Drug dependence treatment and care in the Republic of Serbia

A joint UNODC-WHO programme is a success story

June 2012

“I started injecting heroin in 1994 and continued injecting intensively over the next 16 years. I was on the streets for about five years, with some breaks. I did everything I could to get hold of drugs,” says 36-year old Jovan1, who is sitting in front of the Methadone Center “Savski Venac”, in Belgrade, Serbia.

Side portrait of a patient
Djordje Novakovic

Jovan is one of the patients receiving long-term treatment supported in the framework of the Joint Programme on Drug Dependence Treatment and Care carried out by WHO and the UN Office on Drugs and Crime (UNODC) in Serbia since 2009. The Programme aims to improve coverage and quality of treatment and care services for drug use disorders in low- and middle-income countries.

“Our data show that globally, less than 10% of the persons who need effective treatment, receive it,” says Dr. Shekar Saxena, the Director of the WHO Department for Mental Health and Substance Abuse. “This programme is part of our efforts to promote and increase treatment and health care for drug users worldwide.”

Prevention and treatment resources

In its new Global Health Observatory Database – Resources for Substance Use Disorders, WHO provides details on the resources allocated to the prevention and treatment of alcohol and drug-related problems in 147 countries. The new database covers 88% of the world population and enables countries to compare their services with those available in other countries and to address treatment gaps.

Worldwide, an estimated 230 million people or about 5% of the population aged 15 to 64 used illicit drugs at least once in 2010. Some 27 million of these people have severe drug problems. According to WHO, illicit drug use is one of the top 20 risk factors to health worldwide and drug use disorders are associated with an increased risk of other diseases such as HIV/AIDS, hepatitis, suicide, overdose deaths, tuberculosis and cardiovascular diseases.

Drug treatment also benefits society and the economy

“Drug dependence must be treated primarily as a disease, and not as a crime,” stresses Dr Vladimir Poznyak, Coordinator of the Management of Substance Use team at WHO. “Countries increasingly realize the benefits of drug treatment for the individuals themselves but also for society and the economy.”

Treating drug users in their community has proved to be a very effective approach. “We provide the patients with a mix of treatments in familiar surroundings,” explains Dr. Dorit Nitzan, the Head of the WHO Country Office in Serbia. “The treatment can include medication, psychosocial support as well as support to the patient’s family and friends. In addition, we provide training to medical experts and health workers.”

Under the WHO/UNODC programme, over 500 health care professionals in Serbia have been trained to provide evidence-based care to people with drug use disorders. Patients who benefit from the services include heroin users from underprivileged populations such as Roma who are not covered by health insurance and had therefore no access to treatment and care before.

The waiting room of a methadone clinic, Serbia
Djordje Novakovic

“Savski Venac” was the first primary health care centre to provide methadone in Belgrade. The patients receive treatment and support from skilled staff in an easy accessible environment. There are additional benefits; while the health of the individuals improves other problems often associated with drug use, such as violence, criminal behaviour and social exclusion, decrease.

Apart from Serbia, also Albania, Haiti and Pakistan have participated in the programme from the outset. Due to the positive results, the programme has now been expanded to a total of 15 countries.

Jovan says he is grateful that he is being treated at “Savski Venac”. This has given him the chance to reclaim his life. “I’ve been clean for the last two years. I am now faced with all the ‘normal’ problems: employment, health, everything that everyone else is preoccupied with as well.”

1 Name changed to protect identity.