Drug addiction in army – consequence of psychological trauma or crime?

Author: Tetiana Halkovska

The number of military personnel convicted under Criminal Code articles related to drugs has tripled from 2022 to 2024. Before the war, 67 people were convicted annually for "possession without intent to sell," but in 2024 this number reached 1,571! This issue is rarely addressed during the war, but it exists and is becoming increasingly alarming.

These findings come from a study conducted by the Ukrainian Catholic University together with the Healthy Solutions Foundation.

War changes people and their behavior. Not everyone can withstand the physical and psychological challenges associated with combat. Often, people who had never used drugs before become dependent. Ninety-eight percent of military personnel convicted of drug-related crimes are regular users who had never broken the law before.

The most common substances among servicemen and veterans are opioids (morphine, oxycodone, nalbuphine, tramadol, methadone), stimulants (synthetic cathinones, amphetamine, methamphetamine, mephedrone), hallucinogens (mushrooms), cannabinoids (cannabis), and hypnotic-sedatives and anxiolytics (hydazepam).

Of course, this problem exists not only in Ukraine. However, worldwide and in Europe in particular, processes have begun involving the liberalization of drug legislation, decriminalization of drug use, and the implementation of substitution therapy. In other words, a shift from punishment to support and treatment.

It was under these banners that the Commission on Drug Policy of Eastern and Central European and Central Asian countries (ECECACD), led by Aleksander Kwaśniewski, visited Kyiv. The European commissioners held several meetings, including with the Ministry of Justice leadership, to discuss aligning national criminal enforcement legislation with EU standards.

The goal of these meetings, Aleksander Kwaśniewski said, is "to create policies that align with human rights and the rule of law, consistent with the values of the European Union." In his view, a gradual decriminalization of drug use is necessary:

"Our commission holds a personal opinion, if you have drugs for personal use and cause no harm to others, it should not be considered an offense or a criminal act. Drug addiction should be treated as an illness requiring medical care, not criminal punishment. In Eastern European regions, many people have been imprisoned precisely because of drug use. Seventy-five percent of tuberculosis cases among drug users originate from prisons, where access to harm reduction measures is extremely limited."

Censor.NET spoke with Viktoriia Tymoshevska, co-founder of the Healthy Solutions Foundation and an expert in public health.

- What drives a person who has never used drugs to turn to them during the war?

- I would say, as shown in our research, it is more a symptom of deep psychological trauma, exhaustion, lack of resources for self-regulation, and personal isolation amid combat conditions. Psychoactive substances are often used not for recreation but as a survival tool. For example, to dull physical and mental pain, quickly restore physical and mental capabilities, and overcome fear.

And this is a very serious issue. There have been cases where drug use was detected within units, including among servicemen who demonstrated incredible courage. Yet, once deprived of these substances, these individuals developed panic attacks even when performing simple tasks during combat.

For veterans, the reasons differ after returning home; they are related to adapting to civilian life and trying to cope with trauma and pain.

- There’s really very little talk about drugs; I more often hear about alcohol. Maybe that’s also because there’s a ban on alcohol sales to military personnel.

- Actually, the picture is somewhat different. According to experts, young people aged 18 to 25 are more prone to occasional drug use, those aged 25 to 45 tend to use drugs systematically, while those over 45 are more inclined to alcohol consumption.

- Do you only document drug use, or do you also offer solutions to the problem?

- Of course, we also talk about treatment. We have opioid medications for which substitution maintenance therapy is available. 

- What do you mean? Buprenorphine?

- Buprenorphine and methadone. This is lifelong therapy, although there are cases where a person gradually reduces the dose and even quits entirely. For most of these individuals, rehabilitation includes motivational interviewing and cognitive-behavioral therapy. Currently, two protocols for medical care and rehabilitation are being developed in Ukraine. The first is for people who use opioid drugs and require substitution maintenance therapy. The second is for those who use non-opioid psychotropic substances, where psychotherapy plays a larger role. 

- But that’s a very long process.

-  Yes, it is prolonged therapy, and we cannot always expect complete cessation of use. Very often, it’s a gradual stage of reducing the amount and frequency of use, rebuilding social connections, in other words, a gradual lifestyle change that demonstrates the patient’s commitment to treatment.

- Here, is the attitude of the environment, family, friends, neighbors, probably very important?

- For example, when a serviceman returns home, the community shouldn’t just toast his return with a drink, but should help integrate him, support him, and when necessary, guide him. This is especially true for small communities, where people know each other well and can more quickly direct someone to a specialist. The problem is that small communities lack mental health services. At present, such assistance is more often provided under the "How Are You?" program and at mental health centers attached to hospitals. Usually, these are centers located at cluster hospitals situated in larger cities. Therefore, it is important to think through how the community can help this veteran physically get to these services, organize the process, and provide support so that the person takes their pharmaceutical drugs and does not relapse.

- Is traveling to the city every time perhaps even inconvenient?

- Of course, there are communities that actively address this issue and bring in specialists to conduct consultations on-site. But, as you understand, everything depends on the head of the community and their deputy responsible for humanitarian and medical affairs. There are even cases where donor funds came into a community, they established a rehabilitation center, yet they still suffer from a shortage of specialists.

Unfortunately, many communities do not have donor funding or do not understand how to attract it. In addition, there is a myth that rehabilitation services are very expensive. In fact, some of these services, including psychosocial assistance, are quite affordable.

- These services are supposed to be free of charge in our country, aren’t they?

- Absolutely! In fact, rehabilitation is provided under the packages of the National Health Service. For veterans, this is an extended program, both psychological and physical. What’s probably lacking is more detailed information explaining the scope of assistance guaranteed by the state. This includes up to a year of physical and psychological rehabilitation that enables full recovery. Of course, there will be cases where this support is insufficient, but that’s where civil society and private donors should step in to supplement the help.

- For example, in a village, town, or urban-type settlement where veterans use drugs, what should their initial path be? Where should they turn first, to the local doctor, donors, or look for organizations like yours?

- We do not provide direct services; we offer consultations and work on policy development at the national level. The first point of contact should be their family doctor.

Today, almost all family doctors have undergone training under the mhGAP program, which involves engaging family doctors in providing care to patients with mental disorders. Each family doctor should recognize warning signs and conduct a general mental health screening. They can prescribe medication themselves or, if the case is complex, refer the patient to a neurologist or psychiatrist. There, the scope of needed assistance is determined: whether it is psychotherapy alone, motivational interviewing sessions with a clinical psychologist, or additional pharmaceutical support.

Tetiana Halkovska, Censor.NET