Two years ago in Skopje, Macedonia, a pregnant 16-year-old girl sought treatment for problematic opioid drug use but kept hitting a brick wall. Every program she contacted for help gave her the same answers: they didn’t know how to administer the treatment she needed, they were not competent to treat minors, and so on.

Meanwhile, the girl also couldn’t find anyone who could give her the permission legally required for a minor to be hospitalized; her mother had legal custody and could not be found. The girl would go on to have a miscarriage. She is now 18 years old, a problematic user of opioids, and on the streets.

As this young woman’s story shows, there are times when, despite people’s best efforts, the laws governing social services in Macedonia can make situations which are already complicated even worse. Even clearer is the fact that too many Macedonian institutions are simply not equipped with the medicine, expertise, or guidance they need to help children who are using drugs.