Treatment of stimulants addiction in the former Yugoslav Republic of Macedonia. M-r.d-r Lillian Ignjatova

Transcription

1 Treatment of stimulants addiction in the former Yugoslav Republic of Macedonia M-r.d-r Lillian Ignjatova

2 Amphetamines In the Republic of Macedonia ecstasy tablets appear in 1996/7. Their high cost ( 12 Euro for tablet), low availability as well as their increasing demand has led to amphetamine appearing on the Macedonian market.

3 Amphetamine It was not clear until 2000 that the name of ecstasy was used for various drug types based on amphetamine. After recognizing amphetamine as a drug different from ecstasy tablets, it started to be sold as a powder substance.

4 Cocaine In this period cocaine use was low but stable. In 2009 in capital Skopje there were 138 registered cocaine users from all 4476 registered drug users [1] [1] Ministry of interior

5 First stimulants seizures in the Republic of Macedonia [2] Ministry of interior Cocaine Amphetamines Ecstasy (in kg) (Tabl.) / / / / / 1996 / / / / / / /

6 Drug seizures in 2009 in the Republic of Macedonia 4 cases - amphetamine 6 offenders( 5 Macedonians and 1 Albanian) for Article 215 of the Penal Code: "llicit drug production and release of narcotic drugs, psychotropic substances and precursors") 96 tablets and 11,5 g powder amphetamine 1 case - methamphetamine 5 offenders 2263 tablets [3] [3] Ministry of Interior

7 ESPAD % of students had used ecstasy (3 times more compared to 1 % in 1999), 2.1 % having used it in the last 12 months 1.6 % in the last month; 1,7% of students had used amphetamine (4 times more compared to 0,4% in 1999). [4]ESPAD 2008

8 Stimulants users in needle exchange program in Skopje ( N=1468) Ever used drug Cocaine Creek Amphetamine Ecstasy From total number of 1468 new clients in needle exchange program - Skopje mainly opiate users 605 ever used cocaine, 103 creek, 228 amphetamine, 485 ecstasy.

9 Stimulants users in needle exchange program in Skopje ( N=1468) Cocaine Creek More often used drug Amphetamine Ecstasy From total number of 1468 new clients in needle exchange program - Skopje mainly opiate users 70 use cocaine as more often used drug, 13 creek,40 amphetamine, 104 ecstasy.

10 Combination with other drugs These drugs types are most often used in combination with other drugs. Users combine drugs with opposite or similar effects.

11 Combination with other drugs According to them, rich people use amphetamine and cocaine, while poorer people use amphetamine and heroin or methadone.

12 Never know??? There are a number of cases when users believe they buy cocaine, but they get amphetamine instead. In MMT programs some patients witch rapport cocaine use are positive on amphetamine and negative on cocaine screen tests.

13 Demand of treatment Their first contact with a medical institution is - an urgent center due to heartbeat, higher blood pressure or - a psychiatric hospital due to certain psychiatric disorders as a consequence of stimulants use: fear of panic attack, anxiety, and depression as well as acute psychotic disorders in more difficult cases. Mainly persons with psychiatric disorders after using amphetamine are hospitalized in psychiatric hospitals in the country. So, a smaller percentage of these persons ask for a dependence treatment.

14 Centers for prevention and treatment of drug abuse Centers for prevention and treatment of drug abuse are not attractive for users of only cocaine, amphetamine or ecstasy.

15 Cocaine/amphetamine/ecstasy users in MMT The number of cocaine/amphetamine/ecstasy users who are polydrug users in MMT programs in the Centers for treatment of drug addiction in Republic of Macedonia is bigger, but there are no users of only cocaine, amphetamine or ecstasy.

16 Stimulants users in MMT program in Skopje Our research in The Center for prevention and treatment of drug addiction in Skopje (capital) showed that 55 of 102 patients in methadone maintenance program used cocaine and 32 used other stimulants (amphetamine/ecstasy ) during the treatment[5]. [5]Ignjatova L., Spasovska Trajanovska A., Aleksovska N. 2005

17 DEFFERENT TYPES OF DRUGS OF USE IN MMT PROGRAM number of patients coca. other stimul. lifetime use

18 Treatment with cocaine Some of the patients in methadone maintenance treatment in Skopje tried to treat their methadone dependence by using cocaine or amphetamines, so they become addicted of cocaine or amphetamines.

19 Centers for treatment of drug addiction in other cities and in prisons There are 10 centers in the Republic of Macedonia that are part of the psychiatric department in the Town s Hospital. + There are 2 MMT programs in 2 Prisons in the capital city Skopje.

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21 Treatment of stimulants addiction in Kumanovo In MMT program total number of patients is 91. There are no patients in MMT program that used stimulants???? There is no request for treatment of stimulants abuse in the hospital as well. There is no treatment of stimulants addiction.

22 Treatment of stimulants addiction in Stip Treatment of stimulants abuse is focused on treating symptoms in Day hospitals that is a part of the psychiatric department in the Hospital- Stip. The patients drop out after 3 days on average. In MMT program total number of patients is 42. In MMT program Stip there are no patients with stimulants addiction???? So there is no treatment of stimulants addiction.

23 Treatment of stimulants addiction in Kavadarci In MMT program total number of patients is 32. There is only one patient in MMT program who used stimulants in his lifetime period, but he uses methadone or heroin now. There is no request for treatment of stimulants abuse in the hospital as well. There is no treatment of stimulants.

24 Treatment of stimulants addiction in Strumica In MMT program total number of patients is 65 There is a small number of patients that used stimulants in their lifetime period, but they use methadone or heroin now. There is no treatment of stimulants addiction.

25 Treatment of stimulants addiction in Gevgelija In MMT program total number of patients is 72. In lifetime period: 10 of them used ecstasy and cocaine 20 of them used ecstasy only at parties Current use in 2010: 5 of them use ecstasy. There is no request for treatment. There is no treatment of stimulants addiction.

26 Treatment of stimulants addiction in Tetovo In MMT program total number of patients is 89. In lifetime period: 58 of them used cocaine 30 of them used ecstasy 11 of them used amphetamine 3 of them used creek.

27 Treatment of stimulants addiction in Bitola In MMT program total number of patients 104 In lifetime period: 20 of them used cocaine 12 of them used ecstasy 10 of them used amphetamine. During the treatment: 3 of them used cocaine 10 of them used ecstasy 3 of them used amphetamine. There is no specific treatment for them. Amphetamine users with psychosis are admitted in the Hospital- psychiatric department.

28 Treatment of stimulants addiction in Ohrid Ohrid is town with a lot of tourists, lots of parties and lots of youths during the summer. In MMT program there are 112 patients. During the treatment 1 patient used cocaine???? There is no specific treatment for stimulants abuse.

29 Discussion There are no specific treatment programs for stimulants in Centers for prevention and treatment of drug addiction and the treatment is focused on treating symptoms, without any specific focus on various aspects and challenges that various drugs bring with them.

30 Conclusion There are stimulants users. We have to attract them. A specialized treatment program for stimulants users is needed and it is necessary.

31 Thank you for your attention!