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Four years into Russia's full-scale invasion, half of all Ukrainians report dealing with mental health stress.

Ukraine needs more ways to deal with its mental health burden, and psychedelics offer a possible path.

Psychedelic treatment has shown promise in trials around the world but faces legal hurdles in Ukraine.

Guest Post by Natalie Leticia Gallón

Kyiv, Ukraine—As Ukraine enters its fifth year of Russia’s full-scale invasion, a quieter crisis is unfolding. Beyond the front lines, the war’s brutality is leaving invisible wounds on the soldiers who fought to defend the country, exposing the long-term psychological toll of combat.

With millions of soldiers estimated to be suffering from trauma-related conditions, not to mention civilians, Ukraine faces an urgent question: How will it treat the lasting mental scars of war? Among the emerging possibilities is psychedelic-assisted therapy (PAT) in treatment of war-related trauma, a controversial yet increasingly researched approach that some experts believe could play a transformative role in veteran mental health care.

Stanislav Hibadulin was born in Chișinău, Moldova, but when Russia seized Ukraine's Crimea peninsula in 2014, he felt compelled to fight. “As an individual, I always try to help someone,” he says. “I decided to defend Ukraine.”

He enlisted in the Azov Volunteer regiment in 2015, fighting for several years and taking on the call sign “Hitman.”

In a 2018 ambush, he was shot in the leg and abdomen while his closest friend, Ilya, was severely wounded in the neck. As Hibadulin, a self-described atheist, lost consciousness during evacuation, he began to pray.

“I begged God to leave Ilya alive and to take me. That’s how much I loved my friend. I was ready to give my life for him.”

Ilya did not survive. Hibadulin lost his spleen but survived.

“I understand that many people believe war is something really bad, and that’s true, but after a few weeks in a war, I realized that some people, some individuals who are warriors inside, can even start to love the war,” he says.

Seeking revenge for the death of his friend, he returned to the front, where he was wounded on two more occasions, causing him to lose fingers and a leg.

The war caused three physical injuries and a fourth that he calls “invisible”—post-traumatic stress disorder, or PTSD.

The symptoms began months after leaving the battlefield. “It felt like my body is alive, but my soul is dead, like I lost it,” he recalls.

As his mental state deteriorated, so did his romantic relationship. He began experiencing what he says were hundreds of panic attacks per day. “I felt like I didn’t have enough air to breathe,” he says, describing it using the Ukrainian word for “choking.”

Doctors prescribed antidepressants, but when the panic attacks returned, he knew he needed something different. “I understood that antidepressants and these psychiatrists would not help me to heal the trauma.”

Exhausted, Hibadulin started searching for alternatives.

Despite living a straight-edge life of no alcohol, cigarettes, or drugs, he agreed to try PAT using magic mushrooms. The active substance in them, psilocybin, is a naturally occurring psychoactive compound being studied for its ability to enhance neuroplasticity and reduce fear responses, potentially helping trauma survivors process their distressing experiences in a therapeutic setting.

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Hibadulin’s session took place underground, in someone’s apartment rather than a clinic, because psilocybin is still illegal in Ukraine. “I needed help now,” he says emphatically, recalling the dark place he was in.

During a guided psilocybin session, he focused on a single intention, “heal cycle,” and described what followed as the death of ego and a reunion. “I thought ‘I’m dead.’ So my ego was dead and I didn’t feel my body in this world. It seemed like I was going to heaven,” he recalls.

Since that November day in 2021, Hibadulin hasn’t experienced any panic attacks and hasn’t taken antidepressants.

His experience of PTSD is a deeply personal account, but it also underscores a broader proble:. As the war drags on, the scale of trauma is staggering, and exploring PAT faces hurdles within Ukraine’s political and bureaucratic systems.

To begin, psilocybin is classified under Ukrainian law as a controlled substance and is currently illegal. Rescheduling any substance for clinical trials would require new legislation, as well as coordination with law enforcement and even the SBU, Ukraine’s security service.

“We need to negotiate the rules with the police and the medics and the state in general,” says Oleg Orlov, a clinical psychologist who is co-founder and board chair of The Ukrainian Psychedelic Research Association (UPRA), a non-profit grassroots organization promoting legalization of “the clinical use of psychedelic substances for patients with post-traumatic stress disorder who have not been helped by conventional therapy.”

“By the time we write all the rules and make it look perfect, you will have no one to heal, I guess, because it takes too much time.”

Still, through their continued work, UPRA and the International Foundation "Renaissance" hosted a roundtable event in Kyiv in February on the "regulatory challenges and ways of implementing psychedelic-assisted therapy in Ukraine."

Orlov describes the dual challenges they face as “regulating how research should be done in detail with schedule one substances,” and training specialists.

Orlov estimates that roughly 600 full-time specialists would be needed to address the scale of trauma in Ukraine. But training in a country at war presents significant challenges. There are also practical concerns, from how to securely store the substances to finding safe, controlled environments for clinical trials as well as tackling the social stigma surrounding therapy and mental health.

“We need to act quickly because we need not only to get permission for the use of psychedelics but we need to prepare specialists,” says. Dr. Vladislav Matrenitsky, founder of the Center for Psychotherapy, Psychosomatics and Psychedelic Medicine Expo in Kyiv. Since the war began, his clinic has seen a surge of patients suffering from PTSD, anxiety and panic.

In Ukraine, ketamine is classed as an anesthetic and therefore legal, allowing for scientific research. Trials of the agent to treat PTSD at Matrenitsky’s clinic are currently approved by Ukraine’s Ministry of Health. According to the clinic’s website, “studies show that ketamine increases the brain's neuroplasticity, helping to regenerate synaptic connections between brain cells damaged by stress and depression. The drug affects a completely different level of the neurotransmitter system compared to currently available antidepressants.”

“As a transpersonal psychotherapist, of course I was aware about psychedelic medicine and its potential,” he adds, noting that researchers began paying closer attention as evidence for treating depression and trauma emerged.

But expanding research remains difficult. “For several years I was trying to find money for clinical research; in the last year we succeeded in finding some private sponsor, but after a missile hit his business, he was unable to proceed with the donation. Even a small group of 50 participants will give us formal confirmation of the efficiency of ketamine-assisted therapy, but for a good clinical trial, we need at least 100,” he adds.

Even so, he remains hopeful. Since November, clinical trials have been underway with ketamine-assisted group therapy. With support from a Scottish charity, seven veterans are participating in the trial. “If we can find more funding, then we can conduct larger studies with more convincing results.”

All of the mental health specialists interviewed emphasized that psychedelic-assisted therapy is effective only when combined with conventional forms of psychotherapy. Psychedelic therapy is not a quick fix.

“We often have to tell people that we are not going to just give drugs to veterans,” Orlov says. “Psychedelics are a part of caring for mental health,” he adds, emphasizing the need for integration. “I personally think that you can integrate psychedelics and EMDR, psychedelics and cognitive behavioral therapy. Just psychedelics will not do it for you."

Despite the hurdles, Orlov, too, remains cautiously optimistic. “It’s an ultimate goal to build a system that will be able to provide a million psychedelic therapy sessions to Ukrainians. I don’t know when we are going to reach this goal, but it’s quite possible,” he says. "We have no choice.”

Natalie Leticia Gallón is a journalist who covered the war in Ukraine from the start for CNN. Now working independently, she focuses on long-form journalism that elevates marginalized voices.

Her reporting was supported by the International Women’s Media Foundation’s Women on the Ground: Reporting from Ukraine’s Unseen Frontlines Initiative in partnership with the Howard G. Buffett Foundation.

Olha Konovalova and Dzvinka Pinchuk contributed to this report.

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