Ukrainian therapists are lobbying parliamentarians to allow the use of psychoactive and psychedelic substances in the treatment of post-traumatic stress disorder. Substances such as LSD, psilocybin (extracted from mushrooms) or DMT (extracted from plants) are banned worldwide since they were banned in 1971 by a UN convention.
However, since Russia’s invasion of Ukraine, the number of supporters of the use of these substances in psychotherapy has increased among Ukrainian therapists. Because, with the war, cases of serious mental illnesses also increased.
Psychotherapists confirmed to DW that they have been using these substances with increasing frequency, especially in the treatment of soldiers with post-traumatic stress disorder (PTSD) due to fighting at the front.
Experts are pressuring the Ukrainian Parliament to allow the use of these substances in treatments. The director of the Ministry of Health’s War Veterans Treatment Center, Ksenia Voznitsyna, said she hopes Parliament will determine guidelines for psychedelic substance therapy to be available in Ukraine.
Voznitsyna is optimistic that psychedelic substances will be released for use in PTSD treatments. “A normal psychotherapy session lasts one hour, maximum two. A person with psychic trauma needs many sessions. That’s why therapy usually lasts for one or two years,” she says.
Therapy supported by psychedelic substances can speed up the healing process. “This is all the more important because, because of the war, we have to deal with complicated cases, which cannot be treated through conventional treatment,” argues Voznitsyna.
She makes a reservation, however: “It is not the drug that cures, but the therapy”, that is, the psychotherapy session that takes place while the patient is under the influence of a drug such as psilocybin or MDMA (popularly known as ecstasy). Therapy of this type can only be done in medical centers. It lasts up to eight hours and requires supervision and control by professional psychotherapists.
Legalization of therapeutic use close
Ukraine is, therefore, the new setting for a debate that has pitted supporters and opponents of the use of drugs in psychotherapy for decades. And supporters face strong resistance from those against.
But especially in the United States, the lobby for the use of drugs in psychotherapy is increasingly strong. And defenders of the practice have a strong supporter: the Armed Forces War Veterans Organization. Also, the Department of Veterans Affairs, a federal government agency, is in favor of the use of MDMA in post-traumatic stress disorder therapies. Experts estimate that authorization will be granted in 2024.
This would be a decision with possible consequences also for the therapeutic use of other prohibited drugs. Well, why would some continue to be prohibited if one is permitted?
The legalization of the use of MDMA in psychotherapy gained momentum with the publication of a phase three study in the scientific journal Nature. Successful phase three studies are often the last step toward approval for a drug.
The MDMA “safety and efficacy” study concluded that the substance “reduced PTSD symptoms and functional impairment in a heterogeneous population with moderate to severe PTSD and was generally well tolerated.”
Similar studies with MDMA and psilocybin are also being conducted in Europe, assures the European Medicines Agency (EMA). EMA Director Emer Cooke told the European Parliament that the agency recognizes the need to support psychedelic developers and cooperate with them.
Psilocybin in the early stage of the disease
In Germany, a study on psilocybin therapy extracted from so-called “magic mushrooms” is close to completion. “We are testing the efficacy and safety of psilocybin in therapy-resistant depression,” says psychiatrist Gerhard Gründer from the Faculty of Medicine Mannheim.
“What we can say, superficially, is that we are seeing good results in a small number of patients”, says Gründer. For many patients, however, there is no improvement, he adds, which he attributes to the fact that they have already suffered from severe depression for a long time. “The conclusion of the study, for us, is that we can treat early stages of the disease.”
Gründer recognizes that the use of MDMA in trauma therapy for war veterans has achieved good results, but is skeptical about the use of other substances. He remembers that MDMA does not belong to the group of psychedelics.
Substances like psilocybin “are not used in post-traumatic stress disorders in most clinical studies because there is fear of retraumatization,” he says. He also criticizes therapy in the middle of war. “I consider it extremely questionable, from an ethical point of view, that it would be safe to do something like this in a war zone.”
