Amphetamines and steroids use amongst soldiers in Ukraine

Sunday 15 February 2026

In every war there is the obvious violence of artillery and drones — and then there is the quieter chemistry of endurance. Soldiers at the front line in Ukraine are asked to do something that human bodies are not designed to do for months on end: stay alert when they are exhausted, function when they are frightened, carry weight when they are injured and keep going when there is no predictable end in sight. In that environment, it is unsurprising that some fighters turn to stimulants such as amphetamines, or to performance-enhancing drugs such as anabolic steroids. What is striking — and troubling — is how quickly such substances can move from occasional coping mechanisms to a shadow medical system, one that carries its own casualties.

A recent policy brief by the Global Initiative Against Transnational Organised Crime describes a wartime pattern in which drug use in Ukraine’s military is shaped by prolonged combat exposure, limited rest, pain, psychological strain and the pressures of manpower shortages — conditions that make commanders more pragmatic than punitive, particularly when they fear losing effective personnel. That same research describes how substances can reach units through informal networks as well as organised supply chains, including online ordering and delivery methods that mimic civilian drug markets. Against that backdrop amphetamines and steroids are not merely individual moral failings — they are, in part, artefacts of a war that compresses sleep, recovery and medical care into whatever space remains between missions.

Stimulants at the front — why amphetamines appeal

Amphetamines are central nervous system stimulants. In the simplest terms, they can make a person feel more awake, more energetic and more confident — and less aware of fatigue and hunger. In a trench line or a dug-out, that promise can be seductive.

There are several reasons why a front-line soldier might reach for stimulants.

First, sleep is not merely scarce — it is tactically denied. Drones, intermittent bombardment and the constant requirement to listen for movement can fragment rest into minutes, not hours. A stimulant can feel like a tool to bridge the gap between what the body demands and what the mission requires.

Secondly, the front line is often characterised by long spells of tension punctuated by seconds of action. That rhythm encourages chemical shortcuts — something to keep the mind sharp through monotony, then keep it sharp again after a shock.

Thirdly, stimulants can be used as crude emotional regulation. Fear, grief and hypervigilance are not abstract concepts in eastern Ukraine — they are daily physiological states. A drug that temporarily lifts mood or blunts the sense of collapse can look like self-administered psychological first aid.

Finally, there is the social logic of the unit. If a handful of soldiers in a platoon use stimulants — whether amphetamines or related synthetic stimulants — their perceived ability to stay awake for longer patrols or hold positions through the night can create pressure on others to keep up. The Global Initiative report includes indications of clustered use within units, suggesting that substance practices can become normalised in particular formations depending on leadership and circumstances. 

None of this means stimulants improve soldiering in any reliable way. It means they appear to solve an immediate problem — and immediate problems are what the front line supplies in abundance.

The medical bargain — the dangers of amphetamines

The problem with amphetamines is that their benefits are short-term and their risks scale rapidly with repeated use, poor sleep and stress. Military history contains repeated episodes of stimulant use — and repeated lessons that chemical wakefulness is not the same as sustainable performance.

Even in controlled discussions of amphetamine use in military environments, researchers have long noted cardiovascular strain and other adverse effects, particularly at higher doses. Outside controlled medical settings, the hazards multiply — because dose, purity and co-use with other substances (including alcohol, painkillers or sedatives taken to “come down”) are unpredictable.

The main danger categories are these.

Cardiovascular stress. Amphetamines increase heart rate and blood pressure — and in a war zone that already includes dehydration, cold exposure, heat stress, heavy kit and adrenaline surges, that can be a dangerous combination. Research literature links amphetamine use with cardiovascular pathology and acute events in some contexts. 

Mental health harms. Stimulants can worsen anxiety, provoke agitation and contribute to paranoia — especially when sleep is chronically impaired. Large-scale evidence links illicit amphetamine use with increased incidence of psychosis.  In a combat environment, where good judgement and trust are life-preserving, even a small increase in paranoia or impulsivity can have outsized operational consequences.

Dependence and crash cycles. Amphetamines can create a loop — stimulation followed by exhaustion, irritability and low mood, followed by renewed use. Over time, the drug is no longer taken to enhance performance but to feel normal. Public health guidance notes that long-term amphetamine use can damage the brain and cardiovascular system and is associated with psychosis and malnutrition. 

Decision distortion. A stimulant may increase confidence while degrading judgement — especially when combined with sleep deprivation. Soldiers can become more willing to take risks, more fixated on a task, less receptive to new information — precisely the opposite of the flexible thinking that modern drone-saturated warfare demands.

The central tragedy is that stimulants often begin as an attempt to remain useful to comrades. They can end by making a soldier unpredictable, medically fragile, or unable to reintegrate after service.

Steroids at the front — what soldiers think they offer

When most people hear “steroids”, they picture bodybuilding. In the military context, anabolic-androgenic steroids (synthetic derivatives of testosterone) are the relevant category — not corticosteroids used for inflammation. Anabolic steroids are sometimes used in civilian life to increase muscle mass and strength, speed recovery, alter body composition and enhance self-image. Those motives do not vanish when someone puts on a uniform — they can intensify.

There are front-line-specific reasons steroids may appeal.

Carrying capacity. Modern soldiers carry enormous loads — armour, ammunition, batteries, water, winter kit, sometimes additional drone equipment. More muscle can mean less immediate strain, at least at first.

Injury culture. Front-line service produces chronic pain — backs, knees, shoulders, old fractures that never fully heal. Where rehabilitation is limited and rotation is uncertain, some fighters may try to “train through” injuries, using drugs as a crude substitute for physiotherapy and rest.

Identity and morale. In a war of national survival, the body becomes symbolic — strong body, strong will, strong country. Steroids can be used to align appearance with that ideal. The psychological pull is real — and it is not confined to any one army.

Peer influence. Steroid use can spread through networks that overlap with gyms, combat sports and veteran communities. Where fighters have access to weight training in rear areas, or maintain training habits between deployments, the temptation grows.

Unlike amphetamines, steroids do not create an immediate “on/off” sensation in the same way. That can make them more deceptive — because the user may feel in control right up to the point when health harms become difficult to reverse.

The long shadow — the dangers of anabolic steroids

Medical authorities are blunt: anabolic steroids taken without medical supervision can cause serious side effects and addiction. The research literature is blunter still — describing adverse effects across multiple organs and systems, particularly with long-term or high-dose use. 

Cardiovascular harm is the best documented. Reviews associate anabolic steroid use with increased cardiovascular risks, including cardiomyopathy and other forms of heart disease.  A large cohort study reported substantially increased risk of cardiovascular disease amongst anabolic steroid users. For a soldier whose heart is already stressed by combat conditions, this is not a distant risk — it is a vulnerability that can surface during exertion.

Endocrine and reproductive effects are also significant. Because anabolic steroids interfere with the body’s hormone regulation, they can reduce natural testosterone production, affect fertility and trigger long-term hormonal instability. 

Psychiatric effects matter in war. Steroids are associated with mood changes — irritability, aggression, depression and, in some individuals, more severe psychological symptoms. In a front-line setting, where conflict within a unit can be lethal, this is not merely a personal health issue — it is an operational risk.

Infection and product quality are the hidden dangers. Illicit steroid markets often involve counterfeit or contaminated products — and injectable use carries infection risks when sterile practice is not followed. In wartime supply conditions, quality control deteriorates further — and the user may not know what is actually in the vial.

The cruel irony is that steroids are often used to feel stronger and more resilient — yet the long-term outcome can be a body that is more brittle, a heart that is more vulnerable and a mind that is less stable.

Why this matters beyond the individual

It is tempting to treat combat drug use as indiscipline — but the evidence points to something more structural. When soldiers are deployed for long periods, when leave is difficult to obtain, when pain is undertreated and mental health support is uneven, the appeal of self-medication rises. The Global Initiative report captures this wartime bind — commanders balancing enforcement against the need to keep experienced people in the line, and soldiers fearing that admitting a problem may carry financial or disciplinary consequences. 

If Ukraine is to manage the post-war aftermath — veterans’ health, employment, family stability and public safety — these substances cannot remain a private secret shared within units. They will surface later, as heart disease, addiction, depression, domestic breakdown and the quiet exhaustion that follows prolonged chemical coping. A war can end while its pharmacology continues.

A note on harm and help

This subject is easiest to discuss in abstract terms. In reality, it attaches to real people — many of whom began using substances because they were trying to stay alive, stay awake or stay useful to their friends.

If someone is using stimulants or steroids and feels unable to stop, the safest path is medical support — ideally through a clinician who understands both substance use and trauma. If there are signs of acute danger — chest pain, collapse, severe confusion, hallucinations, or someone seeming out of touch with reality — that is an emergency and requires urgent medical attention.

War demands extraordinary endurance — but endurance purchased on credit can come due with interest. The duty of a state at war is not only to arm her soldiers, but to preserve the bodies and minds that will have to carry the peace.