Troops frequently use substances to help cope with untreated PTSD and anxiety, producing a negative spiral

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even years clean, Oleksandr believed he had left addiction behind. Then, a year into fighting Russia, the Ukrainian soldier was prescribed painkillers for a shoulder injury. Under the strain of war, he relapsed and quickly began using stronger illicit opioids.

“From that moment, I was fighting two wars – one inside myself and one with Russia,” he said, speaking at a rehabilitation facility in Kyiv.

Oleksandr continued to serve for another two years, rising to the rank of officer even as his addiction deepened. “I was hiding my use from the others. It’s the kind of thing you’re ashamed of,” he said.