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Bulgaria

Map of Bulgaria

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’.

Definitions of terms

Drug-free treatment 2005
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

Substitution treatment
2003
2005
2006
Number of units providing substitution treatment
49
6*
11
Number of clients in opioid substitution treatment
380
920
1100
of which with methadone
380
920
1100

Applied substances in substitution treatment
Officially introduced in
Methadone (MMT)
1996
Buprenorphine (HDBT)
N. Ap.
Slow-release morphine
N. Av.


Notes
:
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?
No
Do office-based specialised medical doctors have the right to initiate the prescription of substitution treatment?
No


Notes
: 'specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.

4. References and links

Treatment related EMCDDA resources

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.

Treatment inventories

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 >>

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Page last updated: Tuesday, 19 August 2008