Author: Vesselina Bozhilova
In the mid-90s, heroin spread in Bulgaria and took the lives of many children. Today, fentanyl is the next similar drug, this time a synthetic opiate that leads to death. Among them, there are other synthetic drugs that cause serious damage, but still less often lead to a fatal outcome. Media and social networks are flooded with posts about fentanyl on the occasion of the successful operation of the GDBOP, which is actually the final development of their Ruse colleagues - the dismantling of a fentanyl laboratory in the "Fakulteta" district in Sofia.
A disturbing remark
A large quantity was found - 6 kg, and it seems that this is the production for only one day. A dozen people are in custody. So far, there are reasons to be grateful for a job well done. But why the disputes on social networks, the bright reactions of anger? Because of the statement of the Chief Secretary of the Ministry of Internal Affairs Lyubomir Nikolov, broadcast on television and quoted in newspapers. He literally said the following: “I hope that from tomorrow all fentanyl addicts will be in abstinence!“. He said it in such a way that many of them felt sick. Because they have either seen abstinence, or they are once again convinced that for the police, dealers and addicts are one and the same.
Abstinence is the state in which addicts fall after abruptly stopping the substance. Simply put, it resembles a severe flu with severe pain all over the body, chills, abdominal pain, vomiting, diarrhea, insomnia, seizures. It can be helped with medication, and it can also be done so-called “cold turkey“ - without anything. With fentanyl, abstinence lasts up to two weeks. In fact, with a sharp stop of methadone, which is part of the only state policy against opiates, it lasts up to three months.
Abstinence is practically the door to cleansing the addict's body and every following day his condition is a little lighter. But the urges to return to opiates plus the serious pain are so strong that even an addict who has voluntarily given up can try again. This, at home, requires very serious 24-hour security. The other important point is that if a longer-term treatment is not undertaken after abstinence, the risk of relapse not only remains, but carries an even greater danger, because the next dose can already be fatal. The bitter truth is that most who have died from drugs have previously made attempts to stop them. People who are aware of this moment would like to ask Mr. Secretary General: okay, let them go into abstinence, and then where?
The questions that remain unanswered
The media is blowing all the horns these days, but they did it with the same enthusiasm for both laughing gas and vapes. And the questions that are being asked have been hanging unanswered for years. What should have been done for heroin, later replaced by synthetic drugs, now applies again to fentanyl. Moreover, what was done for heroin was destroyed over the years. Under Minister Tanya Andreeva, the National Center for Drug Addiction was closed. Then the National Focal Center for Drugs and Drug Addiction was also closed. Now, when asked how many victims of fentanyl there are, even specialists cannot answer.
"There was once a unit called the National Focal Center for Drugs and Drug Addiction, which constantly collected and disseminated such information," writes Dr. Momchil Vassilev, who headed it before its closure. That was its function and mission. And it did. During Borisov's administration, the center was dismantled with the help of internal and external collaborators, as well as the entire sector for public response to drugs. This was an idea born of the ostrich syndrome - if you hide your head, the problem doesn't exist“.
The market has changed
They say that the drug market in our country has been completely changed at the moment. Dealers can put fentanyl in your glass while you stare away. Or they can mix fentanyl with various amphetamines, marijuana and whatever else is available for use. But this is not new, 20 years ago dealers from Haskovo were melting marijuana into heroin, and their practice spread quickly because this increased demand. The addictive substance was already very strong. Today it is even stronger, but the thesis that - you see - fentanyl suddenly appeared in our country is outdated. It is not from today, it is not even from yesterday. Here is what Dr. Ivan Dobrinov, head of the Addictions Department at the State Psychiatric Hospital in Radnevo, says:
"Fentanyl is certainly a very dangerous drug, but it is far from the only one. It has long been known in medicine and there have been several breakthroughs with its distribution on the black market since 2010-2011. Even newer opioids are new - the highly effective synthetic derivatives of fentanyl, nitazenes, orphines. The drug market provides a huge number of all kinds of psychoactive substances from different chemical groups: opioids, stimulants, hallucinogens, cannabinoids, benzodiazepines, etc. Combined use is already widespread, which seriously complicates the accurate prediction of risks and the organization of effective assistance. Very often, in combination, the effect of individual psychoactive substances is amplified, changed, potentiated. Unfortunately, the “responsible” state structures have not been particularly alarmed. The prosecution of producers and distributors is just one of the activities that the state should be engaged in“.
Prevention, limiting supply and demand, treatment. The successful fight against drug addiction is based on these pillars. Only one of these elements does not work. This is a complex problem that has a complex solution, and no one from the state dares to approach it. In our country, they only focused on limiting the market, and it has long been clear on a global scale that this does not work. This market does not develop from the outside, but from the inside. That is why prevention and treatment come to the fore in other countries, but not in our country. In Bulgaria, they continue to treat addicts as criminals, not as sick people. And at this moment, some people are filled with a great deal of hatred and will say: “they brought it on themselves”. If they were right, addictions would not be registered with a code in the International Classification of Diseases. But because this disease goes hand in hand with a heavy stigma, with criminal acts, with social rifts, this position can be very difficult to make sense of. And while one is mixed with the other, the problem will go on and develop, and things will become even more serious.
I wonder what the results would be in Bulgaria
More than 20 years ago in Sweden they did an experiment - for one month in Gothenburg they tested everyone detained for drugs for all sorts of reasons. The result was that they created a whole new system for combating drugs, and civil society was also included in the measures. In Bulgaria, only drivers are tested. I wonder if this method is applied more widely, what data will come to light and whether someone will finally take something serious. Over the past 20 years, I remember an attempt by Dr. Vanyo Sharkov and many more meaningful steps by Dr. Mihail Okoliyski. Unfortunately, both were acting ministers of health and after the election of regulars the topic sank again.
We are only trying to count the dead, but we will not be able to count them, because they die of respiratory failure - this is written in the death certificates. More accurate statistics are kept on the streets by people who know them, by people who make efforts to help addicts like those in the "Pink House" in Sofia and Plovdiv, and by those who have not yet burned out in the unequal battle against drugs, but also against the indifference of the state, which has been pretending for so many years that the problem does not exist. And it will continue to grow. If fentanyl disappears, nitazene and orphine will come and everyone will be very surprised again. Or maybe they have already come. This is how we have been doing it for 30 years now - from sensation to sensation and nothing in between.