ANNUAL REPORT 2019-OMBUDSMANNATIONAL PREVENTIVE MECHANISM Furthermore, given that both evidence-based medicines (methadone and buprenorphine) are unavailable, neither in the prison health clinic nor in the Prilep General Hospital, psychiatrists are forced to prescribe medicines that are not the most adequate choice for the treatment of opiate addiction. On the other hand, the unavailability of buprenorphine contributes to the formation of a “black market” in the prison. Namely, the NPM team was informed that some convicts insist on receiving a recommendation from the psychiatrist for treatment with “buprenorphine” in order to get the opportunity to purchase it independently from the pharmacy through their families, so as to resell it later in prison. The NPM team received information that the “buprenorphine” tablets can be purchased illegally in prison and a 2 mg tablet costs 200.00 denars. From the conversations with the officials, as well as with the convicts, the NPM team was informed that in the institution it happened that convicts inject drugs/psychoactive substance if they find a needle, and often instead of using condoms they improvise protection with plastic bags. The fact that there is no female employee in the Security Department, so it is not possible to conduct searches of women who come to visits to the prison, allows the entering of psychoactive substances and/or drugs. 3.2.4. Use of coercive means Prison police officers have been trained in the use of coercive means, and twice a year they attend a shouting training with guns and automatic rifles. In the circle of the institution, when they are among the convicts, the officials do not walk with personal weapons, but only use radio connections. In the records kept for the used means of coercion, in 2018 and 2019 (until the day of the visit), two cases of use of coercive means were registered. Regarding the used means of coercion, in accordance with the “Standard Operating Procedures”, a “Report on the use of coercive means” is prepared, which states by whom and to which person coercive means were used, at what time they were used and the reasons for their use, what type of coercive means were used, data from the medical examination, data on other employees who were present during the event, medical finding, as well as an opinion by the prison police chief and the director of the institution for the justification of the use of means of coercion. In addition to the case, there are statements from the participants and witnesses to the event. Both cases of the use of coercive means in 2019 are assessed as justified. For each use of means of coercion, the director of the institution with special notification, in addition to the entire documentation, notifies the Directorate for Execution of Sanctions. Regarding the use of means of coercion, that is, means of tying during the escorts, it was emphasized that an individual assessment is made in each particular case. However, in addition to the officially registered cases of use of coercive means, allegations were made of the use of force, that is, physical harassment 122