We crossed Albania in September 2010, going from Montenegro (crossed border South of Podgorica) to Macedonia (crossed border towards Ohrid). No visa needed for a Brit. Carnet not needed. Usual green card insurance is OK. Border crossings were relatively painless and quick.
Roads that we were on were all paved but very patchy in quality (even the biggest routes). A bit like driving through roadworks all the time. Road surfaces often filthy with little grip in wet. Road manners of locals left a lot to be desired (e.g. driving the wrong way down dual carriageways, crossing central reservations, etc). No white lines seen on any roads. Millions of speed limit signs (50?kph) on all main roads which are totally ignored by everyone. Agree with previous comment about avoiding Tirana - crappy place with few useful roadsigns. If you stop in the city, kids tend to congregate and attempt to pinch loose stuff off your bike.
Did not travel in the South of the country, so can't comment on that.
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