HARM REDUCTION AND ILLICIT DRUGS

1
HARM REDUCTION AND ILLICIT DRUGS

• WHAT WORKS AND WHAT DOESNT
• HOPE SOFIA

2
Current situation and effectiveness of the harm
reduction in Bulgaria

• In Bulgaria enough harm reduction programs
  operate only on the territory of Sofia and in
  couple of other bigger Bulgarian towns
• In the other country towns only the first steps
  have been made in this direction

3
Bulgaria has one of the most repressive laws on
drugs in Europe, which

• Makes the contact with drug users extremely
  difficult, as the penalties for possession of
  minimal quantities are from 3 to 15 years
  imprisonment
• Makes the needle-exchange programs semi-illegal
  by the meaning of the law, although the official
  policy is in support of harm reduction

4
The world-wide effective harm reduction
practices, implemented in Bulgaria are

• Needle-exchange programs
• Maintaining treatment
• Prevention and control of HIV and Hepatitis C
• Outreach work and counseling
• All of them benefit both addicts and society at
  large, save lives and enormous sums to the
  taxpayers .

5
Needle exchange is connected with the outreach
work and the counseling. They

• Prevent the outburst of blood-born diseases
  epidemics
• Save enormous sums to the public healthcare
  system and to juridical systems
• Restrict the criminality and the commercial sex
  work, related to drugs using

6
The problems under the Bulgarian conditions are

• In many cases the outreach workers and the
  counselors in the newly opened programmes are
  mere bureaucrats
• The programs operate sluggishly, ineffectively
  and are contestably cost effective
• Some of them have not managed to establish
  contacts with drug users for more than a year

7
The counseling is almost pointless under the
Bulgarian conditions, because

• All of the opportunities for treatment, are
  extremely limited and insufficient
• After the new law on drugs was enacted, the
  access to the drug users community became really
  difficult for the outreach workers, because the
  addicts fear of police racket and harassment

8
Besides the above mentioned benefits, the
maintaining treatment also

• Secures the necessary for the users time to
  overcome their psychological addiction
• The medications do not have a distinct euphoric
  effect and enable the patients to start living a
  completely valuable life
• Its low price enables the addicts live without
  being forced to commit crimes
• Is 10 times more cost effective than the
  prosecution of the drugs related crimes and the
  support of inmates

9
The main problems, connected with the maintaining
treatment in Bulgaria are

• The free methadone programs do not offer enough
  effectively neither of the additional obligator
  services like psychotherapies, social work,
  family planning, etc.
• The extremely limited number of slots in the free
  state methadone programs, and the financially
  unaffordable private maintaining programs

10
The prevention and the control of HIV and
Hepatitis C can be effective only when

• All of the three of the above harm reduction
  practices function perfectly well
• There are possibilities for free access to
  sterile injecting equipment
• There are possibilities for free blood tests for
  the representatives of the marginalized risky
  communities and the people are motivated for
  regular checks of their status

11
The problems with the prevention and the control
of HIV and Hep. C in Bulgaria are

• Such a project, which should have been operating
  for already year and a half, was implemented on a
  larger bases only a couple of months ago
• Bigger part of the infected drug users do not
  receive treatment