EMCDDA Home
  • EN
Search

Harm reduction overview for Bulgaria

Map of Bulgaria

1. National context

In Bulgaria, the prevention of overdoses and drug-related infectious diseases is implemented in accordance with the National Strategy to Combat Addictions; the National Programme of Prevention and Control of HIV and Sexually Transmitted Diseases; the Narcotic Substances and Precursors Control Act; the HIV/AIDS Control and Prevention Programme financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the project funds will run until 2014); and the Regulation issued by the Minister of Health on terms and conditions for implementing harm reduction programmes, which was adopted in 2011.

In 2012, services to prevent drug-related infectious diseases were provided through needle exchange at 82 fixed sites located in 28 towns, mainly by NGOs. In addition to targeting people who inject drugs, these NGOs also target other risk groups, such as drug users of Roma origin and sex workers, and provide information materials on safe injecting, overdose and infectious diseases, and testing for blood-borne infections in addition to supplying sterile injecting equipment. Services are provided through outreach work in 54 units, four mobile medical consulting rooms and a number of drop-in centres. New demands on the qualification of harm reduction staff are related to the increasing proportion of stimulant injectors among clients at low-threshold facilities. In 2008 an Internet-based system for all agencies providing injecting equipment was set up, improving data reliability and consistency. An estimated 432 000 syringes were distributed through specialised agencies and outreach programmes in 2013. Syringes are also sold at pharmacies, but there are no pharmacy-based programmes providing sterile needles and syringes to PWID.

Ten NGOs, the NCA and 19 medical services in the bigger towns provide anonymous counselling and testing for HIV/acquired immune deficiency syndrome (AIDS). People living with HIV and AIDS are treated in five specialised wards established in clinics for infectious diseases. The government has not implemented specific vaccination campaigns against HBV among drug users since 2000, regardless of the fact that the Action Plan of the National Strategy to Combat Drug Addiction identifies this as one of the subtasks necessary to lower the prevalence of infectious diseases among PWID. It should be noted that in 1993 vaccination against HBV became mandatory in Bulgaria for all newborn infants.

top of page

2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  Limited
NSP availability at NUTS3  39 %
Drug use equipment distributed at specialised drug agencies (standard prevention material)
availability of alcohol pads  Yes
availability of dry wipes  No
availability of containers  Yes
availability of water  No
availability of condoms  Yes
availability of foil  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  Limited
Availability of universal hepatitis B immunization programme  Yes
Hepatitis B vaccination programme specific for high risk groups  No
ARV treatment of HIV infection Extensive

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes Limited
Availability of programmes for practical advice and training on 'safer use/safer injecting' Limited
Involvement of peer educators in the response to infectious diseases prevention Yes

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

top of page

3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Extensive
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  Limited
Availability of overdose response training  Limited

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities n.av.
Number of cities n.av.
Number of consumptions per year n.av.

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
N.Av. stands for ‘The intervention is not available in the country’.

top of page

4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  :  :  :  :  :  Does not exist
Festivals  :  :  :  :  :  Does not exist

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

top of page

5. References and links

Related EMCDDA resources

 

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

Contact us

EMCDDA
Praça Europa 1, Cais do Sodré
1249-289 Lisbon
Portugal
Tel. (351) 211 21 02 00
Fax (351) 218 13 17 11

More contact options >>

Page last updated: Monday, 01 June 2015