It is necessary to continuously educate professional staff who provide services to people who use drugs

In Montenegro, it is necessary to continuously educate professional staff who provide services to people who use drugs, as well as to strengthen the capacities of non-governmental organizations so that support services are available throughout the country.

This was announced in the second part of the conference on needs, local and national policies in relation to people who use drugs, which was organized by the non-governmental organization Juventas and the Montenegrin harm reduction network LINK, the PR center reports.

The head of the Department for membership in international bodies in the field of drug abuse prevention policies in the Ministry of Health, Sandra Pestorić, believes that the previous Strategy on the prevention of drug abuse was well done, but that it did not have clearly set performance indicators.

"We are facing the difficulty of understanding the needs of local governments. I think it would be important to analyze the situation on the ground," said Pestorić.

She pointed out that in practice they also face resistance from professionals and the situation that psychiatrists will not work with such a sensitive category of the population, even though they are educated for it, due to the large presence of stigma and discrimination.

"I think we need to strengthen the capacity of people who are in direct contact with people who use drugs," Pestorić pointed out.

He also believes that the prevention of drug use should start earlier.

"The point is not to pass the Strategy, which will be a dead letter on paper, but a document that will make it possible to implement concrete activities," said Pestorić.

The author of the Monitoring Report of the Drug Abuse Prevention Strategy from the Institute of Public Health, Tatjana Đurišić, explained that there are five epidemiological indicators in the field of drug epidemiology, based on which the situation in that area is assessed in each country.

"When we talk about the drug addiction registry, which is one of those indicators, it is not and will never be a list of all people in a country who take drugs. "It is a registry that has a registration form that is in line with the standards of registration of persons who report for treatment due to drug use," Đurišić said.

She said that the consequences of drug-related problems can be seen on the global stage, which, as she explained, increase the challenges in the field of public health and safety, especially in less developed countries, reports the PR center.

"Established drugs have never been more affordable, and powerful new substances continue to emerge. Almost anything with psychoactive properties can appear on the drug market, often mislabeled or in mixtures, which is why users are often unaware of exactly what they are using. This increases health risks and creates new challenges in the implementation of legislation and regulation," said Đurišić.

She said that the market is now characterized by relatively high availability of a wider range of drugs, which are often of a high degree of potency or purity, and that Europe remains an important production area for synthetic drugs and cannabis.

"In the areas of drug use prevention, addiction treatment, harm reduction and recovery support, we now have a better understanding of which interventions are effective. There is also a greater recognition of the need for more integrated and comprehensive responses. Synergy with policy and practice in other areas is necessary, including social protection, general health care, services for young people and the elderly, mental health care services and the criminal justice system," said Đurišić.

She pointed out that in the new National Strategy in the field of drugs 2023-2027, they proposed that preventive activities be concentrated in the following areas of the educational system, the media, the health care system, the social care system, prevention at the workplace, in the environment and in the local community .

Đurušić, speaking about the recommendations that need to be undertaken in the coming period, said that it is necessary to harmonize the data collection system in the area of ​​safety aspects of drug use with EU standards.

"It is recommended that in order to increase the effective criminal investigation and prosecution of criminals, joint investigation teams should be formed at the local and national level. Strengthening knowledge and effective practice should remain emphasized in the next action plan, taking into account the need for (highly) specialized training. Human resources, as well as the requirements for technical equipment of the services, should also be defined," said Đurišić.

Also, as she added, it is necessary to clearly define "drug availability" and take into account all possible appropriate indicators that can be used to measure drug availability.

Speaking about the mapping of services, available services and their sustainability, the coordinator of the Department for work with people who use/inject drugs, people who engage in sex work, people in prison and former prisoners, Marija Radović, reminded that services for people who drug users are provided within: the health care system, the social and child protection system, the criminal sanctions enforcement system, as well as through the implementation of harm reduction programs.

"When it comes to available services provided by the non-governmental sector in Montenegro, it is the Damage Reduction Program. The organizations are focused on addiction treatment and support in the recovery process. "Also, there are services provided by non-governmental organizations as licensed service providers in the field of social and child protection, and in the criminal sanctions enforcement system there is a self-support group for people with a history of drug use," said Radović.

She stated that the state sector provides services within the health system, the social protection system, the criminal sanctions enforcement system, and at the local level within the offices for the prevention of addiction diseases.

She explained that the services provided by the civil sector as part of the damage reduction program are carried out through the work of drop-in centers and field work.

"It is important to note that Juventas has two licenses for the provision of services: the license for the Counseling service and the Support for life in the community-housing service," stated Radović.

Talking about what is missing, which would contribute to the work of services and services, is the official statistics when it comes to treatment and overdose.

"It is important that there is a functional early warning system without obstacles in communication and functioning, more uniform prevention programs - program standardization, new services such as community testing and safe injection rooms," said Radović.

She pointed out that there is a lack of personnel and space capacities in various institutions that provide services, and that the additional specificity and burden of work is financial sustainability.

"It is important to additionally and continuously educate the professional staff who provide services, to simplify the procedures for inclusion in the treatment of blood and sexually transmitted infections, as well as the procedures for inclusion in teparium with methadone/buprenorphine. "We still lack services provided to minors, as well as a shelter for women who use drugs and are victims of domestic and/or other forms of violence," said Radović.

Coordinator for community building in the Montenegrin network for harm reduction, Link Marko Dragićević, pointed to the results of research that showed that support services are concentrated in the central part of Montenegro.

"Our clients from the southern and northern regions rely mainly on the field work of organizations from Podgorica, because they do not have adequate support services in their cities. 63,3 percent of all support services are available in the central part of the country," stated Dragićević.

He also said that organizations do not have sufficient capacity to deal with all vulnerable groups of people who use drugs.

"Therefore, in the coming period, it is necessary to strengthen the capacities of civil society organizations so that support services can be available to everyone," said Dragićević.

He also said that two Link researchers conducted research in pharmacies and health centers in Podgorica using the "mystery shopper" method.

"One of our colleagues, who seems to have been characterized by the people he came into contact with as "addicts" or "like everyone else", was looking for needles and syringes in pharmacies, and after him our colleague, who seems to be often called "normal" in society she asked for the same. "In 11 pharmacies, they acted in accordance with the rules and regulations and they received that kit," said Dragićević.

He indicated that in eight pharmacies a discriminatory and stigmatizing attitude towards the researcher was carried out.

"He asked for a kit at the pharmacy and with certain comments they refused to sell it to him. After they rejected him, they sold the same equipment to our colleague who entered after him. "Also, the same researchers visited 12 health centers in Podgorica, of which only two health centers gave him sterile equipment," said Dragićević.

He warned that pharmacies did not act in accordance with the Law on Pharmacy Activity, because they did not respect the principle of pharmacy activity to be carried out without discrimination.

The conference was organized within the project "Competent, transparent, efficient and responsible civil society that deals with people who use drugs in Montenegro", which is financed by the European Union, through the EU Delegation in Montenegro.