Between 200,000 and 300,000 Bulgarians are chronically addicted to alcohol or drugs. Many abuse experimentally. There are also no accurate statistics for abusers of psychoactive substances, with drugs that are legally prescribed. This is what Pavel Pavlov, creator and head of the "Samo Dnes" (Only Today) Therapeutic Center, said in an interview with BTA.
He is an addiction therapist, consultant and representative of the national patient organization, the Confederation for the Defense of Health, on issues related to addictions. He has been working with addicts and their relatives since 2006. He is the creator of the Association for Prevention and Treatment of Addictions "Samo Dnes".
Pavlov was asked to comment on the results of the latest action of the Ministry of the Interior for road safety, in which dozens of drivers who have abused alcohol or drugs are found every day.
According to him, the problem for the country is huge. Probably people from all three groups drive, ride scooters, motorcycles, bikes.
Pavlov pointed out that the group of abusers of psychoactive substances, with drugs that are legally prescribed, can hardly be covered. On many of the leaflets of these medicines there are warnings: "do not operate machines, do not use them while driving", but users drive and work, and with the available means that law enforcement agencies have, these substances cannot be accounted for, the expert added.
Asked if there is tolerance for alcohol use in our society, Pavlov said that more and more people believe that only the abuse of illegal substances is the serious problem.
"If you look at the world statistics, in the first place with the most addictions are legally prescribed psychoactive substances, in second place - cigarettes, and in third place - alcohol addiction. In the first three places are absolutely legal substances," summarized the therapist.
Our legal system, society as a whole, concentrate more on illegal substances and this leads to a feeling among the people themselves who drink alcohol that it is not wrong that everyone does it, Pavel Pavlov pointed out. According to him, this is the cause of another problem - those who use drugs have the feeling that they are above society, that way they are more interesting, important, different, it is becoming a fashion, especially among the youngest.
One person with addiction affects the lives of an average of four others
The COVID pandemic, social isolation and telecommuting have taken a particularly hard toll on people at risk of addictions. According to an 11-country Global Drug Survey from early last year, 43 percent of people said they had significantly increased their alcohol consumption, and 1/3 of addiction professionals reported increased drug use, Pavlov said.
The situation in Bulgaria is not much different. Addiction Prevention and Treatment Association “Samo Dnes” reports an increase in consultations and requests for therapy work of more than 50% in the last year alone.
There are American and Russian studies that during a crisis, regardless of the cause of the crisis - war or financial, there is a sharp increase in the use of various substances in society, this is perceived as a way to cope with difficulties in life, the therapist pointed out. According to Pavlov, the poorest sections of the population also have a very serious problem with the abuse of psychoactive substances.
However, the subject of addiction is much larger. According to publications by Hemfelt, Minirth and Meier, each addict affects the lives of an average of 4 other people - his relatives, loved ones, colleagues. These are people who are directly involved in the problem and often develop symptoms of the so-called codependency. Addiction may be personal, but the suffering it leads to is shared, the expert pointed out.
If we look at a family with addicts, what do we see - addiction is a chronic disease, the whole family concentrates on the sick person, it affects everyone's life, the therapist pointed out.
The family begins to unconsciously serve the addiction. There is a moment of stigma in which this problem is denied - "it can't happen to us, it can't happen in our family". In some cases, relatives deny this problem longer than the addict himself.
After acceptance, caregiving begins for these people, as relatives unwittingly help the addict continue to abuse, the therapist said. They often face the inconsistencies of our health care system, they adjust their whole lives to these people, Pavlov also pointed out. According to him, everyone lives in fear of how he will go to work, what debts he has incurred, parents are looking for their children all day long, where they are, what they are doing.
If there is a parent who is in such a state, his children necessarily develop dysfunctional behavior, the therapist said.
According to Pavlov, this is an endless chain of influence - if the addict works, but does not do his job properly, his colleagues begin to hide him and take over his duties so that he is not fired by the employer.
Prevention saves a lot of public resources
The Americans had calculated that one dollar invested in prevention subsequently saves society seven dollars, Pavlov said.
According to the expert, in recent years, many things have happened in our country in the direction of positive change, modern approaches are also used, but there is still much to be done. The funding is "piecemeal", there is no unified system, but the idea of such a system has started - manuals have been made, and the trainers of "Samo Dnes" also have credit for this, said Pavel Pavlov.
There are also attempts at legislative changes. In Bulgaria, people are put in prison for alcohol and drug abuse, but there is no treatment there. Some countries have very serious prison treatment systems, and in others there is a choice, when a person has not committed a serious crime that necessarily requires prison, to either go to prison or go to a treatment center, reporting for the programs he is going through, added Pavel Pavlov. According to him, such opportunities exist in Poland, in developed European countries in general, and in a large part of the American states.
"In Bulgaria, people are caught rioting, having aggressive behavior after abusing substances, they are locked up in a psychiatric clinic for a certain period, their crises are temporarily fixed, they are released and they continue," said the therapist.
Addiction treatment centers still do not have a clear status
According to Pavlov, the status of the Centers for the treatment of addicts is still not clear, they are legally responsible for social service, but are conducted as a social activity, which leads to the payment of VAT and other complications, the specialist said. Things are still quite confused, but the good news is that we are moving in a positive direction, many changes have been made, many treatment centers, added the expert.
Asked if such treatment is expensive if poorer families can afford it, he said that in practice they cannot because it is very expensive. Our center has a staff of 12 people, there are costs for food, electricity, any other specific services, he pointed out. We have to collect donations, funds to support people in financial difficulties, but with this crisis, it is impossible to do that, said Pavlov.
Even if these people had money, if they delayed treatment, they often ended up in debt, and by the time they recognized a problem, they no longer had the means to fix it, the therapist pointed out.
According to him, many people also don't know what treatment is - they see it as "give me some drugs, put in me some implant". People are ready to give money for an inadequate method of treatment and there are colleagues who, unfortunately, abuse this - by telling them that it is a treatment, added Pavel Pavlov.
If the addiction is chronic, the treatment process is very long, the expert pointed out. According to him, there are people who define themselves as cured if they change one addiction to another – heroin with alcohol, for example. Or they stop drinking but develop an addiction to benzodiazepines. There are those who come in a terrible state, stuffed with legal substances, a state I have not seen in others who abused illegal substances, said Pavel Pavlov.
According to him, methadone, which is used for treatment in some places, is also more difficult to stop than heroin itself. Treatment can sometimes delay the treatment itself, irreversible processes in the brain also occur, added Pavlov.
With today's young people, who start using from the age of 10-14, there is a huge social problem, the treatment of addiction itself is not that difficult. The problem with them is social skills - we literally reteach them to be able to live without abusing, the therapist said.
Asked why the age limit has dropped so much, he said the reason is sometimes over-nurturing parents, television, movies and an inadequate education system.
Our education system hardly teaches social competence, thousands of unnecessary things are taught, and adequate skills for survival in life are not created, he stated.
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