Response stories

Montenegro: Wind of change in healthcare system that brings unexpected moments to the key groups

By the Strategy of Montenegro for the Prevention of Drug Abuse 2013-2020 addiction treatment is conducted within the health care system in the country, and rehabilitation measures aimed at social reintegration and maintaining achieved abstinence are carried out in the social security system. Treatment is planned and implemented in accordance with the needs of each individual and changed, if necessary, in relation to the condition. During the treatment only professionally justified and validated procedures should be used. That means guidelines for the treatment of addiction are necessary, as well as quality standards in relation to treatment introducing in the institutions that provide such services. Also, buprenorphine substitution has not yet been introduced into regular practice in all centers for substitution therapy, as well as changes in healthcare system bring unexpected and not always positive moments to the key groups populations. 

Interrupted treatment… due to the health system

On August, 2022 a user of substitution therapy (OST) contacted REActors with a complaint that his right to health treatment was violated in the way that the distribution of the drug buprenorphine, which was prescribed as a therapy for opioid addiction by a psychiatrist, was interrupted. Due to the changes in the functioning of health system of Montenegro, which is reflected in the abolition of mandatory health insurance and the payment of contributions for the same, as a result of which the Health Fund, as an institution responsible for the procurement of medicines, was left without funds for their purchase, it was difficult to provide many medicines. And so also in this particular case, when there was a cessation of therapy for people using a substitution drug. 

Massive work of REActors

Immediately after receiving the notification from the patient, representatives of NGO CAZAS contacted the competent institutions to check the credibility of the complaints. They tried to react as soon as possible with a press release that was carried by all relevant media and with which they informed the public about the massive violation of the rights of OST patients and called on the authorities to solve the problem as soon as possible. REActors also informed the user who contacted them of his rights, and gave him a copy of the complaint form to the health institution. With this support, the user filled out a complaint, which REActos sent to the health institution.

Thanks to the quick reaction of the members of the organization, sending of press releases and contacting of health institutions, the therapy for OST users continued already the next morning. Complaints submitted to the health services are awaiting a response.

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Response stories

Unprofessional attitude of medical stuff in Montenegro that brings to the violation of rights

In 2013 Ministry of Health, Montenegro adopted Strategy for the Prevention of Drug Abuse 2013-2020 which proclaimed that country provides conditions and environment in which there is no place for discrimination. However, the reality shows that the situation is reverse – stigma and discrimination against people, who use drugs are still the largest obstacles to prevention and providing the necessary measures for the rehabilitation of affected persons.

“You’re a liar!”

On June, there was a violation of the rights of the patient Sofia (name was changed), who is a woman, who use drugs and user of the OST service. The violation of her rights as a patient occurred in the way that she was exposed to the doctor’s unprofessional attitude and inappropriate comments during her visit to the infectious disease clinic. A few days after the event, she contacted REActor, complaining about the doctor’s attitude towards her on the medical examination. During the meeting with the REActor, the patient explained that in the earlier period she was involved in the treatment of HCV treatment, which at that time in health system of Montenegro consisted of pegasus drug therapy, with which a 100% cure is not possible. During the conversation, the patient explained to the doctor that she was positive for the presence of the HCV virus at the last test. She also informed the doctor that she followed the rules and avoided risky behaviors and regularly tested for the presence of psychoactive substances, but despite everything, it was again positive. Sofia explained that in the meantime she had a child and that she had an additional obligation to solve the problem. The doctor reacted negatively to everything she told. He accused her of lying and of using psychoactive substances again. The patient understood from his story that he did not want to include her in the treatment process to which she is entitled and was disappointed because he used offensive words at times.

Situations won’t be repeated

After the conversation and in agreement with the patient, the NGO CAZAS requested and held a meeting with the director of the infectious disease clinic, where she was informed about the situation and received assurances, which were later confirmed, that such situations would not be repeated and that the patient would be enabled to enjoy all the rights she has the law guarantees. REActors decided on this approach after talking with the client, because together they came to the conclusion that this is the best option at the moment, considering the fact that the patient must be involved in HCV treatment through the infectious disease clinic. The patient expressed her fear that the initiation of a more serious procedure would not negatively affect that process, if the treatment was conducted by the same doctor from whom she experienced discrimination. Although REActors guaranteed her that they would enable her rights as a patient to be respected in the regular and legally prescribed procedures, as a measure of compromise in this agreement, the patient was assigned another doctor at the infectious disease clinic.


By the records from 2014, among the population that is using drugs, 53 percent is infected by hepatitis C. In 2018, the positive list of medicines had 1156 medicines available publicly through the Health Insurance Fund. The list has been expanded with 114 new medicines that cover a wide range of diseases: hypertension, diabetes, cancer, thrombolytic therapy, new medicines for infectious diseases such as HIV and hepatitis C, medicines for transplantation, autoimmune diseases and mental disorders. 

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