The capacities for the treatment of alcoholism in Montenegro are limited and exceed the needs of citizens in relation to alcohol abuse, according to CAZAS, while the Institute for Public Health (IJZ) states that prevention is key in the fight against this addiction and that apart from health system, a very important role of the police and inspection.
Seven people are being treated for alcoholism in the "Dobrota" Special Hospital for Psychiatry, and two people are being treated primarily for this type of addiction in the Kakaricka Gora Public Institution.
The psychiatry department within the Clinical Center also offers the possibility of rehabilitating certain conditions that are the result of an abstinence crisis or the consumption of psychoactive substances, which includes alcohol, and the hospital in Nikšić has a department where alcoholism can be treated.
"Capacities for the treatment of alcoholism in Montenegro are unfortunately limited and have long exceeded the needs of citizens in relation to alcohol abuse," said CAZAS to the MINA agency.
CAZAS said that all these institutions have a limited number of places and beds for treatment and, as they stated, treatment is mostly approached exclusively from the medical model without community support programs and linking with social care institutions.
"The insufficient and often non-existent capacities for the treatment of women are of particular concern, among which there is also an increase in alcohol abuse," CAZAS said.
They emphasized that very often, because alcohol is culturally acceptable in Montenegro, people who use it are not aware of the problem, nor are their surroundings, which is why help is often never sought or it is very late.
"In the context of treatment, it is important to strengthen capacities not only in the treatment of alcohol addiction, but also in lowering the rate of alcohol use, because it is the same risk factor in more than 60 different diseases and conditions and one of the leading causes of mortality in the world", according to CAZAS .
They emphasized that much greater focus should be on prevention and timely involvement in treatment.
As they said, Montenegro needs much more human and spatial capacities for the treatment of alcoholism, as well as the availability of larger capacities for the treatment of women within psychiatric departments.
CAZAS said that they are pleased with the construction of the Clinic for Mental Diseases, which should expand the available capacities and enable the range of services to be expanded.
"It is important to work on the introduction of more effective statistics in this area and the monitoring of other conditions associated with the use of alcohol in order to spread awareness of the harmfulness of its use and of alcohol addiction, which is only one, the extreme of its use," said CAZAS. -a.
They emphasized that it is necessary to strengthen prevention and early intervention, as well as to strengthen personnel, financial and technical capacities to provide comprehensive support services in the treatment process.
According to them, it is important to work on strengthening the network of Alcoholics Anonymous, which is a proven program in the community that gives good results in the world and whose work methodology helps people maintain abstinence after treatment and continue a functional life in the community.
CAZAS has established a free support service for people affected by the use of alcohol, where counseling services are available to citizens with professional staff and with people who have gone through the treatment process.
All information is available by calling 067 600 988 and 067 602 345.
CAZAS stated that alcohol in Montenegro is available, cheap and socially acceptable, integrated into numerous cultural, social and even religious customs, and there is a lack of social awareness of the harmfulness of alcohol.
As they said, there are no sustainable and structured alcohol prevention programs in Montenegro.
"It is important that prevention is based on proven methods that produce results," said CAZAS and added that it is not enough to implement lectures in schools, but it is necessary to focus on programs to strengthen the skills of children and young people to resist peer and social pressure .
According to them, it is important that prevention starts already in the family and then in kindergartens, schools, the community, and the media.
CAZAS emphasized that the media must also become an ally in the promotion of healthy behavior patterns, much more than a marketing space for advertising the use of alcohol.
They say that they do not have precise data on the number of people who need treatment, because there is no registry for alcohol, which would collect data based on screening programs, treatment, but also because the majority of those affected by alcohol use never seek help.
According to data from the World Health Organization, an average of 12,24 liters of pure alcohol is consumed per capita in Montenegro. According to these figures, Montenegro ranks 12th in terms of average alcohol consumption.
The IJZ told the MINA agency that prevention is key in the fight against alcoholism and that it must involve many experts, because alcoholism is a complex problem, and its prevention should not be relied solely on health institutions.
"Apart from the role of the health system, the role of the police and the inspection in the prevention of alcohol use and alcohol-related disorders is also very important," said the IJZ.
As they explained, it is important in terms of raising awareness about the harmful use of alcohol when participating in traffic, as well as activities directed against excessive alcohol consumption in public places, at sports events.
The IJZ said that, based on the European survey on the use of psychoactive substances and non-chemical means of addiction among young people in Montenegro (ESPAD), which was conducted in 2019 among sixteen-year-olds, it is recognized that there is still a lack of a comprehensive and effective system of control over by selling alcoholic beverages to minors.
This refers to the sale of alcoholic beverages in retail and catering establishments.
Systemic measures and preventive programs aimed at this issue are missing, as added by the IJZ.
They pointed out that the catering and food sales sector has a very significant role in the prevention of harmful alcohol use among young people.
Speaking about the legal regulations, IJZ reminded that the Law on Tourism and Hospitality prohibits the serving of alcoholic beverages in catering establishments to persons under 18 years of age, while the Law on Public Order and Peace prohibits the sale of alcoholic beverages to persons under 18 years of age.
"It is necessary to carry out activities that will strengthen and educate this sector with the goal of zero tolerance for the sale of alcohol to minors", stated the IJZ and added that the number of inspections on the sale and serving of alcohol to minors is insufficient.
They said that the main reason is that there is an insufficient number of inspectors and authorized persons who can carry out supervision, so it is urgently necessary to work on increasing the capacity of inspections.
At the end of 2021, the Ministry of Health adopted the Program for the Prevention of Harmful Use of Alcohol and Disorders Caused by Alcohol in Montenegro from 2022-2024. year, which plans to amend the Law on Excise Taxes in the part of increasing excise taxes on alcohol, so that the availability of alcohol would be reduced through the excise policy.
The IJZ said that the Agency for Electronic Media planned to improve the legal framework for the protection of minors from commercial audiovisual media services, with the aim of improving protection against content that promotes the consumption of drinks that have a lower, but no less significant, percentage of alcohol.
As they said, activities of advisory and educational work with teaching assistants and teachers on the consequences of harmful alcohol consumption and continuous implementation of the parent/guardian education program on how to recognize and prevent risky behavior of children and young people are planned.
They said that a significant step forward was the drafting of the Protocol on handling after the detection of alcohol intoxication for emergency services.
The IJZ emphasizes that it is also necessary to improve support for people after discharge from treatment institutions.
They stated that in primary prevention, the main part of the work to combat alcoholism consists of a broad, documented activity and well-conducted education against the consumption of alcoholic beverages.
As they explained, the measures are based on raising the level of knowledge and motivation for healthy behavior, changing risky behavior, adopting positive models of behavior and developing responsibility for health.
The Institute said that specific primary prevention is aimed at solving various social, educational, health and other difficulties that affect narrower groups.
That prevention, as they added, aims to prevent the unfavorable causes of alcohol, immediately before its possible effect on individuals and social groups where there is a greater possibility of alcohol addiction, considering the characteristics of their social status, age and other socio-psychological characteristics.
The IJZ stated that specific measures for the primary prevention of alcoholism among young people would be the prevention of the occurrence of disorders in different subgroups of young people who consume alcoholic beverages to a greater extent, permanent work with young people to successfully solve certain developmental phases of the life cycle.
Among those measures would be work on successfully overcoming development crises, should they arise, work on improving communication with the environment, opposing the influence of certain subgroups of peers who use alcohol.
The Institute explained that in secondary prevention, everything is done so that a person does not become a true alcoholic due to his inclination to drink alcoholic beverages.
As they stated, the treatment of alcoholics should include, in addition to professional, health and social workers, other collaborators, and primarily the alcoholic himself.
Alcoholic recovery begins when hospital treatment is completed and is a lifelong process.
The Institute pointed out that during the rehabilitation phase of alcoholics, it is important to avoid people who consume alcohol, places and events related to drinking, to practice new activities, favor new acquaintances and, most importantly, to enjoy life with their family.
In Montenegro, according to the data from the Research on Quality of Life, Lifestyles and Health Risks of Montenegrin Residents conducted by the Institute of Public Health in 2017, more than 60 percent of residents aged 15 to 64 consumed alcoholic beverages at least once in the last 12 months. with no significant difference between the sexes.
The IJZ warned that in Montenegro there is insufficient enforcement of recognition of persons with alcohol use problems.
They emphasized that it is planned to continue the program of screening and short interventions for people with harmful and dangerous alcohol use at the level of primary health care and to provide training for health workers for these interventions.
The MINA agency was told from Kakaricka that there are 26 clients being treated in that institution, two of whom are being treated primarily for alcohol.
They emphasized that almost all clients have polytoxicomania, the abuse of several psychoactive substances at the same time, so the number of them who have a problem with alcohol, and who are currently undergoing treatment, is significantly higher.
From Kakaricka, they stated above that since the establishment of the institution, they have received over 500 admissions.
"Today, we have numerous examples of clients who have gone through treatment at the institution and live functional lives, study, are employed, have started a family," said people from Kakricka above.
They explained that when it comes to the disease of addiction, the term cured is used, because the disease of addiction is chronic and cannot be cured, but it can be brought under control.
From Kakaricka above, they said that they had clients who are returnees, who were previously treated for alcoholism.
"This shows exactly how serious the disease is, how much constant self-work is required for a person to abstain. The return of addicts to the consumption of psychoactive substances is possible, while relapse is an integral part of the disease," said people from Kakaricka Gora.
As they stated, the treatment at the Public Institution is based on the approach that recovery from addiction is not only the establishment of abstinence, but implies a change in lifestyle, behavior, thinking and attitudes, which is, in essence, a long-term process.
From Kakaricka above, they said that there is no possibility of treating minors from any addiction disease in the Public Institution, adding that they conduct informational discussions with parents in order to educate them about the problem of addiction.
Seven patients who are being treated for alcoholism are hospitalized in the "Dobrota" Special Hospital, and all of them are men.
From that health institution, they said that they do not have hospitalized female patients who are being treated for alcoholism, because there is no women's department for the treatment of addiction.
They told the MINA agency that over 50 percent of returnees are in the Addiction Treatment Department.
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