Experts: North Macedonia lacks a system for detecting new drugs

The situation regarding drug use in North Macedonia does not differ dramatically from that in other Western Balkan countries, but the main problem is that there is no early warning system for new psychoactive substances, experts in addiction prevention and treatment from the Skopje-based association “HOPS – Healthy Options Project Skopje,” Bogdan Kolev and Hristina Todorovska, told Kosovo Online.

Kolev noted that, based on nearly 30 years of experience working directly with people who use drugs, he often sees major differences between what is written in laws and strategies and what actually happens on the ground.

“Although a national drug strategy and action plans have been developed, implementation is limited and does not always produce the desired results. Some measures and activities remain only on paper, without sufficient funding, personnel, or clear mechanisms to monitor whether those measures are actually working,” Kolev said.

He emphasized that it is particularly concerning that North Macedonia still has not established an early warning system for new psychoactive substances, nor services for testing the composition of substances.

“If such a system existed, it would help identify risks in a timely manner and better protect the public health of all citizens. At a time when new psychoactive and unpredictable substances are constantly emerging, this is a serious shortcoming across the Western Balkans. I know this because I have information that such a system for detecting psychoactive substances does not exist in other Western Balkan countries either. Another problem, in my opinion, is policymaking in which experts and organizations with many years of field experience are not always listened to sufficiently. As a result, some measures are not based on people's real needs and do not produce long-term results. In practice, institutions often react only after a problem has already emerged, instead of investing more in prevention,” Kolev said.

He added that many people have the impression that the state's response is most visible through police operations, which are often directed at drug users or young people, while much less attention is paid to dismantling the networks behind the illegal drug trade that profit from it.

“If we want real results, we need an evidence-based approach, greater involvement of experts and civil society organizations, better coordination among institutions and stakeholders, and more investment in prevention, treatment, social support, and harm reduction. Our experience shows that the problem cannot be solved solely through punishment and repressive measures. A system is needed that recognizes the reasons why young people begin using drugs and offers them timely support before the consequences become more serious,” Kolev explained.

He believes that legalization and regulation in the field of psychoactive substances could help create order and predictability in this area.

“I would recommend that all governments consider drafting laws on legalization or regulation. Although many people believe that legalization would lead to a breakdown of social order and increased drug use, the opposite would happen. Through regulation, we would know exactly who can produce, who can buy, at what age it can be purchased, under what conditions, and in what quantities. In addition to these benefits, and the fact that the state would collect taxes, there would also be advantages for the medical profession. Some substances have significant therapeutic value, meaning that once something is regulated, research can be conducted and scientific studies can be produced. The state would certainly benefit greatly from that,” Kolev concluded.

Todorovska: The fight against drugs should target criminal organizations

His colleague from the association, counselor Hristina Todorovska, stressed that the fight against drug abuse must be directed at organizations involved in illegal trafficking.

“I would first like to address the so-called traditional stimulants, which are becoming increasingly available across the Western Balkans, unlike new substances, for which we do not know whether they are present here or not. This is a result of the lack of substance-testing programs, or ‘drug checking’ programs. We do not have such a program, and therefore we cannot know whether a new substance has arrived or is being produced here. Such programs exist in Europe, and they show that new substances, new variants, and substitutes constantly appear, making them difficult to track. In North Macedonia, the problem is that we have no programs whatsoever for detecting these substances,” Todorovska said.

She presented data from a study conducted last year with EU support, involving users of new psychoactive substances, which showed that 41 percent had used synthetic cannabinoids, 36 percent synthetic psychedelics, or new variants thereof, and 29 percent dissociatives, mainly ketamine.

“When it comes to addressing this problem, we must return to the fact that North Macedonia lacks programs for detecting new drugs. The addiction treatment centers we have are primarily intended for opioid users, but they face a significant shortage of qualified professionals and staff,” Todorovska said.

She stressed that the fight against drugs should not be directed against people who use substances.

“They are crime victims. The fight should be directed against organized crime and the networks that profit from illegal trafficking. That is why I believe a balanced approach is needed, one that prosecutes the networks profiting from illegal trade while at the same time providing support, treatment, and protection to people who need it,” Todorovska concluded.