In a way it’s really not complicated

We met Sarah Evans as an exceptional, activist-driven individual spreading positive energy and inspiring people from her surroundings to work more actively and enthusiastically on the advancement of society. Sarah is a senior program officer with the Open Society Public Health Program in New York, USA. She is in charge of advancement of the health and rights of marginalized people who use drugs throughout the world. Previously, she worked on development of the harm reduction programs in British Columbia, Canada. However, the reason for our conversation was her experience with the opening of the first legal supervised drug injection facility in North America. We had the interview on 7 February, 2013, during her visit to Macedonia and we share it further bellow, convinced that it is high time to open the discussion on safe injection facilities in our country as well.

Dear Sarah, we are happy to have you here, in Skopje, Macedonia. You are an expert, actually have experience with safe injecting spots, in Vancouver, Canada, and we would like to ask 
you, if you can share some experience with us about safe injecting spots?

Sure I can, first of all thank you very much. I am very happy to be here and speak with you about this today. I did work at the injection site as the manager, from the time that it opened, in 2003 until shortly before I moved to New York to work for Soros, in 2011. But the struggle to get the injection site open, started a long time before that, probably even before my time. The first main event I was involved in, that I was aware of, was in 1998, when we put on a large conference under a circus tent, in a public park, to talk about harm reduction. This was a new idea, that none of us had ever heard of, that we thought would help in our city. And we had invited some experts from Europe, where they already had some injection sites, to come and speak to us about their experience, and we also invited some other people who could talk about some other aspects of harm reduction.

And because it was in a tent, in the park, we could also have the community there, so drug users were there as well as policy makers, as well as politicians. And what we essentially were able to do about this was establish a community dialogue about harm reduction and supervised injection, and it put the idea on the map, mentally, for people. That was in 1998, and from then until 2003, when the site opened, we still had many struggles, basically it was like building a wall, one brick at a time. It took people working on the inside with the government, people fighting on the outside, drug user organizations, it took non-profit societies, parents’ groups, church groups, journalists, researches to create this kind of critical mass, where what had been a private problem, which is somebody suffering from an addiction, to become a public problem, that needed public solution. It took several years, as I said, from 1998, to 2003, to be finally able to open the injection site.

Call for Articles for 12th issue of the Drugs – Policies and Practices magazine

HOPS – Healthy Options Project Skopje’s Center for Education, Documentation and Research and Coalition MARGINS announce the call for articles for 12th issue of the Drugs – Policies and Practices magazine.

The main topic for the 12th issue of the magazine is Drugs and sex. Despite the main topic, we welcome all other articles related to the aforementioned topics.

Deadline for this call is November 05, 2018. Editorial Board will do the selection of received articles and other materials. Selection criteria are:

  • Expertise (knowledge and experience for described topics)
  • Creativity
  • Cutting-edge
  • Due performance

Drugs – Policies and Practices target audience are people who use drugs, people on drug addiction treatment, experts for drug use and drug treatment issues and all for people with interest

Implementing Different Harm Reduction Policies in the Republic of Macedonia – Safe Drug Use Facilities

In normal, developed countries where care and rehabilitation for drug users is real, and not merely declarative, as well as in countries which work substantially, and not just making-do, on sustainable programmes for prevention and protection of drug use effects developed for citizens who have decided to use drugs - in those countries it is not at all unusual to implement programmes for opening safe drug use facilities, starting with the so-called soft drugs (cannabis, hashish) all the way to drugs most likely to impact the lives and health of people and having the biggest potential to create addictions – here, above all, I mean opiates.

The most public and popular example for safe drug useare of course the well known coffee shops in Amsterdam, the Netherlands. Certainly, the word “safe” in this context is almost obsolete since the fact that cannabis is safe and does not bring about harmful consequences on people’s lives and health is well known, its use justified from a purely legal aspect. Of course, the idea behind is, I presume, to target the safe use of harder drugs, specifically the use of heroin injection.

In the 21st century, globally there are already positive examples of how states should regulate this issue. These spaces, better known as Safe Injection Sites (SIS), are spaces permitted by law, where under medical supervision, in hygienic conditions, without the stigma of the general population, individuals consume drugs intravenously – spaces which, where permitted, are part of harm reduction programmes and provide sterile needles, treatment, advice and basic medical care. However, it has to be stressed that these spaces DO NOT sell or provide drugs, nor do they suggest to someone the consummation of drugs but rather provide a solution to an already existing problem.

Eleventh issue of Drugs - Politics and Practices

We are publishing the eleventh issue of the magazine Drugs - Policies and Practices. This number is dedicated to drug consumption facilities.

Drug consumption facilities save lives. It is a fact already established; no further proof is needed in its support. Or is there? Such an approach can certainly save lives in Macedonia as well. However, a proposal of this sort takes some courage. And so, we gathered the courage to open the discussion. Of course, we are aware that certain people in Macedonia still believe needle exchange to encourage drug use, and on the other hand, here we are, talking about the opening of sites where people can freely and under the supervision of trained personnel use drugs. But we are not going to just sit on our hands and wait for “better days” to come.

Rather than waiting, the founders of M.A.S.K.A rolled up their sleeves, as early as 1996, and opened the first harm reduction programme in Macedonia. Although M.A.S.K.A. no longer operates, today such programs have been established in 13 towns throughout Macedonia. The process was encumbered by obstacles, still is, but prevention of HIV spreading throughout the country would have been impossible if not for the harm reduction programmes.

Our recommendations


„The Teachings of Don Juan“ by Carlos Castaneda

Carlos Castaneda (1925-1998) was a Peruvian-American anthropologist and a writer, with a Ph.D. degree in anthropology from the University of California.

He became known with a series of novels, twelve of them, starting with the first “The Teachings of Don Juan” in 1968. The novels are written in the first person, relating the author’s personal experiences as a student of the Indian shaman (brujo) don Juan Matus from the Yaqui tribe, whom he met in 1960.

Motivated by the desire to find out more about the effects of hallucinogenic mushrooms, cactuses, and herbs used by the Mexican Indians, Castaneda came into contact with the ancient Indians. More precisely, the teacher Don Juan, who gradually introduced him to the wonderful research world behind hallucinogenic plants: peyote (Lophophora williamsu), Jimsonweed (Datura inoxia) and from the kingdom of hallucinogenic mushrooms - (Psilocybe mexicana).

Ana Vernova

Ana Vernova
By her mother from Bitola sent
in Skopje for study to her aunt
at music-high, and she then
at that piano faculty enrolled.
Everything was somehow over focused
on that existence forced;
in which possible was even dying
but not without exams giving.
That is how that stupid mum attached
her destiny with the school bench
as well with the piano-tank, a way
which crushed her in the last day…
…of the third semester when
the genesis of that hard torment
reached its peak, as mum interested
was in nothing else but the head…

Rakia and shopska

A classic night out in a kafana. Rakia and shopska to start with, standard for hanging out with friends, right? Of course, any another salad will do, but here, in Macedonia, it’s the first thing that comes to mind. Nothing else dawns on you, even in winter when tomatoes and cucumbers aren’t in season. The choice of rakia you ask? Well, of course it’s žolta. Who can imagine hanging out in a kafana without a shot of rakia and a salad? Typically Macedonian! We’re not hungry, far from it, it’s just meze, something to water down the alcohol with. 

Glasses clink as you toast, making eye contact with the other person, it’s the custom. Careful not to hit the mouth of the glass you’re clinking with the bottom of yours. A grave insult, it’s common knowledge. Hmph, all the complexities of our drinking culture.

Arthur Heffter, Albert Hofmann, Alexander Shulgin, Terence McKenna

Arthur Heffter (Jun 15, 1859 - Feb 8, 1925)
Arthur Carl Wilhelm Heffter was a German pharmacologist, chemist, researcher and professor. He was born in Leipzig where he finished chemistry studies. After receiving his M.D. degree and doctorate in pharmacology in 1890, Heffter did seminal work on alkaloids derived from the peyote cactus.

Arthur Heffter is known as the chemist who isolated mescaline from the peyote cactus in 1897, the first such isolation of a naturally occurring psychedelic substance in pure form by that time. In addition, he conducted experiments on its effects by comparing the effects of peyote and mescaline on himself. He was the first to gain the title of "psychonaut", because of his willingness to test on himself (bioassay) the chemicals he isolated.  

Heffter was the first chairman of the German Society of Pharmacologists, and was largely responsible for the first Handbook of Experimental Pharmacology.

Heffter was also Professor of Medical Chemistry and Pharmacology at Leipzig University and University of Bern. In 1993 The Heffter Research Institute from USA was established in honour of Dr. Arthur Heffter.

Apology for “Narcomania”

First of all, I would like to apologize to all who consider themselves as “narcomaniacs” or are considered as such by other members of the community, for using this term further in the text. My choice of words is not accidental, rather made to emphasize how pointlessness the expression is and the value consigned to it by society, culture, state etc.

The expression “narcomaniac” derives from the word ναρκόω (narkóō, “I put to sleep”) and μανία (manía, madness, obsession), meaning madness for narcotics. The term is discriminatory and above all not simply a denotation but rather a connotative association attaching to the denotation narcomaniac the realty of an entity (a being) lower than others, more inefficient than others, a gruesome, filthy being who does not deserve to live let alone share the same societal and social values with its signifiers (non-narcomaniacs). This “added” value is attached to the drug user, in this case, similar to the act of denoting the Albanians as Shiptars (a derogatory term for an Albanian in Macedonian – trans. note). An expression not only of denotative but also connotative dimension. This places people who use drugs as individuals with a lower status, uncompleted and unevolved, excluded from social interventions without the possibility for any social and societal recuperation, with zero chances for political mobilization.

Decriminalization Now

According to data from the Ministry of Interior of the former Socialist Republic of Macedonia, the number of registered drug users in 1990 was only 314 in a country with a population of two millions. Only fourteen years later, the Ministry of Interior informed that in 2004, the number of registered drug users had increased to 6,583 or more than 20 times.

At the same time, in the past few decades, the state apparatus has been attempting to deal with the growing number of drug users as well as the increased drugs influx with conservative methods – mostly with more severe penalization. Towards this end, the prescribed minimum sanction for criminal acts pursuant Article 215 from the Macedonian Criminal Code targeting production, sale, transport, drug possession with an intention to sell, imprisonment, was increased from one to ten years to three to ten years. Additionally, from 2015, the country began implementing the idiotic legal solution called Law for Determination of the Type and Duration of Sentence.