Dorian’s case – Aksion Plus, Albania

Dorian is 22 years old boy – for the last six months he is not using heroine anymore. Adding six month of methadone therapy we may say that he is clear for more than one year. During the last year he is tested negative for heroine (in two tests he resulted hashish positive).

Dorian was admitted a tour center two years ago, accompanied with one of his relatives. At that time he had some problems with his family members because of his drug abuse. He belongs to a strong family with very good moral and social values. When he was introduced at the center he was almost 20 years old having a four years career on drugs. He started with hashish and then he continued with heroine and ended by injecting it. He is intelligent, with good results in school, and because his family has good income he could manage to procure drugs. But some problems related to his drug use began to show up.

It was clear that he was forced from the family to enroll to our program – after the first he interview he admitted this fact. Before coming at the Methadone therapy he had three negative attempts of detox at the Military Hospital followed by immediate relapses. During the first interview he didn’t speak too much and it was not easy to communicate with him – he is a sort of calm and introverted person, very often hermetic and mute. He liked to listen heavy metal and other death oriented hard rock bands – it was obvious he admired that type of music – his heroes were rock stars, and he was behaving like them.

In the following months we had a long experience of therapy with him – ups and downs as he started to open up. He liked to experiment with drugs but he was not a poly drug abusers. He regularly used heroine but also hashish and benzodiazepines in order to feel a combined and a different effect. In the first period of heroine tests he resulted positive. After recurrent and failed attempts to talk to him one day he said: “yes, I’d like to talk…”.

In fact we started to talk with him; his life style, his perspective, myths populating his mind and the real facts. We made him a proposal: we will communicate but this communication will break down at that moment when the heroine testing will result positive. This was a very challenging step, but we had nothing to lose. As time passed by things started to change for better – he started to change his behavior, his friends and even he cut his hair – he swore that never will cut his hair during his life on earth. At that time we decide to hire him as a volunteer at our center. At the beginning he did whatever he was asked to – bringing cups of coffees, cleaning the rooms and so on. He repeatedly said to us that being a volunteer gives him self-confidence not to take heroine anymore.

One night one of our therapist had a phone call from Dorian, he was having a strong temptation to use drugs – he admitted to the therapist. It was a relief and a pleasure for us to hear that – in general clients admit of using heroine after taking it. The progress was a little but steady as the counseling advanced. He was a smoker too, and he was using less cigarettes per day. He was also involved in our MMT project in prison.

Ten month ago he said to us that he intends to taper the dose as he wanted to quit methadone “afterwards I’d like to resume my studies”. Some years before he was studying in Germany but he interrupted because of drug related problems. After a consultation with the Aksion Plus staff and his family members we decided to start the countdown with the methadone. A positive factor was the exploration of myths and misunderstandings with methadone – the so-called methadone dependence and other myths. Actually we trusted him a lot and eventually he quit therapy in seven weeks. In the following month he admitted having some minor problems with hashish but he did not smoke anymore, he was having only one coffee a day and started some sport activities.

At present he is negotiating with the University in Germany to begin with his interrupted studies. He is reading a lot and preparing himself for the up coming challenge…

After he was admitted at our center, three of his friends followed him, and now they are also clear of drugs. Dorian laughingly says: “myths about drugs are really dangerous…”.

Some days ago we were invited for a coffee by a Dorian’s family member – he wanted to thank all of us – tomorrow Dorian is departing to Germany to pursue his studies. Before Dorian was also sleeping on the road… Farewell, my friend – have a nice trip – life has so many pitfalls and battles that should be won – until the end of time.

“The girl ” from Shkodra

“I am not like the others and this makes me suffer for the life I am leading”. She is only 19 years old, from 6 years now on it is not he but has another status expressed by her dresses, her look and her way of staying. Being homosexual is not easy because the majority of the societies do not accept this .Being homosexual and sex worker is even more difficult because you are doubly discriminated end excluded from the family, the society and the community.

Till 11 years old Krista had lived with her family in Shkodra. She had always worked as a beggar due to the economic difficulties. She had never frequented school and she doesn’t know how to write and to read. She had never thought that her life would be so difficult, but in this moment she doesn’t see any possibility to wriggle out from this circle, that is making her suffer so much like taking her breath away.

When she arrived in Tirana for nearly 2 years she slept in the streets of Tirana and she begged. The building surrounding’s had been her bed and her roof. The cardboard had been her quilt while her dreams had been the” heaters” of her mind when she needed to live. When she first arrived she remembers that while sleeping as usually under the palaces someone threw her a mug. She awaked only in the morning and she considers herself a lucky person because death didn’t take her.

She began working as a sex worker when she was 13 years old; because she thought maybe her life would be easier in that way. The beginning was even more difficult because she was only a child and she had to deal with lot of unknown situations. The other adults involved her in their own groups and now she has her own areas and clients.

Her clients belong to different ages, from 15 to 60 years old. In some cases they return and ask for them again. She has her own working areas as the hotels, the area near the railway -station, etc. She prefers places with more light as she might be violated by the clients. She works till 1or 2 o’clock pm and during the day the number of her clients could arrive up to 5 or 6.

His families (which live in Shkodra) didn’t easily accept the fact that their son dresses, make up, or acts like a girl. They beat, violated and even “they even put electricity wires on my body” him but these things didn’t make him renounce from what he feels and believes. She already goes in her home only to see her mother, because as she says: ”the mother for a child is everything, and it is thanks to her I can get into the house”.

At the age of 11 years old she had smoked hashish, while actually she is a heroine user and it is for this reason she is treated in the methadone center “Aksion Plus”.

Living far from the family at an early age made her know and learn the most evil things in the world. She had suffered a lot but she had also learned how to protect herself from eventual life’s risks: “Only God knows our suffering”.

She is worried for her look, for the way she dresses , the way she stylizes her hair, how beautiful she is how she acts and how feminine she etc . She spends better part of her earned money for coloring and stylizing second the trends press the hairdresser. She feels good when she captures the attention like a woman or when the others consider her so.

She hasn’t done any medical visit because just they see her they say “go out”. Discrimination is very high and it follows her everywhere she goes. She is blackguarded, offended and some also hit. The main reason for these behaviors is always her look, which most of the society do not easily accept. After all this doesn’t means she must renounce from the life she had chosen to live, apart from the prejudices.

Her worst moment had been when she was in prison for 6 months. She was sentenced for ”prostitution”. She had made a suicidal attempting using different methods as cutting her reefs (she has a big sign of that in her left hand), hanging oneself, battering her head against the wall. She works afraid because she doesn’t want to return again in prison.

She had known a boy of 23 years old and for her this is most beautiful thing that had happened to her. She is enthusiastic about him and she wrote her name in her breast. She had spent the best moments of her life with him because her hearts beats when his name is mentioned. She wants to be always close to him and life for the eternity. He is convicted for stealing. The expectancy has been very difficult for her. She says:” I don’t know the exact period he is convicted because I don’t know where I could find this information”. Everyday she hopes he leaves as soon as possible the prison so they can live together and has their own house.

Methadone Maintenance Therapy in Albania – run by Aksion Plus

The first community based methadone center for nearly 110 veterans users of heroin started in 2005. This program was financed by IHRD and the Ministry of Health. At present GFATM is supporting this project. In cooperation with state structures Aksion Plus is striving to extend the methadone program in other towns of Albania where the drug use phenomenon is reaching dramatic levels. In Albania there are altogether 30-40000 drug users, 8000-10000 out of them are intravenous drug users.

The methadone treatment and other harm reduction activities are extended to drug users who are in prisons and in pre-trial settings.