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DRUG USE AND ABUSE IN BULGARIA:
RESULTS OF THE FIRST NATIONAL POPULATION SURVEY

Answers to the question "What is the number of drug users in Bulgaria?" used to range from "No one can tell" to "More than 100,000". Without disregard to the variety of opinions, CSD tried to establish a common point of departure for the evaluation of drug use in the country. For that purpose a national representative survey of the issues of drug abuse was conducted for the first time in the country. Although there had been quite a number of surveys up to that time, they had focused on demographic groups (e.g. secondary school students in certain large cities or drug addicts that had sought help). Even if population-based surveys are often unreliable for stigmatized and hidden patterns of drugs use, they are the type of surveys that provide a comprehensive representation of the situation in the country as well as relevant information basis on which later in-depth studies could build.

The survey was conducted jointly with Vitosha Research at the end of 2002 and the beginning of 2003 as the agency made use of its former specific surveys such as victimization surveys and corruption assessment. In designing the methodology, both international experience and the characteristics of the Bulgarian environment were taken into account. In order to obtain quality data two additional steps were taken:

First, an additional representative sample of the most endangered group aged 15-30 was added to the general one of the population aged 15+.

Secondly, the traditional direct questions, adapted from population surveys run in Western Europe and the US, were supplemented by indirect ones. This step was motivated by the hypothesis that it was unclear whether Bulgarian respondents were ready to admit to the use of banned substances (regardless of the explicit instruction given to the interviewer network to that effect).

There were no considerable discrepancies between the data from the two samples which is a good reason to deem the results as fairly reliable. According to interviewers' reports there are no noticeable constraints for respondents to admit soft or synthetic drugs use. The indirect questions registered a higher number of drug users.

Apart from the quantitative survey, two qualitative ones were conducted. The first one covered heroin addicts as well as regular soft drug users. The second one was done among experts and people working with drug addicts.

The qualitative study provided various groups of data concerning values, attitudes, expectations etc. The data provoking greatest interest and debate are those about the variations in the use of different types of drugs. Usage can be divided according to the supply mechanisms. There are three independent markets at present - the soft drug market, the heroin market and the synthetic substances market. These three groups of psychoactive substances can be clearly distinguished, especially in larger cities, even though at different times "grass" dealers can be observed selling amphetamines as well or vice versa.

1. The soft drug market (cannabis, marijuana, hashish). Based on interviews with users, experts and police officers, it can be ascertained that there are two antagonistic sub-markets in that group. The larger relative portion of cannabis is distributed by petty dealers that are in contact with producers and sell it to a circle of friends at a low or no profit at all; this has come to be known as "friendly trade" and is characteristic of the cannabis market in developed countries. The rest of cannabis production and distribution is controlled by organized crime. They sell "joints" mostly to adolescents and sometimes adults.

According to the survey data the direct question "Do you use?" any of the enumerated varieties of soft drugs 0.5% of the respondents replied that they have tried it. The analysis of replies shows that there is an 80% overlap between the groups using cannabis and those using marijuana and hashish. This percentage corresponds to a number of 35-40, 000 people.

Direct questions register the level of soft drug penetration among the population. The percentage of those admitting to have tried psychoactive substances of the soft variety is 0,4%-0,5%.

Indirect questions such as "Would you try?" and "Friends and acquaintances of yours who have tried?" show that the share of the population currently using any of these drugs is 1% - 1,3%, i.е. about 90-100,000 people. Regarding the penetration level, i.e. the number of "lifetime prevalence" people with respect to soft drugs is about 120-130,000.

It could be concluded that the number of people presently using soft drugs varies between 35-100,000, while penetration figures reach 130,000 people. Nevertheless, the level of 100-130,000 should not be taken as an absolute, since in-depth interviews show that the group of regular soft drug users half that number. The low quality of available drugs was pointed as the main reason for that.

2. The heroin market, undoubtedly the most risk-laden of all, is under near total control of criminal groups. Police and other special services claim that the network of dealers is very flexible and built on a strict hierarchy. Security measures have been toughened in the last two years and today's dealers have to use mobile phones and caches in contrast to their small-scale colleagues of the 1990s who could sell the stuff undisturbed in public places. Drug barons would not any longer hire drug addicted dealers anymore. Survey data show that when asked directly "Do you use heroin?" about 0.2% of the respondents declare to have tried. In numbers, this is roughly 12-14,000 peoplе, admitting to the use of heroin. With indirect questions like: "Would you try if given the chance?" 0,5% of the respondents claim that they have already tried. This percentage corresponds to a number of 32-34, 000 people. Similar results are obtained in reply to questions like: "How many of your friends and acquaintances have tried heroin?" Comparison of survey data, police registration information and data from programmes like "needles and syringes" indicate that the number of actual heroin users ranges from 15 to 25,000 people.

The heroin market brings into focus several points of interest:

  • Has the heroin epidemic peaked? Have prevalence rates become stable? Judging by the data of police and medical registers in the largest cities, the epidemic reached its peak in 2000.
  • Which are the groups at greatest risk of addiction? Following data from police sources, programs implemented by NGOs, as well as qualitative surveys predominantly Roma regions have proven most affected by the problem. A telling example is the fact that 50-60% of users registered with the "needles and syringes" program in Plovdiv and Sofia were of Roma origin. Certain suburban secondary schools in Sofia, Varna, Plovdiv and Bourgas can also be considered a group at risk.
  • Given the present quality of heroin can we speak of existing dependence? As indicated by chemical analyses the degree of purity in a dose bought in the street is between 3 and 5 % (or even less in Roma-populated areas). In comparison, the heroin concentration in the period 1998-2000 was 8-12%.


3. The synthetic drugs market. The mass consumption of this type of drugs started only after 1997. Two characteristics of this market deserve noting. One is that the amphetamines sold in the country are locally produced and sold under the label "Ecstasy". The confusion of these two drugs is widespread not only among young people and not only in Bulgaria (genuine Ecstasy is too expensive for mass consumption). The other trait is that amphetamines are sold in hangouts that are mostly frequented by gray market or criminal figures.

Quantitative surveys show that 0,7% of respondents mark a positive answer to the direct question about use, while 1,0% declare to "have tried". The corresponding figure thereof is 45-70,000 people. Similarly to soft drug users, amphetamine users speak openly about their choice. In-depth interviews suggest that synthetic drugs are perceived as "strong stimulants similar to the drinks 'Shark', 'Red Bull' etc"; "weed" is thought to be a feeble drug, while amphetamines are considered a type of medicine. Therefore, there could be grounds to the concern that next drug epidemic could be in synthetic drugs.

A certain comparison with another notorious amphetamine producer - Poland - would show that the quality amphetamine production run by organized crime is particularly high there since it is intended for Western markets. Bulgarian exports, in contrast, are targeted at the Middle East, which means low-quality amphetamines causing problems to users. Thus the lack of uniform quality raises the risk of overdosing.

Finally, it is important to highlight the significance and potential that similar data collection methods have. In the EU there is specialized body - the European Monitoring Centre in Lisbon - which is mandated to help member states provide reliable and comparable information in this field. The main reason behind this initiative is that international cooperation in prevention and enforcement could not be effective without this type of support. In Bulgaria, there have been a number of regulatory and institutional measures introduced since 1997; in 2002, a National Strategy was developed. For these to be effective, they ought to be based on a mechanism evaluating both the distribution and use of drugs and the effectiveness of the policies. This would not be possible without independent surveys carried out on regular basis and allowing comparability.

June 2003
Sofia

 
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