Methadone treatment in Macedonia and all problems which we are facing with it.

My name is Georgievski Vitomir but most of the people know me as Vito. I want to say that I am drug user activist and this days I am working for two NGO’s in Macedonia, one which is dealing with problems that methadone patients have and the second one which is drug users union we are trying through direct action to change something in the drug users area. Currently I am also a board member of INPUD and I am general secretary of the same organization. I have also been on methadone maintenance treatment for more then 12 years, currently on 150 mg per day officially from the methadone clinics and 100 -150 mg more from the black market something for what I will tall you later in this story.

I will try shortly to explain with what kind of problems we are facing with the methadone treatment in the clinics in Skopje, which is capital city of Macedonia. We have had money for opening 6 methadone clinics in Skopje donated by the Global Fund for fight against AIDS, TB and Malaria since 2003. Several times the authorities/politicians have made some kind of efforts to open the clinics in Skopje where 70% of the drug using problem is. We have one clinic which was opened in the late 80's and since then it was the only one. Last summer after the notification from the Global Fund that the money which was not spent for opening methadone clinics in Skopje should be returned, the minister of health in 20 days opened another methadone clinic. Because we have had waiting list for more then 6 years the new clinic was full with clients and again we have had to open the waiting list. The capacity of the new clinic was around 80-100 so it was full very fast. What is frightening  is that in the near future there isn't any news about opening the second and then the rest of 6 clinics which was an obligation in our application for the Global Fund. I have to admit that the Global Fund personal were very kind, having in mind that if they punish Macedonia for not opening the clinics the final result will be disaster for the drug users so I have to thank them publicly. If I start to speak about the clinics which are already working we have another problem. The doctors don't want to work by the guidelines/protocols which they produced themselves and they are refusing to adjust the dosage which methadone clients/patients are receiving. They have established stupid rule that limits the dosage to 120 mg per day for person. This means that if you need more then 120 mg methadone you will have to buy on the black market. Then they are saying that lot of methadone is selling on the black market. Yes it has to be sold simply because one basic economic rule about the needs of the market, if there is a need for methadone there will be people who will supply or sell the methadone. On the other hand because lot of people do not have access to treatment they also have to buy methadone on a black market.

Another stupidity this remarkable situation has made. Young drug users’, because they don’t have opportunities to have access to treatment, commit crimes to enter jail where they will receive methadone immediately because in the jail there isn't a waiting list. Then after they will do the time and leave the jail they will be admitted on the methadone treatment because they are on the priority list or simply there isn’t a waiting list for them. There is much more but I think that this is enough for the first time explanation about our Macedonian methadone experience.

Thanks for reading the story in advance,

Take care,