1. National context
In Bulgaria, the National Drug Council (NDC) was established in 2001 and is responsible for the coordination, accreditation, monitoring and evaluation of treatment at national level. The secretariat of the NDC also coordinates the activities at regional level, and is responsible for the planning, implementation and the coordination of services at local level.
Drug-related treatment is mainly delivered by a combination of public and private institutions. Outpatient psychosocial treatment is predominantly financed by the National Programme for Prevention, Treatment, and Rehabilitation of Drug Addictions. Substitution treatment is funded by the National Health Insurance Fund. The financing of residential psychiatric treatment is the responsibility of the government through the Ministry of Health and through municipal budgets. In Bulgaria, drug treatment is provided by 11 state psychiatric hospitals; 12 psychiatric dispensaries, 11 psychiatric wards of multi-profiled hospitals offering active treatment, and four psychiatric clinics at university hospitals.
The most common form of drug-related treatment in Bulgaria is substitution treatment with methadone, a substance which was officially introduced in 1996. Methadone is provided by specialised drug treatment units, and in 2006 a national programme for the development of a system of methadone maintenance programmes in the Republic of Bulgaria for the period 2006–08 was adopted by the Council of Ministers. The strategic goal of this programme is to reduce drug use and the related health and social risks, through the development of effective and accessible programmes for methadone maintenance treatment. Furthermore, in recent years there has been an increase in the number of specialised units delivering methadone substitution treatment: in 2006 there were six specialised programmes, providing substitution treatment to 1 100 clients.
2. Treatment registries and monitoring systems
At the moment there is no national register for clients in treatment, but a new integrated system is being developed which will be based at the National Centre for Addictions.
3. Provision of treatment
Sources: The following data were submitted by National Reitox Focal Points through Standard Tables on Treatment Availability in 2004 and 2006, and National Reports in 2007. ‘N. Av.’ stands for ‘Non Available’ and ‘N. Ap.’ stands for ‘Not Applicable’.
|Total number of clients in drug-free treatment (inc. generic and specialised units)||N. Av.|
|Number of specialised outpatient units||approx. 10|
|Number of clients||N. Av.|
|Number of specialised inpatient units||1|
|Number of clients||250|
|Number of units providing substitution treatment||
|Number of clients in opioid substitution treatment||
|of which with methadone||
|Applied substances in substitution treatment||
Officially introduced in
MMT: INCB Technical reports 'Estimated World Requirements for 2001 – Statistics for 1999' Part four. Statistical information on narcotic drugs, INCB, 2000.
HDBT: Buprenorphine is not registered in Bulgaria.
* Data available only for specialised units providing Methadone Maintenance Treatment, while 2003 data includes units that also provided other substitution treatment substances (e.g. substitol).
For an European overview please consult our Statistical Bulletin: Table HSR-1: Year of introduction of methadone maintenance treatment (MMT), high-dosage buprenorphine treatment (HDBT) and heroin-assisted treatment, including trials and Figure NSP-1: Year of introduction of methadone maintenance (MMT) and high dosage buprenorphine treatment (HDBT) in 27 European countries and Table HSR-3: Estimated number of clients in methadone treatment and of clients receiving any opioid substitution.
Legal framework of substitution treatment
|Do office-based medical doctors have the right to initiate the prescription of substitution treatment?||
|Do office-based specialised medical doctors have the right to initiate the prescription of substitution treatment?||
Notes: 'specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.
4. References and links
Treatment related EMCDDA resources
- Statistical Bulletin 2008 - Methadone substitution and needle and syringe programmes
- Statistical Bulletin 2008 - Demand for treatment for drug use
- Treatment Demand Indicator EMCDDA webpage
- Drug Treatment Responses EMCDDA webpage
- Best practice portal - EMCDDA webpage
For a comprehensive overview on drug treatment systems, availability and utilisation in Europe, please consult the 2008 online report on ‘Quality of treatment services in Europe - drug treatment - situation and exchange of good practice’ published by the Directorate General for Health and Consumers.