Bulgaria Country Drug Report 2018

Harm reduction

In Bulgaria, harm reduction as a public health objective is addressed in the Narcotic Substances and Precursors Control Act and the terms and conditions for implementing harm reduction programmes are set out in a regulation issued by the Minister of Health in 2011.

Harm reduction interventions

In 2016, seven harm reduction programmes, operated by non-governmental organisations (NGOs) were active in Bulgaria, providing services at 8 fixed and 122 outreach sites across the country. The work of these NGOs is funded in the framework of the National HIV/AIDS Control and Prevention Programme.

In addition to providing services to people who inject drugs, these NGOs also address the needs of other high-risk groups, such as people of Roma origin who use drugs and sex workers. The services provided include information and training on safe injecting, safe sexual behaviour and the prevention of overdoses and infectious diseases; testing for blood-borne infections; and supplying sterile injecting equipment. Most services are provided through outreach workers in the street or in shelters and institutions, but drop-in centres are available. In recent years, the number of syringes distributed through specialised agencies has fallen. In 2016, an estimated almost 215 000 syringes were distributed through specialised agencies and outreach programmes.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No No No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czech Republic Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.