North Macedonia

Death Penalty 100/100

1 Does the country retain the death penalty for drug offences? No

source: Harm Reduction International (2021), THE DEATH PENALTY FOR DRUG OFFENCES: GLOBAL OVERVIEW, Available online at: https://www.hri.global/death-penalty-2020

North Macedonia is not listed as one of the states that retains the death penalty for drug offences in Harm Reduction International's (2021) The Death Penalty for Drug Offences: Global Overview 2020.

2 What is the extent of death penalty application for drug offences in the country? N/A

source: Harm Reduction International (2021), THE DEATH PENALTY FOR DRUG OFFENCES: GLOBAL OVERVIEW, Available online at: https://www.hri.global/death-penalty-2020

Not Applicable

Extra-Judicial Killing 100/100

3 To what extent is the practice of extra-judicial killing prevalent in the course of military and police anti-drug activity? Not at all

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Militarised Policing 0

4 To what extent are military or special security forces are involved in drug operations? To a very large extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Life Sentencing 100/100

5 Is there provision in legislation or sentencing frameworks for the imposition of life imprisonment for drug offences? No

source: GDPI Coding Team.

No reference to life imprisonment for drugs-related offences exists within the legislation.

6 Where there is provision in legislation or sentencing frameworks for the imposition of life imprisonment for drug offences, what is the nature of such sentences? N/A

source: GDPI Coding Team.

Not Applicable

7 How frequently are formal life sentences imposed for drug use and personal possession offences? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

8 How frequently are formal life sentences imposed for drug supply offences (production, dealing, or trafficking)?  N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

Non-consensual confinement 50/100

9 To what extent is there a practice of non-consensual confinement in compulsory drug treatment centres? To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Human Rights Violations 50/100

1 How often are suspects in drug cases subject to violence or torture by the police? Rarely

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

2 To what extent does arbitrary arrest and detention for drug offences exist? To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

3 What is the country's score on the World Bank Fair Trial Indicator? Substantially Restricted

source: World Bank Data Repository: https://tcdata360.worldbank.org/indicators/hd45eb4d6?country=BRA&indicator=41895&viz=line_chart&years=1975,2019

Some elements of fair trials exist but the courts are not fully independent of the government and/or the justice system is characterized by widespread corruption, intimidation and inefficiency.

Equity of Impact of Criminal Justice Response 25/100

4 To what extent does enforcement of drug policy disproportionately impact certain ethnic groups?  To a large extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

5 To what extent does enforcement of drug policy disproportionately impact women?  To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

6 To what extent does enforcement of drug policy disproportionately impact low-income groups? To a very large extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Mandatory minumum sentencing and pre-trial detention 37/100

7 Do the state’s drug laws or legal frameworks include mandatory minimum sentences for any drug offences? Yes

source: GDPI Coding Team.

Criminal Code, Article 215: several drugs-related offences carry mandatory minimum sentences.

8 For states whose drug laws or legal frameworks include mandatory minimum sentences for any drug offences, does this relate to first offences or multiple offences? Mandatory Minimum Sentences Apply to the First Offence

source: GDPI Coding Team.

No provision is made for leniency in the first instance. Therefore, all MMS are taken to apply for first offences.

9 Do the state’s laws include mandatory pre-trial detention for drug offences? No

source: GDPI Coding Team.

Certain drugs-related offences are only met with fines. Therefore, they do not warrant jail time, pre-trial or otherwise.

Alternatives to arrest/prosecution/conviction/punishment 85/100

10 Is there any provision in state criminal justice policy for alternatives to arrest, prosecution, conviction and/or punishment for drug-related offences? Yes

source: GDPI Coding Team.

Criminal Code, Article 62.5: those convicted of drugs-related offences may be sentenced to compulsory treatment in lieu of imprisonment.

11 Do alternatives exist at the point of initial contact with law enforcement (i.e., the police or other law enforcement officers) – before arrest and/or prosecution? Yes

source: GDPI Coding Team.

Fines may be issued for a range of drugs-related offences (Law for Narcotic Drugs: Article 92).

12 Do alternatives exist after the point of arrest, but before conviction or formal criminal court proceedings? Yes

source: GDPI Coding Team.

Criminal Code, Article 215.5: individuals who aid the court in revealing crimes (notably the identification of ring leaders) may be 'acquitted from punishment'. The wording here indicates that this process occurs before final sentencing.

13 Where individuals are convicted with a final sentence (courts), are there alternatives to incarceration for drug offences? Yes

source: GDPI Coding Team.

Criminal Code, Article 62.5: those convicted of drugs-related offences may be sentenced to compulsory treatment in lieu of imprisonment.

14 Do alternatives to arrest, prosecution, conviction and/or punishment for drug-related offences include treatment or care elements?  Yes

source: Survey of Experts in States' Drug Policy

This was ascertained through the GDPI survey of survey of experts in state drug policy.

15 Where alternatives to arrest, prosecution, conviction and/or punishment for drug-related offences include treatment or care elements, is relapse / non-attendance / treatment “failure” associated with subsequent imprisonment or punishment? Yes

source: Survey of Experts in States' Drug Policy

This was ascertained through the GDPI survey of survey of experts in state drug policy.

16 Where alternatives to arrest, prosecution, conviction and/or punishment for drug-related offences include treatment or care elements, are a range of treatment options and modalities made available to people based on their clinically assessed need or preferences? Yes

source: Survey of Experts in States' Drug Policy

This was ascertained through the GDPI survey of survey of experts in state drug policy.

Extent of imprisonment of individuals involved in non-violent drug-related offences 25/100

17 To what extent does the pursuit of state drug policy result in the imprisonment of non-violent offenders? To a large extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (adjusted for topic confidence levels) of the GDPI survey of experts in state drug policy.

Decriminalisation Policy 0

18 Is there a provision in national legislation or in official national policy documents for the decriminalisation of drug use and the possession of drugs for personal use?  No

source: GDPI Coding Team.

Law for Narcotic Drugs, Article 28: the cultivation of opium poppy is legal under certain circumstances. Likewise, the medical use of marijuana was legalised in the 2016 amendment of the Law on Control of Narcotic Drugs and Psychotropic Substances (29a, 95d, and 95d). Under the definition of decriminalisation used in this project, this results in a coding of 'no' here.

19 What % of the population live in a state/territory with decriminalisation provisions? N/A

source: GDPI Coding Team.

Not Applicable

20 For states or sub-national units with decriminalisation, what substances are decriminalised? N/A

source: GDPI Coding Team.

Not Applicable

21 Where there are administrative (non-criminal) sanctions for drug use and possession for personal use, what is the severity of these sanctions? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

22 To what extent has decriminalisation in this state been effective in diverting people who use drugs away from the criminal justice system? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

Extent to which State Policy Prioritises Harm Reduction for People Who Use Drugs 48/100

1 Is there an explicit supportive reference to harm reduction in national policy documents? Yes

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

2 Are people who use drugs included in the HIV national strategic plan? Yes

source: GDPI Coding Team.

Injection drug users were explicitly mentioned within older iterations of the national HIV/AIDS plan. So, it stands to reason that they'd still be included in the latest 2017-2021 plan, though I cannot find a pdf copy of this.

3 In states where people who use drugs are included in the HIV national strategic plan, are people who use drugs specified as key and vulnerable populations to be targeted for services? Yes

source: GDPI Coding Team.

Injection drug users were explicitly mentioned as as a vulnerable population within older iterations of the national HIV/AIDS plan. So, it stands to reason that they'd still be included in the latest 2017-2021 plan, though I cannot find a pdf copy of this.

4 Are people who use drugs included in the Hepatitis-C national strategic plan? Coding Team Unable to Find Plan

source: GDPI Coding Team.

No plan could be found.

5 In states where people who use drugs are included in the Hepatitis-C national strategic plan, are people who use drugs specified as key and vulnerable populations to be targeted for services? N/A

source: GDPI Coding Team.

Not Applicable.

6 Are people who use drugs included in the Tuberculosis national strategic plan? No

source: GDPI Coding Team.

While discrete national TB plans have existed in the past, North Macedonia signed on to the WHO European Region TB Action Plan in 2016 in lieu of this (https://drive.google.com/file/d/1tQURV4Fi3NyE7nAAHPGQQlzQaLCq1pO_/view?usp=sharing). This plan does not contain explict reference to drug users.

7 In states where people who use drugs are included in the Tuberculosis national strategic plan, are people who use drugs specified as key and vulnerable populations to be targeted for services? N/A

source: GDPI Coding Team.

Not Applicable.

Harm Reduction Funding 31/100

8 How Adequate Are Levels of Harm Reduction Funding Relative to Estimated Need? Moderately low

source: Harm Reduction International GDPI team

Estimated by Harm Reduction International at between 30-49% of harm reduction resource needs met (see project methodology for details)

9 Which of the following best describes the sustainability of harm reduction funding in the state over the next 3-5 years? Uncertain

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Harm Reduction Intervention Availability and Coverage 42/100

10 Is at least one needle and syringe programme operational in the state? Yes

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

11 Which of the following best describes the availability of needle and syringe programmes for people who inject drugs? Limited availability

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

12 Is at least one opioid agonist therapy programme operational in the state? Yes

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

13 Which of the following best describes the availability of opioid agonist therapy programmes for people who use opioid drugs? Limited availability

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

14 Is peer distribution of naloxone available in this state? No

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

15 Which of the following best describes the availability of naloxone for people who use opioid drugs? Very Limited Availability

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

16 Is at least one in-prison needle and syringe programme operational in the state? No

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

In this instance, although NSP is listed as being available in at least one prison in Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition, the GDPI expert survey respondents were unanimous that that NSP is unavailable in prisons. As such, we have coded North Macedonia 'No' in this instance.

17 Which of the following best describes the availability of needle and syringe programmes to people in prison? Unavailable

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

18 Is at least one in-prison opioid agonist therapy programme operational in the state? Yes

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

19 Which of the following best describes the availability of opioid agonist therapy to people in prison? Wide availability

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

20 Is at least one drug consumption room operational in ths state? No

source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2020

Source: Harm Reduction International (2021), The Global State of Harm Reduction 2020 - 7th Edition. Available at: https://www.hri.global/global-state-of-harm-reduction-2039

21 Which of the following best describes the availability of drug checking services to people who use drugs? Unavailable

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Equity of Access to Harm Reduction Services 66/100

22 To what extent are there disparities in access to harm reduction services due to individuals’ ethnicity? Not at all

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

23 To what extent are there disparities in access to harm reduction services for women, including during pregnancy? To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

24 To what extent are there disparities in access to harm reduction services due to individuals’ sexual orientation and/or gender identity?  To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Policy prioritisation of availability and accessibility of controlled medicines for the relief of pain and suffering 42/100

1 Is there an explicit provision in national legislation (or in official national policy documents and regulatory instruments) that establishes the government’s obligation to make adequate provision to ensure the availability of controlled medicines for the relief of pain and suffering? Yes

source: GDPI Coding Team.

The National Drug Strategy 2014-2020 makes clear the government's obligation to provide controlled pain medication for the therapeutic treatment of drug addicts.

2 Is there an approved national medicines policy plan that recognises the importance of the availability and accessibility of controlled medicines for the relief of pain and suffering? No

source: GDPI Coding Team.

Though the National Drug Strategy 2014 - 2020 makes clear the government's obligation to provide controlled medicines to ease pain and suffering, it recognises the need for an official plan to implement this. This implies that such a plan does not exist, or at the very least did not exist in 2014. Moreover, no formal medicines plan could be obtained, increasing the likelihood that it does not exist.

3 To what extent does the policy-making process relating to controlled medicines meaningfully include stakeholders such as medical boards, health professionals (including pharmacists), patients, and representatives of patients?  To a small extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

De facto availability and accessibility of controlled medicines for the relief of pain and suffering 63/100

4 What range of narcotic drug consumption does the state fall into? Moderate Access

source: INTERNATIONAL NARCOTICS CONTROL BOARD (2021) 2020 Narcotic Drugs Report. Available at: https://www.incb.org/incb/en/publications/annual-reports/annual-report-2020.html

Source: INTERNATIONAL NARCOTICS CONTROL BOARD (2021) 2020 Narcotic Drugs Report. Available at: https://www.incb.org/incb/en/publications/annual-reports/annual-report-2020.html

5 To what extent are there geographic disparities in access to controlled drugs for the treatment of pain? To a small extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Equity of Access to controlled medicines for the relief of pain and suffering 75/100

6 To what extent are there disparities in access to controlled drugs for the treatment of pain due to individuals’ gender? Not at all

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

7 To what extent are there disparities in access to controlled drugs for the treatment of pain due to individuals’ socio-economic status? To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

8 To what extent are there disparities in access to controlled drugs for the treatment of pain due to individuals’ ethnicity? Not at all

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

9 To what extent are there disparities in access to opioid analgesics for the treatment of pain for people who use drugs? To a moderate extent

source: Survey of Experts in States' Drug Policy

This score reflects the median result (weighted by topic confidence level) of the GDPI survey of experts in state drug policy.

Filter Question for 'Development' Dimension N/A

1 Does the country include ‘alternative development’ or ‘sustainable development’ programmes to provide alternatives to the cultivation of crops used for illegal drug production? No

source: GDPI Coding Team.

The National Drug Plan 2014-2020 makes no provision for alternative development approaches to drug crop cultivation.

Alternative Development Policy Design N/A

2 Are Alternative Development policies and programmes embedded within a broader development programme? N/A

source: GDPI Coding Team.

Not Applicable

3 To what extent are local communities, participants, and (where applicable) indigenous and minority groups meaningfully included in the design, implementation, monitoring, and evaluation of alternative development policies and programmes? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

4 To what extent is the protection of the environment prioritised in alternative development policy and programmes?   N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

5 To what extent does alternative development operate within a framework of militarized/security sector operations as part of security policy? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

Management of Crop Eradication N/A

6 Does alternative development policy include provisions for forced crop eradication? N/A

source: GDPI Coding Team.

Not Applicable

7 Where provision is made for forced crop eradication, does policy also make provision for aerial spraying in forced crop eradication? N/A

source: GDPI Coding Team.

Not Applicable

8 To what extent are alternative development programmes sequenced to ensure that targeted households have adopted viable and sustainable livelihoods in advance of any crop eradication efforts? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

Efficacy of alternative development policy for key beneficiaries N/A

9 To what extent do alternative development policies and programmes facilitate the empowerment of women? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

10 To what extent do alternative development policies and programmes benefit young people? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable

11 To what extent do alternative development policies and programmes implement a successful ‘pro-poor’ strategy? N/A

source: Survey of Experts in States' Drug Policy

Not Applicable