Substance use among Ukrainian soldiers is driven by a complex mix of factors: physical pain, psychological trauma, pre-existing dependency, and the extreme demands of combat. While cannabis and legal pain relief and anti-anxiety medications are among the most frequently used substances, alcohol remains the most pervasive. The widespread use of amphetamines and synthetic cathinones (‘salts’) also points to the scale of stimulant consumption during wartime. 

Field interviews and survey data suggest that drug use is not confined to any single profile. Some soldiers bring established habits into service; others develop new dependencies during combat. The use of battlefield analgesics – particularly nalbuphine – can lead to addiction after only a few days, causing severe withdrawal symptoms and psychological distress. Others may turn to substances simply to relax during rare moments away from the front. 

The current military policy in Ukraine towards drugs is one of zero tolerance. All forms of drug use – including methadone required by opioid substitution therapy (OST) who have enlisted – are punishable by loss of pay or combat status. Soldiers also fear that substance use may affect posthumous compensation for their families in the event of their death. This has created a climate of secrecy, preventing individuals from seeking help and potentially amplifying long-term harms. 

Drug supply to soldiers occurs via multiple channels: informal exchanges, family members, volunteers and organized crime networks. Some soldiers receive packages ordered through Telegram and delivered by private postal services. Enforcement of prohibition policies varies significantly between units, with some commanders turning a blind eye or even facilitating trafficking in exchange for bribes. 

While the issue is gaining recognition in some areas of government, including the Ministry of Veterans Affairs, the risks of substance use among veterans has yet to be integrated into Ukraine’s official veterans’ policy – an omission that may carry serious consequences for reintegration and public safety. 

The brief calls for policy reforms that prioritize support over punishment. Recommendations include legalizing access to OST within the military, creating anonymous treatment pathways, improving pharmacy coverage, and strengthening data collection on drug use among soldiers and veterans. ù

Click here to register for the Ukraine Observatory mailing list.