Drug Policy in Contemporary Serbia
Use of recreational drugs in modern Serbia is endemic; and it also has a series of profound but misunderstood effects. Both the international community and the country's domestic institutions must adopt more sophisticated tools to manage these problems.
Belgrade has a hidden epidemic of recreational drug use, and this article discusses the nature of the epidemic and how best to treat it from a social policy point of view. This author does not believe that criminalisation of drug use is a useful or sustainable tool in reducing the use of harmful recreational narcotics by young people (nor indeed by anyone), and there must be alternatives. In addition there is a hidden drug gang war in Belgrade, which is dangerous and to which the criminal law ought to be applied to prevent people from suffering from violence.
To understand the nature of the problem, we must go back to the 1990’s and the events leading to the overthrow of Slobodan Milosevic. Yugoslavia did not historically have much of a drug problem (or if it did then there are no statistics about it). In the 1990’s across Europe, so-called “party drugs” - that is to say, recreational narcotics consumed in conjunction with music parties, become popular amongst young people. The reason for this was because the party drugs in question - and there are two main ones although there are several others - are synthetic and can easily be made in more or less ad hoc circumstances in factories or even in people’s homes. Hence these narcotics started to replace markets in natural (non-synthetic) recreational narcotics, such as heroin, cocaine and marijuana.
The rise of youth movements associated with music in the movement to overthrow Slobodan Milosevic’s regime in Belgrade in early October 2000 (the so-called 'Bulldozer Revolution') became associated with recreational drug use. Because the then-Yugoslavian economy had collapsed under the weight of international sanctions, Serbia’s pharmaceutical factories had excess capacity. It is often overlooked that Serbia is one of Europe’s major pharmaceutical exporters, just because of the locations of the pharmaceutical factories on Serbian territory as constructed during the communist period.
The excess pharmaceutical capacity was used to make recreational narcotics, which could be sold cheaply to the impoverished and politically agitated youth of the time. Music festivals and mass music events were built up around the availability of recreational narcotics manufactured in Serbian pharmaceutical factories because the foreign markets for those factories’ medicines had to an extent melted. Soon the pot-heads of Europe had caught on, and Belgrade developed a reputation as the nightlife centre of Eastern Europe. If you wanted music plus recreational drugs, the capital of Serbia was (and to a substantial extent remains, some twenty years later) the place to come.
The two principal recreational narcotics consumed in Belgrade are high (extra-medical) doses of two psychiatric pharmaceuticals. One is methamphetamine (also known as Desoxyn), a stimulant medically typically used to treat psychiatric problems in the field of attention-deficit hyperactivity disorder. In its recreational form, in which it is consumed in massive overdose, it is known in the United States as 'crystal meth’. It is also known in England as 'speed' or 'whizz' in powder form.
The other main pharmaceutical used as a recreational narcotic both in Serbia and indeed across the world is 3-4-methylinedioxymethamphetamine, a narcotic originally developed as an anti-depressant. Although some countries have come close to doing so, no country has actually licensed 3-4 methylinedioxymethampthetamine as a pharmaceutical, mainly because relatively little is known about its long-term side effects (if any); and also because it has become so associated with being a ‘party drug’ that substantial stigma is attached to it within the halls of pharmaceutical regulatory authorities.
Nevertheless it is a pharmaceutical; it is made in pharmaceutical factories; and it is relatively easy to produce. Phsychopharmacologically, it is an anti-depressant with a pathway of action believed similar to lawful anti-depressant medications in the class of what is known as SSRI inhibitors or similar such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine. In its recreational form it is is generally known as ‘MDMA’ in crystalline form, and ‘Ecstasy’ or 'E' when produced in tablet form mixed with an insoluble substance intended to procure delayed release (often an acrylic).
Anecdotal evidence suggests that amphetamine is substantially more popular in Belgrade than MDMA, because it is virtually half the price: 4.50EUR as opposed to 9EUR for a ‘hit’. These are approximate prices and they do vary depending on availability; the street markets in these substances is remarkably liquid even from one week to the next.
To the best of the knowledge of the medical profession that specialises in drug abuse, amphetamine is much more damaging to a consumer's welfare than MDMA, because it is in the class of psychiatric medications labelled as a physically ‘highly addictive substance' by the Medication Fact Book for Psychiatric Practice, a standard book on the effects of psychiatric pharmaceutical medicines. Anyone who was watched the television series ‘Breaking Bad’ may have formed something of a admittedly caricatured view of the effects of recreational use of this pharmaceutical upon both the individual and society. By contrast MDMA does not appear to be physically addictive. However there have not been any very reliable studies, a problem common in assessing the effects of proscribed narcotics - it's impossible to gather reliable statistical data because it is illegal to do so.
Both narcotics create similar primary effects: euphoria and a reduction in the capacity for analytical thinking. Both these drugs are made in pharmaceutical factories in Serbia. As, in other countries, they are typically made in domestic establishments for domestic use, compared to some other narcotics there is relatively little cross-border transport of these substances.
Now we we proceed to studying what has happened to the sale of these two narcotics in the course of 2021 in Belgrade, the city where the majority of such narcotics are consumed within Serbia. Recreational narcotics are what economists call 'luxury goods' (this is virtually a technical term within economics), which means that their demand curve is extremely steep relative to disposable income. In other words, when household budgets fall due to recession or inflation then luxury goods, including recreational narcotics, are the first things to get cut because they are non-essential.
Due to Covid-19, family incomes in Serbia are down and hence demand for these narcotics has reduced, particularly for MDMA (again due to its relative price).. Because street dealers generally buy on a 'sale or return' basis (a typical street dealer in narcotics does not have a capital base to do otherwise, or he or she would have progressed up the triangle of narcotics vendors), produced quantities have been falling heavily to meet lower demand.
Because amphetamine is cheaper, there has also been a proportionate preference-shifting from MDMA to amphetamine. This is obviously of the utmost concern, if one accepts the hypothesis that amphetamine is very damaging to the consumer but MDMA is mostly harmless. Professor David Nutt, the well-known English neuropsychopharmacologist, was famously removed from his position as Chair of the UK Advisory Committtee on Misuse of Drugs, for observing that taking MDMA. is far less risky than riding a horrse. Horse riding carries an adverse event about once every 350 exposures, whereas MDMA carries an adverse event about once every 10,000 times.
The point is a fairly straightforward one. The principal danger known to be involved in the consumption of MDMA is that a consumer at the height of MDMA elation may lose their balance and fall over or onto other people. This is generally how one identifies MDMA consumers in nightclubs; they keep falling over or into people. People can also fall off horses; but the typical damage done per incident of MDMA consumption is far less than that done per incident of horse riding. Nevertheless a variety of intensity of adverse events are associated with drug use, as the following chart, prepared by Nutt, indicates.
If one accepts Nutt’s data and analaysis, then the consumption of Ecstasy is substantially less harmful than the consumption of alcohol, and also less habit-forming. Nutt’s data is not perfect; two of the most difficult things to assess are cumulative harm of narcotics, as well as calculating dependency. Where there is physical dependency (as with methamphetamine), it is possible to measure dependency by measuring bodily reactions to withdrawal. Where there is so such obvious dependency (as with MDMA), it is not possible to measure that and hence one has to rely purely upon psychological surveys and the like that may be less robust.
In any event, medical facilitites are required both to assess the extent of these problems and to treat them where they exist. One of the main problems this writer sees is that Belgrade does not have the medical facilities to assist people physically addicted to pharmaceuticals, to overcome their addictions. It typically takes 10 days to 2 weeks to 'dry out' from a physically addictive pharmaceutical substance. By analogy one may be aware of the 10-day rule in drying out alcoholics; it takes exactly 10 days to remove the physical addiction from alcohol, interestingly irrespective of an addict’s body mass index (BMI) or one's general state of health and/or fitness. Similar sorts of principles are at work with other physically addictive drugs. It does not matter how large or fat you are; it will you take you the same amount of time to overcome a physical addiction in each case.
Overcoming an amphetamine addiction requires something like a week or so of close care. You cannot just go 'cold turkey’ with a person who has been taking large overdoses. You have to supervise the absence of the stimulant with careful use of medicines such as benzodiazepines, which are addictive in much the same way. So you have to taper down-up-down, under the supervision of experienced personnel and in a comfortable environment that reminds the person of having fun. The comfortable environment is to prevent people from leaving. 'Drying out' does not work in a plain, bare hospital ward, because either the patient leaves or they smuggle in drugs to overcome the boredom. Nor does it particularly work in prisons, because prisoners, all the more bored, have even greater incentives to smuggle drugs into the prison.
To put matters simply, for an amphetamine drug rehabilitation clinic you need a faux bar environment with beds upstairs and nurses, TV, videos and casual reading materials downstairs downstairs - and discreet locks on the outside of the exterior doors only, so that you're not allowed to leave for a week. That is how to lose your physical addiction to amphetamines. Belgrade has no such facilities. To open such a facility - a sort of Belgrade version of 'The Priory', a well-known English rehabilitation clinic that focuses upon physical comfort for its residents - might cost up to US$2 million to establish in Belgrade. This is not a lot of money by international standards. It would be a well worth investment by a philanthropic institution or a foreign government development grant.
There are other side-effects of these narcotics, as with all pharmaceuticals. Both methamphetamine and MDMA create physical problems during their periods of onset, including irritable bowel syndrome for MDMA and sexual dysfunction for amphetamines. But these issues have been documented elsewhere. They likewise need to be addressed in an atmosphere without stigma. In particular, the long-term effects on health of consuming eupohrics at above-medicinal doses is unknown and needs to be examined.
Now let us turn to the socio-economic consequences of reduction in demand amidst growing poverty in a middle-income country whose GDP per capita is barely US$7,100 per annum. Recent growing poverty in Serbia has been due to economic contractions relating to Covid-19. Because narcotics are luxury goods, demand drops and hence so does supply. The pharmaceutical factories do not produce as many drugs as they normally would, if fewer people are taking them. It is a waste of capital to produce something that cannot be sold and for which there are no foreign markets either. (Other countries can produce their own synthetic narcotics using their own factory facilities.) Normally in a situation of proportionately reduced supply and demand, a reduction can be observed in the number of middle-men - the surplus of such middle-men, given the reduction in traded goods, just retires.
But in low-margin drug dealing in Belgrade, this result is not being observed. The main reason appears to be that the costs of retirement from the middleman profession (i.e. street dealer) are too high. In Belgrade, street dealers appear to be recruited by persons at the bottom end of informal debt structures. In the absence of an enforceable legal debt collection system involving courts, mortgages and repossessions, and the garnishment of bank accounts and salaries, debts are lent informally and then collected informally. The system is tiered, so that a person may borrow money from a high-calibre lender, as it were, but upon default find that the high-calibre lender has ‘syndicated’ the loan elsewhere. In this way, debts get downgraded to 'debt collectors’ whose principal modus operandi is to compel the debtor to sell drugs 'on the street' on pain of violence, to cover the interest payments 'due' upon the debt. Ergo the margins are very narrow for the street dealer; everything is eaten up in 'interest payments'.
One phenomenon this author is told is becoming more common is street dealers selling amphetamine pills, asserting that they are 'E' pills at discount prices. The precise economics or medical effects of doing this are precise from clear to this author. But it must be a bad thing that people are sold one pharmaceutical while being told that it is another one. Given that every person reacts to individual pharmaceuticals somewhat differently, deception in sales must surely increase the potential dangers associated with the use of recreational narcotics.
Hence with street dealers unable to retire for fear of violence or murder, they fight with one-another - often with bloody results ignored by the Police for a variety of reasons. Add to this collapse in consumer demand in countries like North Macedonia and Albania, and Belgrade is suddenly awash with dealers seeking new markets, as the 'party capital' of Eastern Europe. This likewise increases violent frictions between existing dealers and the incomers from foreign lands who share language and cultural traits with the Serbs.
The way to combat drug misuse in Belgrade may therefore be to go after the loan sharks and debt collectors. Regulate these professions more thoroughly; have an independent police unit that polices the new regulations and ensures that they are enforced; and ensure long prison sentences for unlicensed lending or unlicensed debt collection methods. Ban doorstep collectors, and imprison those who insist. At the same time one should improve the efficiency of collection for legitimate lending - for example, the time taken to repossess mortgaged property upon default. (At the current time this is almost impossible and it can take years and endless facilitation payments - even then it may not happen). One needs also to improve the standards by which funds are garnished from bank accounts or employers.
All of the above is separate from an entirely different business, with different political and social problems, aimed not at the domestic market at all, which is the transit of Western European mainstream narcotics (by this I mean cocaine and heroin) through Serbia and indeed other Balkan countries. This problem is not unique to the Balkans, but the political circumstances of the Balkans render it particularly lucratively and relatively straightforward. Should one be a cocaine or heroin smuggler through the Balkans, then in INCOTERMS one might describe the margin is the difference between DAP Albanian and Montenegro ports (from Latin America or Pakistan); and FOB Western European distribution centres. A number of these used to be in Eastern Slovenia, but in recent years they have spread. The reason why the Balkans are a particularly propitious environment for the transit of the more expensive narcotics into their Western European markets is because the borders and law enforcement are both poor. It is possible to travel from the aforementioned ports into Western Europe with a minimum of customs supervision, and the situation has persisted for so long that the politics of the Western Balkan region have been substantially distorted by the cash flows created from these activities.
Cocaine and heroin cannot easily be bought in Serbia, for the obvious reason that demand is minuscule - at European prices of EUR60 a gram (heroin) and EUR80 a gram (cocaine), very few people in Serbia can afford it - save for the drug dealers themselves. Hence the distribution networks to regular citizens do not exist save for a small market of visiting Western European drug tourists in the summer months. As an analogy, imagine trying to buy a Rolls Royce in Kinshasa. It's the same sort of issue: so few people can afford it that there's no showroom.
This market for the transport in expensive narcotics is counter-cyclical viz-à-viz the Serbian domestic economy; it becomes more profitable as the Serbian economy slides, because the necessary facilitation payments involved in the transit of these more expensive narcotics drop as rule of law is corroded and law enforcement officials, meagrely paid, are more likely to accept lower facilitation payments. The route of course is well-known, from the Albanian and Montenegrin coast through Serbia then Bosnia, to Croatia and onwards. Economics teaches us that a poorer Serbia entails a greater flow of these premium narcotics to Western Europe. Nevertheless 2020 and 2021 has seen violence between regional drug cartels involved in moving these expensive narcotics, because demand for those narcotics in Western Europe has agains eroded because they are likewise luxury goods. And for the same reasons - the dealers in the Balkans are stuck in spiders’ webs of complex debt arrangements - it is for them to retire when demand from their Western European purchasers collapses.
The most effective means of undermining trans-Serbian premium narcotics flows would be to secure the borders and promote rule of law. The measures involved might include the following: (a) a 'land swap' with Kosovo, fixing currently unstable and de facto open borders; (b) political stability in Bosnia and Herzegovina, closing the (very) large numbers of informal borders that country has; (c) Serbia’s admission to the Schengen Agreement, tightening all Serbia's borders, most of which in fact are porous (there is no neighbour of Serbia for whom you need to show an identity document to cross the border, if you know where the informal roads are); and (d) capacity building investment in rule of law in Serbia.
There is much work to be done, and the regional political measures described above have been the subject of much writing elsewhere. Nevertheless all these problems are likewise essential to address if one is to control the flow of expensive narcotics through the Western Balkans. The fact that these narcotics flows are so lucrative in comparison to local salaries is one of the reasons why the Western Balkans remains blighted by poor rule of law more generally, with all the problems that entails, including glamorisation of professions related to the transit of drugs; social acceptance of drug use; the influence of drug money in politics; and the suppression open debate about dealing with drug problems for both people and society.