Fighting Addiction and Stigma in Wartime Ukraine

By Ben Simms

Wars can often exacerbate preexisting crises. Defending your country against invaders creates areas of neglect and powerlessness to provide for some people facing health issues. Russia’s war on Ukraine has proven no exception. Many Ukrainians dependent on their government for support with substance abuse and addiction are no longer able to receive adequate care. Narcotics control within a country at war can also be difficult. The despair caused by war can increase substance use. Russia’s war against Ukraine has created a terrible new dynamic for Ukrainians seeking to combat their own addictions.

Prior to the 2022 invasion of Ukraine by Russia, Ukraine already had one of the highest prevalence rates in the world of people who inject drugs: approximately 1.7 % of the adult population was injecting drugs, mostly opioids. Since 2015, a year after Russia’s annexation of Crimea, there has been an increase in the use of methamphetamine and NPS, new psychoactive substances, in Ukraine. To combat this epidemic, the government of Ukraine has funded expanded treatment services since 2017. These services meant that Ukraine had the highest number of people receiving treatment in Eastern Europe and Central Asia before Russia’s full-scale invasion began.

A Ukrainian addiction hotline operator at work in 2021. Source: theglobalfund.org.

Addiction treatment facilities and organizations are struggling to remain open during the war. Furthermore, many clinics have been forced to temporarily close at unpredictable hours to protect patients and staff. The war has disrupted supply lines needed to provide necessary medicine for addicts. In the capital city of Kyiv, addiction treatment services are still able to operate, but other parts of the country are not faring as well. Many facilities are either running out of supplies or contact has been lost with local drug treatment teams altogether. As of January 2022, a month before the invasion, 14,868 people were receiving substitute opiates such as methadone and buprenorphine as treatment. Since the outbreak of the war, substance abuse levels have only increased. The war has made it difficult to calculate the full number of those receiving or needing treatment.

A mobile treatment center in Odesa, 2022. Source: APH.

For those Ukrainians living under Russian occupation, the future looks even grimmer. Russia is the only country among the 47 member states of the Council of Europe that prohibits opioid substitution therapy.  The International Narcotics Board has encouraged bordering countries to ensure access to substitute opiates for refugees. It is not clear how successful those efforts have been.

Along with this discussion of addiction treatment comes the stigma and taboo associated with drug use. Russian propaganda has furthered this stigma. Putin has claimed that Ukrainian leaders are a “gang of drug addicts and neo-nazis”. Russian influencers even tried to create a fake, intercepted document claiming “that psychotropic drugs were officially… supplied to the Armed Forces of Ukraine”. This claim has since been debunked, but it is an example of Russia’s attempt to portray Ukraine as a country consumed by drug use. As is often the case with Russian propaganda, the truth about drug use by combatants may be the opposite: based on some field reports, Ukrainian soldiers have claimed that Russian troops are on combat drugs: certainly the Russian state has relied on prison recruits who have prior addiction issues making up the ranks of Russian soldiers (the symptoms, as a major assessment notes, are more likely from hypothermia).

Russian Recruitment Ad stating “Mobilization cures drug addiction and defeats thuggery.” Source: Jerusalem Post.

Russia’s war has indeed created other, often unseen, crises in Ukraine. Drug use in Ukraine has increased because of the war, and the relative success of prewar treatment options are becoming increasingly limited. That combination will not beget good future outcomes for the people of Ukraine, but their resilience against the invasion has shown that the Ukrainian people will persevere in this fight too.

Ben Simms is a sophomore majoring in Political Science

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