Psychoactive Substance Use in Pregnancy and Effects on the Fetus

With opioid addiction, methadone substitution treatment is recommended for better control of the addiction as opposed to risking the life of the woman and the fetus with abstinence crises which cause additional stress to both. 

Numerous studies confirm the harmful influence of alcohol and nicotine on fetal development and the potential occurrences of fetal abnormalities, mental or physical disorders, deformities, as well as miscarriages. However, there are very few studies on the effects of illegal psychoactive substances, such as cannabis, opioids and psychostimulants on the fetus during pregnancy, and no studies at all on the harmful effects of new psychoactive substances. Data and potential harms are based on isolated cases and cannot be used to make a generalization on the negative impact. 

Harmful effects are largely dependent on the drug use frequency during pregnancy, particularly if persistent in the first trimester when the pregnancy might remain undetected if unplanned. 

Harmful effects can be heightened with addiction, abstinence or drug injection, all additional risk factors for the pregnant woman and the fetus, simultaneous use of different drugs like alcohol, nicotine, caffeine, cannabis, opioids, psychostimulants etc. Life style, nutrition, stress and socio-economic circumstances should not be disregarded neither, with drug use or in general.  

Call for Articles for 10th issue of the Drugs – Policies and Practices magazine

HOPS – Healthy Options Project Skopje’s Center for Education, Documentation and Research and Coalition “Sexual and Health Rights of Marginalized Communities” announce call for articles for 10th issue of the Drugs – Policies and Practices magazine.

The main topic for the 10th issue of the magazine is Drugs across culture. Despite the main topic, we welcome all other articles related to the mentioned topics.

Dead line for this call is October 20, 2017. 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 promotes topics about drugs, drug use, drug treatment, and other related topics, such as: sex work and drugs, HIV/AIDS and drugs, Hepatitis B and C and drugs, Tuberculosis and drugs, rights of the marginalized groups/communities, gender perspectives, free access to public information, researches, policies, advocacy, civil society, activism, social work, social policy, health, through the drugs perspectives.

Another Sad Story

During my long experience working with people who use drugs in HOPS – Healthy Options Project Skopje, I have often been faced with instances where I simply couldn’t remain indifferent to the institutions’ disregard. The constant transfer of responsibility to one another whenever we ask the required services on behalf of a client is annoying. It is beyond comprehension that after years of cooperation and trainings, they still fail to establish joint coordination and alleviate the process of giving services to the socially marginalized communities. Somehow, it seems to me, civil society organizations doing their job suits them just fine. And yet, these organizations are no better off than their clients. After having wandered pointlessly through the institutional labyrinths all we can do is announce bitterly to our clients how we are unable to help further and just watch their lives crumble to pieces. I could talk for days about various examples, but I will attempt to capture the harm people who use drugs experience due to the institutional barriers through one specific example.

R. was 16 years old when she asked help from HOPS. At the time she was injecting drugs and came to seek help for opioid addiction treatment. That’s where the laborious journey through the institutional labyrinths began.

A woman who has used drugs can also make something of herself in life – she can become a mother, have a job

Е. is a woman with first-hand experience in using different drugs for many years, although she is only addicted to opioids. She hasn’t been using drugs for a long time now and is treated from addiction with a methadone substation therapy. In the meantime, she has a job and takes care of her child as a single parent. The difficulty of expressing her feelings was quite obvious, particularly when being interviewed by a man, and yet she agreed to the conversation, happy for the opportunity to share her experiences as a woman who has used drugs. Е. sincerely hopes her testimony will help appeal to the competent institutions to increase the help offered to girls and women who use drugs, including those treated from drug dependence. Her experience, and from what she knows from other girls and women, confirms the need for introducing specific gender-oriented services for girls and women who use drugs and are treated from drug dependence. 

Why women and drugs?

In Europe, almost a quarter of the people with severe problems caused by drug use are women. On average, there is one woman for every three men being treated, and one in five death cases caused by drug use are women.

The gender perspective is crucial for the interpretation of every issue and every problem, drug use not being any different. Men and women differ not only biologically, rather femininity and masculinity are determined culturally, historically and socially. The topic of this issue of Drugs – policies and practices strives to accentuate the importance of gender specific approaches in the drug use, addiction and treatment problematic in order to solve the challenges of women who use drugs.

The eight issue of the magazine „Drugs - Policies and Practices“

In October 2013, the Association HOPS - Healthy Options Skopje and the Coalition „Sexual and Health Rights of Marginalized Communities" published the first issue of the journal Drugs - Policies and Practices. Today we are promoting the 8 issue of the magazine, dedicated to "Women's Voice For effective programs for women who use drugs. "

Yes, that’s right, as strange as it might sound, women also use drugs. They have used drugs in the past too. At least as far in the past as current research allows us to investigate. The only difference was that they were forced to hide better due to the predominant values, more tolerant towards men. While drug use has been a bitter topic for decades, discussion of women using drugs was apprehensively introduced to the public some twenty years ago. However, it was not until the past few years that more and more people gathered the courage to loudly and openly speak about what women who use drugs need. Why is that? Because gender aspects are biologically, but also culturally determined. Because women who use drugs face different challenges than men who use drugs, hence the different needs.

Post-translational rotten youth no.2

So, you would say it must be entirely their fault for being too weak and slipping into addiction, while you belong to the tribe of "strong, rational, 9-4, no-bullshit" people?

But, are you sure that you want to point a judgmental finger at entire generations of confused, apathic, self-sabbotaging, ruined young people, many of whom just couldn't stand being part of the rat race, many of whom simply never had anyone to teach them how to adapt to it; young people who pretty much inherited only one big, rusty fan and a huge pile of shit from the previous self-righteous generation?

Before you rush in to dismiss them as "scumbags who oughta be killed" because such a thing is strictly a private problem that only happens to lazy, stupid, unambitious people and could never happen to you or your close ones, just take one closer look at the illusion of control and comfort that you're helping maintain, day in, day out, until your name gets engraved onto a tombstone, above the epitaph "A well-behaved citizen who never rocked the boat as he/she sailed the ocean of self-interest".

/Shot at "La Luna", a popular night club during the time when this industrial city was enjoying economic prosperity; today the place is in ruins and serves as a local hotspot for junkies and vagabonds.

Zmaj Poemography

Harm Reduction In Macedonia

The first Harm reduction programme in Macedonia was initiated in 1996, and since then a total of 17 programmes have been developed in 13 cities across the country. These programmes provide complementary services integrated at one spot, including needle exchange, condoms, basic medical services, social support, HIV and Hepatitis C testing, as well as free-of-charge legal support. Because of these characteristics, the programmes are recognised as good practices in the region and much wider. Many study visits have been hosted in Macedonia, whereby participants from different countries have visited the services operated by HOPS in Skopje to learn how to develop a successful harm reduction programme.

A petition for supporting Harm Reduction Programs and HIV prevention in Republic of Macedonia

Sign up!

Support the petition which is a call for the Ministry of Health and the Government of the Republic of Macedonia to provide funding and continuing the HIV prevention and harm reduction programs!

Save lives!

 A petition for supporting Harm Reduction Programs and HIV prevention in Republic of Macedonia.

Further survival of harm reduction programs and HIV prevention is uncertain. The current financial support of the Republic of Macedonia from the Global Fund to fight AIDS, Tuberculosis and Malaria ends in June 2017, which will result with over 10,000 people who use drugs as well as their family members without proper social and health care.

Thanks to harm reduction programs, only two new HIV cases have been recorded in Macedonia in the last ten years as a result of drugs injecting, and less than 5% of 315 registered cases of HIV were people who inject drugs. These figures are far smaller than the neighboring countries. Macedonia can boast with the lowest HIV rate in Southeast Europe, but if these programs are not implemented, there is a risk of HIV epidemics as a result of interaction with the epidemics in neighboring countries and the possibility of increasing risk behaviors.

Call for CONSULTANCY for developing „Guidelines for CSOs on working with children and youth who use drugs in the Western Balkan“

HOPS – Healthy Options Project Skopje  announces this call for CONSULTANCY for developing „Guidelines for CSOs on working with children and youth who use drugs in the Western Balkan“
Minimum requirements:
  • University degree; Advanced degree in social work, psychology, pedagogy, public health or other relevant field would be considered a strong asset;
  • At least 5 years of experience in the area of social or health protection of young people at risk,
  • Knowledge of relevant international standards and good practices in service provision for children and youth who use drugs, and ability to adapt these to the regional context;
  • Familiarity with the health, social and child care systems in Western Balkan countries;
  • Familiarity with the civil sector in the region;
  • Fluency in any of the Western Balkan languages or English; Applicants who can produce the Guidelines in English would be preferred;
  • Strong communication skills and ability to work within short deadlines;
  • Excellent writing skills with proven record of publications within the last 5 years.
The detailed Terms of Reference for the consultancy position can be found at this LINK.