmitro is a lieutenant in the Marine infantry.
02:39He commanded troops during his service and was wounded in combat.
02:43At the time of our interview, he was on medical leave undergoing rehabilitation.
02:50I was given painkilling injections.
02:54And the painkillers made me feel really good.
03:00When I was discharged from the hospital and released, I felt bad.
03:06I returned to service and I felt bad.
03:08You have to find something.
03:10You have to manage somehow.
03:11I started taking Pringolin, a painkiller.
03:22They brought us new soldiers as reinforcements for our battalion.
03:28And one of them went straight into action.
03:32And on his very first day, he did not return from the mission.
03:38He was killed, unfortunately.
03:40After that, we went over to them.
03:42I saw that they were all sitting there, you know, not sober.
03:48I sat them all down at the table.
03:50We started talking.
03:51I said, guys, what happened?
03:53At that time, we had very heavy losses.
03:57And the guys could hardly cope with it psychologically.
04:01And they bought me a bag of methadone tablets.
04:06There were probably 500 or 700 in there.
04:10I don't know exactly.
04:12Of course, I confiscated the tablets.
04:16I told them not to get involved with that kind of stuff.
04:20But since then, I've had my own experience with painkillers.
04:26I knew that methadone is also a painkiller.
04:32I started taking two or three tablets and slowly reached the point where I could no longer control myself.
04:45I began to consume regularly.
04:47My commanders noticed that something was wrong with me.
04:52Honestly, it is very difficult for me to talk about this, because it's a very intimate topic.
05:01But basically, I had a very good position.
05:06I had over 200 people under my command.
05:11And when I lost all of that because of drug abuse, I thought, I have to do something.
05:19Somehow, I have to solve this problem.
05:26Most of those people I work with are in the assault brigades.
05:29These are the young people, 35, 40 years old.
05:31They are the pride of the nation.
05:34Ihor Alferov is a psychotherapist with more than 20 years of experience treating addiction.
05:40In this war, he has also served as a military chaplain,
05:43supporting troops and working with soldiers struggling with substance abuse.
05:48And the stress increases, and you grasp that every day could be your last.
05:56The work of assault brigades is extremely difficult, morally.
06:01During a mission, there's no drug use, absolutely none.
06:06But when you come back, when they are safe, when they can shower,
06:12when they're in a house,
06:14then the psyche lets go, only with great difficulty.
06:19And yes, some then resort to some kind of doping.
06:35They're exposed to multiple, maybe minor trauma, physical trauma,
06:40but it adds up, and they start experiencing severe pain syndromes
06:45that are often not treated by usual medications that are available over the counter,
06:51like ibuprofen or paracetamol.
06:53And they are seeking other effective means to control their pain
07:00because they have to return to duty and participate in the missions.
07:07Victoria Timoshevska is the executive director of Health Solutions,
07:11an advocacy organization that researches drug use in both civilian life and the military.
07:16During the war, her organization has documented rising substance use
07:20linked to combat stress and gaps in mental health support.
07:23Lastly, is that indeed, even in cases when they're injured severely,
07:31they're being evacuated, hospitalized, treated, and come back to duty,
07:38they continue to have some poorly managed pain syndrome
07:42as well as some elements of PTSD and other psychological conditions
07:49that would require probably a combination of medical management,
07:53pharmaceutical management, and psychotherapy.
07:56So I would say it's not drug abuse.
07:59It often starts with self-medications because of the conditions that they are in.
08:07Well, there were not many comrades left, very few.
08:10Those I trained with, those I served with, not many.
08:14Most of them are no longer alive.
08:18Stas was mobilized in 2023 and joined the infantry.
08:22After basic training, he was deployed to the Zaporydzha region,
08:26one of the fiercest fronts of the counteroffensive.
08:28In 2024, he left his unit and is in hiding now.
08:34I probably started using as early as training.
08:37There was such a mood among everyone.
08:39It started with alcohol, and then everyone snorted amphetamine.
08:46When I first arrived in the direction of Zaporydzia,
08:50everything was calm.
08:51There was no heavy combat, nothing.
08:54And then methadone appeared.
09:01When you're on methadone, you can forget a little.
09:04Somehow you get a feeling of, how can I put it,
09:07not that you gain strength,
09:08but you can distance yourself from these horrors
09:10and from this constant anxiety.
09:13You are constantly tense, constantly under stress.
09:16There's a lack of sleep, a heavy overload.
09:18I had never served before,
09:20and for me, it was immensely stressful.
09:29And methadone gave me reserves.
09:31But you know what they say, there's a price to everything.
09:34Without methadone, I could no longer manage.
09:37I couldn't even get out of bed.
09:39And then it became an addiction.
09:47There was very heavy shelling.
09:49The Russians began some kind of counterattack.
09:52Our company was shattered.
09:54I won't say how, but I had some help getting out of there.
10:03That's when you understand the value of life,
10:07how quickly you can lose it.
10:11And I prayed to God, and I pleaded,
10:14if I manage to somehow get out of here alive,
10:17then I will stop using drugs.
10:30When a person does these drugs that many do there,
10:33salts, alpha-PVP, and similar,
10:38they have a very strong effect on their perception.
10:42That means reality and what he actually sees differ extremely.
10:48For example, we had a case.
10:50A major who was with us was shot a very good man, my mentor.
10:5718 shots in the back.
10:59Then the shooter even changed the magazine
11:01and shot another soldier.
11:07He walked up to him and fired three shots into his head.
11:15There was also another guy who shot his comrade,
11:18emptied the whole magazine into him,
11:20just like that, without speaking.
11:22He turned around, chambered around,
11:24and emptied the entire magazine at him.
11:27Drugs bring bad luck with them.
11:28They make people weak.
11:33Many Ukrainian soldiers have been serving
11:35since the start of the full-scale invasion
11:37more than four years ago.
11:39With recruitment falling short
11:41and no demobilization plan in sight,
11:44many remain on the front line for months at a time,
11:47often without rest or leave.
11:49People who regularly consume drugs
11:51or are addicted burn out quickly.
11:54They die or something happens to them.
11:56But there are also people who just consume periodically.
12:00And then there are the natural stress hormones
12:02inside their bodies,
12:03such as cortisol, adrenaline,
12:05which are produced in war.
12:09And the biggest problem, as I see it,
12:11is our country cannot offer people
12:13normal, competent social support
12:15after they are discharged from hospitals.
12:22That means we have no institutions,
12:25no services where one can go.
12:32You know, where veterans can meet,
12:35I don't know, somehow spend time,
12:39that they are taken somewhere,
12:42to museums, into nature, somewhere.
12:48We don't have psychologists working to provide
12:50some kind of rehabilitation services
12:52for people who need help.
12:57We do not have anything like that.
12:59And that's very problematic.
13:02No, it will not go away.
13:04Moreover, I would say that there are people,
13:07and there is evidence that people can start self-medicating
13:12after they actually being demobilized
13:16due to their conditions.
13:19Particularly because of lack of services
13:22that they can access in their civilian lives.
13:25Secondly, there is still a lot of stigma,
13:28especially among male population,
13:31that, you know, referring to such services
13:33is an indication of your weakness
13:35and inability to self-control.
13:38And therefore, it will be a growing problem
13:41for the communities.
13:46These commanders don't cover up these issues.
13:49They throw people out to maintain
13:52the reputation of their unit.
13:57And there are other commanders
13:58who either do not understand
14:00the scale of the problem
14:01or think there is no need to deal with it
14:04because they do not take part in operations.
14:15Drug abuse has not been acknowledged
14:17as a problem by Ukraine's military leadership
14:19for a long time.
14:21Government support for soldiers
14:23struggling with substance abuse
14:24was only recently added to Ukraine's veteran strategy
14:27as a pilot project.
14:30Drug use remains strictly prohibited in the armed forces.
14:33Soldiers who are caught can face severe penalties.
14:38If drugs are found during an autopsy,
14:40families risk losing state compensation payments.
14:45The informal practice is that
14:48once it is not affecting your ability
14:50to fulfill your duty
14:51and participate in missions and operations,
14:55it is tolerated.
14:57Meaning tolerated that they're giving a blind eye on it.
15:02Again, as long as you operate,
15:05as long as you come to your duty
15:07and you fulfill the tasks that are given to you.
15:15I did half a year of rehabilitation
15:18and for over a year I've been a volunteer.
15:23That's what I do.
15:24I talk to others
15:25and I try somehow to understand them.
15:29There's a saying,
15:30when you're drowning,
15:32you have to save yourself.
15:34To teach them how to swim
15:36and convince them that it is possible.
15:40That is what I am doing right now.
15:47As long as the flag of victory is not flying,
15:51I would like to continue fighting
15:53despite my health limitations.
15:56But how will that work?
15:57I don't know.
16:00I'm going before a military medical board
16:02and my case may lead to discharge.
16:05Very likely I will be discharged.
16:07I will be discharged
16:08and then we'll see.
16:11First of all,
16:12this is my country
16:13and I will live here.
16:15I want to be able to cross the street
16:16without being afraid
16:17that someone will drive through a red light.
16:20I want to be able to talk to people,
16:23look them in the eyes
16:24without fearing that someone will snap,
16:26pull out a pistol and shoot.
16:28I have two small granddaughters.
16:31I don't want them to marry sick people,
16:33but normal people.
16:35And in the end,
16:36I want these people to come back
16:39and not be the problem of my country.
16:41But it's pride.
16:42It's not the problem of my country,
16:44but the proud of the country.
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