Beginning in May 2008, with the support of the Roma Health Project of the Open Society Institute, the Initiative for Health Foundation (IHF) has launched a methadone maintenance program in Sofia, Bulgaria. This is the first methadone program in the country administered by an NGO. It came as a natural continuation and scaling up of IHF's long experience in implementing harm reduction programs for injecting drug users and sex workers in Sofia. Since 1999, the organization has been providing needle exchange, HIV testing, and other basic services through outreach and in two drop-in centers.

The program enlists the services of a team of psychiatrists and nurses from the Sofia Oblast Mental Health Dispensary. IHF also provides a social worker for the program, and maintains supportive relations with the community, thus creating a positive model of cooperation between a state-run hospital and an NGO. The program is initially serving 47 patients. All services are free of charge for clients.

The program is situated in the drop-in center of IHF, designed for drug users from the largest Roma community in Sofia. Although there is no rule of accepting Roma clients exclusively, the program is designed in a way to be mainly available and appropriate for this minority group and namely for those who hardly have any access to other similar services, due to their social status.

In addition to the funding provided by the Roma Health Project of the Open Society Institute, the program is also supported by the Bulgarian Ministry of Health, which provides the methadone, and partially by the "Prevention and Control of HIV/AIDS" program funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.