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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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