Cases of compulsory treatment of drug addicts who have not committed a crime are extremely rare in Bulgarian practice, and this circumstance is rooted primarily in the widespread and fundamental misunderstanding of drug addiction as a disease.
Drug dependence is classified in the International Classification of Diseases, 10th Revision, under “Mental and behavioral disorders due to psychoactive substance use.” According to the diagnostic guidelines in this classification, a key sign of addiction is the subjective feeling of compulsion to take drugs, and awareness of this can only be observed when attempts are made to stop or reduce substance use. That is why, very often, precisely because of a lack of awareness of the problem, the relatives of the addict ask whether it is possible to proceed with compulsory treatment of drug addicts.
What is drug addiction?
The answer to this question is provided by psychiatric science. Numerous and extensive studies on the subject have concluded that drug addiction is a mental disorder, and that systematic drug abuse can trigger a number of other mental illnesses.
Drug addiction itself is a mental disorder that is chronic in nature, worsens over time, and is characterized by a high risk of relapse even in cases where the patient has not used drugs for a long time. In other words, the patient may go into remission, but at present there is no known permanent cure.
What are the signs of drug addiction?
Psychiatric science has defined several signs that can be used to determine whether a patient is suffering from drug addiction. In order to make a definitive diagnosis of “drug addiction”, three or more of these signs must have been present simultaneously in a particular patient over the past year.
- presence of a strong to irresistible desire or subjective feeling of internal compulsion to take drugs;
- reduced or lost control over the initiation, cessation, or amount of substance used;
- presence of withdrawal symptoms (the outdated term is “abstinence”) when use is discontinued or reduced;
- replacing the preferred drug with another type or another psychoactive substance (e.g., alcohol or medication) when attempting to stop or reduce use;
- increased tolerance to the drug dose;
- loss of interest in activities other than use;
- continuing to use it despite the harmful effects suffered.
Is it possible to arrange compulsory treatment for drug addicts?
Drug addiction alone is not grounds for compulsory treatment of drug addicts. This is because compulsory treatment as a restrictive measure constitutes a form of deprivation of liberty, and therefore several essential conditions must be met before it can be undertaken.
The first set of requirements in the law concerns the mental state of addicts. In order for compulsory treatment of drug addicts to be initiated, one of the following conditions must be met:
- unlocked mental illness as a result of systematic drug abuse, which has led to a serious impairment of mental functions. It is known that systematic use of narcotic substances can lead to psychosis (especially in the case of stimulant abuse), as well as to severe personality disorders;
- presence of permanent mental impairment as a result of addiction.
The second group of requirements concerns the consequences of drug addiction. In order to proceed with compulsory treatment of drug addicts, it is necessary for patients to have such deviations as a result of their addiction that they may commit a crime that endangers themselves, their loved ones, or other people in general.
Drug addicts often resort to self-harm out of desperation at their inability to stop using drugs. Unprovoked aggression towards loved ones is also observed, often due to their refusal to provide them with the means to purchase drugs or their attempts to encourage the addict to stop using. Finally, drug addiction is a criminogenic factor and, as such, can lead to the possibility of committing crimes, most often against property, in order to obtain funds.
If the above signs are present, a procedure for compulsory treatment of drug addicts may be initiated.
Is there a procedure for compulsory treatment of drug addicts?
There are two legally established procedures for the compulsory treatment of drug addicts.
The first procedure is carried out in accordance with the Health Act and is more preventive in nature, i.e. in general, compulsory treatment of drug addicts under this procedure is ordered when the patient has not yet committed a crime of a general nature but is likely to do so. It is this procedure that will be the subject of this article.
The second procedure is carried out in accordance with the Criminal Procedure Code. In this case, compulsory treatment of drug addicts takes the form of compulsory medical measures after a crime has been committed. This procedure is possible both when the perpetrator is acquitted of the crime because, as a result of drug addiction, he has lost the ability to understand the nature and significance of his actions and to control his behavior, and when he is found guilty because the addiction did not significantly affect their mental and cognitive functions. This procedure will be the subject of a separate commentary.
A request for compulsory treatment of drug addicts may be submitted by two categories of persons.
First, this can happen at the request of a prosecutor after being notified by the addict’s relatives with a reasoned request. In this case, it is advisable that the application be prepared by a lawyer specializing and experienced in working with addictions, as it is essential for the successful conduct of the procedure, while respecting the fundamental rights of the addict, is the correct and systematic presentation of the relevant facts and essential medical documentation, providing whatever may be necessary before preparing the application to initiate compulsory treatment for drug addicts.
The second person who can initiate compulsory treatment for drug addicts is the head of the medical facility where the addict is admitted for the purpose of treating an emergency condition. Often, such an emergency condition is psychosis resulting from the abuse of stimulants (usually amphetamines). In this case, the head of the medical facility may decide to keep the patient for up to 24 hours for treatment, and in exceptional cases – up to 48 hours, but only with the permission of a judge. If the head of the medical facility determines that longer treatment is necessary due to addiction, they may request the court to order compulsory treatment for drug addicts admitted for emergency care.
Court cases for compulsory treatment of drug addicts are heard before the relevant district court.
Protection of addicts who have been ordered to undergo compulsory treatment
As mentioned above, ordering compulsory treatment for drug addicts significantly affects the fundamental human right to liberty and security, as it is carried out on an inpatient basis in a treatment facility designated by the court. That is why these cases are heard by a criminal court with the mandatory participation of a prosecutor and a defense attorney.
If the person subject to compulsory drug treatment does not appoint a lawyer, one will be appointed for them. In order to avoid the possibility of unjustified compulsory treatment, it is advisable to engage a lawyer who specializes and has experience in dealing with addiction.
The fundamental rights of the dependent person in the compulsory treatment procedure for drug addicts are:
- to be defended by a lawyer;
- to object to the request for compulsory treatment and to present evidence in support of their objection;
- to be heard personally and directly by the court;
- to appeal the decision to appoint an expert and to terminate the proceedings.
Cases involving compulsory treatment of drug addicts fall under the category of expedited proceedings. This is because the question of whether the conditions for placement are met is decided within approximately 24 days.
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You can find more interesting topics related to alcohol, drug, and gambling addiction, as well as the firm’s work with people suffering from addiction, in the sections “Criminal Law” and “Human Rights.” .
Silvia Petkova Sole Proprietorship Law Firm is the only law firm in the country specializing in providing highly qualified legal assistance to addicts and addicted offenders.
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