The discussion about the drug issue in Macedonia began in the early 1990s with the country’s independence. The transition period was one of the worst ones for the fight against addiction and drug abuse. In such times, when the state was going through a process of transforming the social system, the population suffered the most, of course, due to the country’s neglectfulness and inability to protect it from the consequences of the transformation.
The discussion about the drug issue in Macedonia began in the early 1990s with the country’s independence. The transition period was one of the worst ones for the fight against addiction and drug abuse. In such times, when the state was going through a process of transforming the social system, the population suffered the most, of course, due to the country’s neglectfulness and inability to protect it from the consequences of the transformation. During these dark years, the Balkan drug trafficking route traversed through the country, times when most of the drugs were traded, and continue to be so, on the black market. The so-called Balkan Route is best known for the heroin trafficking from Afghanistan through Turkey and from the Western Balkans to EU. Heroin from Turkey passed through Bulgaria or Greece before entering North Macedonia and Serbia. The route then led north, along the so-called Central-European Route, to Hungary, Slovakia, Austria and Switzerland. Heroin was also smuggled in Italy through North Macedonia and Kosovo, and through Albania and Monte Negro. From Serbia and Monte Negro the drugs also ended up in Bosnia and Herzegovina only to continue further to Croatia and neighbouring Slovenia. In 2015, the total gross profit realized by opiate traders in Southeast Europe was estimated to be 1.7 billion US dollars annually. Heroin is not only traded but also processed on the Balkans. The extreme level of ignorance among the young population during the 1990s and the frail prevention programs led to many young people becoming drug addicts, particularly from opiates – heroin. The group of opiates encompass drugs produced by the processing of opium. Opium is the dried sap that seeps from the cuts in the poppy seed pod. For centuries it was used for pain relief (the ancient Sumerians called it the “plant of happiness”). In the 19th century, morphine and codeine, opium alkaloids, were isolated and were used in medicine as analgesics. The opiate groups include: heroin, methadone, morphine. Opiates are listed in the group of the most dangerous, highly addictive psychoactive substances. Official statistics on the number of drug addicts in the country is lacking, however it is believed that as many as 20% of the individuals aged 15 to 64 use drugs in some way. The first registered drug users in the Republic of Macedonia were recorded by the Ministry of Interior (MOI) in 1969. Between 1990 and 2004, the number of registered drug users increased from 314 to 6,583, while 2005 saw 549 new registered drug users. The biggest portion of this percentage were citizens from urban areas, mostly from Skopje (as many as 51% of the total number of registered users). The group aged 19 to 31 takes up 82%, while 18 year-olds only 3.8%. According to MOI’s evidence on drug addicts, in 55% of the cases, the drug in question was cannabis. The number of registered people using heroin in Macedonia seems relatively stable according to MOI’s numbers. Of the total number of registered cases in 2004, 41.3% belongs to people using heroin. Male individuals are more common, in a ratio ten to one in comparison to women.
Unsafe intravenous drug use, or more precisely sharing needles by several people is a serious risk factor in spreading contagious diseases such as HIV/AIDS, Hepatitis B and C and other blood-borne diseases. The number of HIV positive people with AIDS in Macedonia increased from 59 to 76 in the period from 2001 to 2005. Eight of them were intravenous drug users (10.5%). With regards to users addicted to drugs who are on drug treatment, 70-90% of them are infected with Hepatitis C. Intravenous drug use could be considered as the main risk factors for spreading HIV/AIDS in Macedonia in future. When the drug issue first occurred, the state failed to offer any systematic solutions but rather addressed the problems in accordance to certain outdated established methods inherited from the former governing system of Yugoslavia. The programs created for drug prevention from that time were terrifying and stigmatizing, without systematic solutions or peer education in schools. The chief messengers on drug prevention were doctors who used language inappropriate for drug use prevention. In addition, drug detoxification programs were organized according to outdated methods in hospital centres, failing to offer proper treatments. The biggest role in raising the awareness among the population on accepting drug addicts, decreasing the stigma, creating drug treatment and prevention programs, and creating drug policies belonged to civil society organizations formed in the 1990s with staff trained in EU countries and throughput the world. These organizations not only improved the situation and treatment of addicts in the country but also worked on developing special programs for decreasing the percentage of addiction-related infections, such as HIV/AIDS, Hepatitis C and others. The first harm reduction and HIV prevention program (with needle exchange) for people who use drugs was launched in 1996. The programs were intersectoral, implemented by civil society organizations, medical and social centres. With the support of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria 17 such programs were opened in 14 different cities in 2004, considered to be one of the best in Central and East Europe, as well as Central Asia. Due to the programs, only two new cases of HIV transmitted by injecting drugs were registered in the past ten years. Part of the advocating activities of civil society organizations is the creation of drug policies which resulted with two national drugs strategies and the Local Drugs Strategy of the City of Skopje (2015-2020). The strategies aimed to ensure and reinforce the wellbeing of society and the individual, protect the public health and provide high level of safety. Both strategies are based on EU principles and UN Conventions on implementation of drug policies. Some civil society organizations in this field went a step further in their activities on addressing the addiction issue by developing programs for admission and treatment, as well as rehabilitation, re-socialization and reintegration programs. Organizations that have developed such programs are the Association for Counselling, Treatment, Reintegration and Resocialization of People Addicted to Psychoactive Substances “Izbor” from Strumica and Healthy Options Project Skopje – HOPS. There certainly is no doubt that civil society organizations have played an important role in the creation of public policies and responding to drug-related problems in the last three decades since the country’s independence. They are constantly monitoring and in step with drug policies implemented on European and on a global level, finding ways to apply such trends in a holistic manner in our country as well. The role of civil society organizations is to initiate policies, tools and solutions for addressing issues related to drug use/abuse, while institutions are those that need to provide safe means for decreasing drug-related crime and better mechanisms for solving problems related to drug addiction.
Author: Jasmina Pijanmanova
Jasmina Pijanmanova holds a Bachelor degree in Ethnology and a Master’s in Cultural Management from the University of Arts in Belgrade at the UNESCO Chair of Cultural Management and Intercultural Dialogue. She has been working in the civil sector for many years in the field of social politics, drug and alcohol prevention, as well as culture, art and development of cultural policies. At present she is employed as a curator of ethnology at the NI Institute for Protection of Cultural Monuments and Museum in Strumica.
- Жариште на организиран криминал на Западен Балкан, мај 2019, Скопје, p.4. (The core of organized crime in Western Balkans)
- 2006-2012 National Drug Strategy and the 2014-2020 National Drug Strategy