Unofficial statistics from 2022 indicate that between 200,000 and 300,000 Bulgarians are addicted to alcohol or drugs. In other words, roughly between 3% and 4.5% of the entire population of Bulgaria suffers from addiction to psychoactive substances.
Systematic abuse and dependence on alcohol can often lead to serious physical and mental disorders, which the addict either does not realize at all, or, even though he understands that he has lost control over his consumption, does not want to seek treatment voluntarily because he believes he can cope on his own. In this case, it is logical for their loved ones to ask whether it is possible to order compulsory treatment for alcoholism.
What is alcohol dependence?
Alcohol dependence is no different from any other addiction, except for the substance used. It is included in the International Classification of Diseases as a mental disorder resulting from the use of psychoactive substances.
Addiction to alcohol and drugs has been the subject of extensive medical research for more than a century, and science has defined it as a mental disorder, characterized by a loss of volitional control over use. It has been established that this disease progresses over time and can lead to severe physical lead to severe physical and mental disabilities, including cirrhosis of the liver, alcoholic epilepsy and delirium tremens.
Addiction is a chronic disease that often recurs, even after long periods of abstinence. With alcohol addiction, it is possible to achieve complete and lasting remission.
When is alcohol dependence considered to be present?
To determine the presence of alcohol dependence, the World Health Organization has established a number of criteria that are used to assess whether a particular patient suffers from alcohol dependence syndrome. In order to make such a diagnosis, it is necessary to establish the presence of three or more of the WHO criteria for a period of one year prior to the time of the examination.
There are six criteria in total, defined as follows:
- feeling of an inner, indefinable urge to consume alcohol;
- difficulty controlling alcohol intake in terms of when to start, when to stop, or how much to drink;
- withdrawal symptoms when reducing the amount consumed or when stopping use, as well as the use of alcohol or other psychoactive substances to alleviate these symptoms;
- increased tolerance;
- elimination of alternative pleasures or interests outside the use of alcohol;
- continuation of use, despite the presence of obvious harmful consequences (e.g., taking medications for liver cirrhosis while drinking alcohol).
Is there a procedure for compulsory treatment for alcoholism?
In order for compulsory treatment for alcoholism to be initiated, establishing alcohol dependence is not sufficient. This is because, in addition to this, the law requires a number of other conditions to be met before allowing the restriction of the addict’s freedom, which is also his fundamental human right.
Therefore, in order to initiate compulsory treatment for alcoholism and ensure its successful completion, it is necessary, first of all, that the addiction has led to a mental illness that significantly affects the patient’s mental functions or has caused permanent mental damage.
For compulsory treatment for alcoholism, it is necessary, secondly, that the patient poses a danger to themselves or others due to the possibility of committing a crime. Given that this is only a “possibility” and not an actual act, the assessment is to some extent subjective and is made by an expert psychiatrist within the framework of the court case to decide on the initiation of compulsory treatment for alcoholism.
When the addict has already committed a crime, the decision to place them in compulsory treatment for alcoholism is made by the criminal court, which decides on the question of guilt and responsibility when passing sentence.
How is the procedure for compulsory treatment for alcoholism initiated?
The procedure for compulsory treatment for alcoholism is usually initiated upon a reasoned request by the patient’s relatives to the competent prosecutor. For this purpose, it is advisable to engage a lawyer who specializes in working with alcoholics, as the correct presentation of the relevant facts and the provision of all necessary documentation would facilitate the work of the experts who, within the framework of the subsequent court proceedings, will prepare an expert opinion on the condition of the addict, and a properly prepared expert opinion ensures the success of the procedure for compulsory treatment for alcoholism.
This procedure may also be initiated by the head of the medical facility where the alcohol-dependent person is admitted when they are in an emergency condition that requires treatment (e.g., severe convulsions due to alcohol epilepsy).
What are the rights of an alcohol-dependent person against whom proceedings have been initiated for compulsory treatment for alcoholism?
Very often, even though the patient suffers from alcoholism, the conditions for his admission are not met, as he has no permanent mental disorders or, if he does, he does not pose a danger to himself or others due to the lack of risk of committing a crime. In this case, it is possible that the patient’s relatives are simply desperate about his condition and unable to care for him, but at the same time, compulsory treatment may not be in the best interests of the addict.
In all cases, when initiating proceedings for compulsory treatment for alcoholism, the addict has the right to defense, since if the case is successful, the end result is practical deprivation of liberty through placement in inpatient treatment in a medical facility with a restrictive regime. That is why the law provides for the mandatory participation of a defense attorney. If the addict does not authorize an attorney of their choice who specializes in the field of addiction, the court will appoint a public defender.
The fundamental right of the dependent person in the process of placement for compulsory treatment for alcoholism is to be heard in person by the court. If they do not wish to appear or in any way obstruct their hearing, compulsory attendance may be ordered by the Judicial Police.
The alcohol-dependent person also has the right to object to the request for compulsory admission for treatment and to present evidence in their support.
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More information about the rights and legal options of people dependent on psychoactive substances and their loved ones can be found in the sections “Criminal law” and “Human rights“.
Silvia Petkova Sole Proprietorship Law Firm is the only law firm in Bulgaria specializing in providing legal assistance to individuals dependent on psychoactive substances. The attorneys have extensive experience in defending individuals dependent on psychoactive substances who have committed crimes.
Contact:
Working hours: Monday to Friday from 10:00 to 18:00
Address: Sofia, 2 Tri Ushi Str., 3rd floor
Telephone: 0885 47 77 57
email: office@petkovalegal.com
Consultations by telephone and on site at the office are provided only with a pre-booked appointment time.