1. Understanding changing patterns
of drug use in Georgia:
Implications for service delivery
and policy development
DDavid Otiashvili, M.D.
Irma Kirtadze, M.D.
Addiction Research Center, Alternative Georgia
Global Addiction Conference
Piza, Italy
May 7, 2013

2. Brief information on Georgia
Indicator Info for 2011
Surface area 69.700 sq km
Population 4.497.6 m
GDP per capita in
PPS
2549.09 euro
Unemployment rate 15.1%
Prison Population
Rate (per 100.000)
524

3. Drug use
• General population
No data
• Problem drug use
40,000 (95% CI: 39,000-41,000)
prevalence 1.5% among 15-64 years old
• Drugs injected
shift from traditional opium, heroine and
buprenorphine to home-made ATS (“vint”, “jef”) and
opioids (desomorphine, “krokodile”)

4. Drugs injected

5. Abuse of over the counter
medications
• 2003 – explosive abuse of poppy seeds
• 2005-2008 – injection use of Coaxil (Tianeptin)
• 2010-2011 – widespread oral consumption of
anticonvulsant Lyrica (Pregabalin)

6. Common features of Georgian drug
scene
• Drugs use intravenously (no sniffing, smoking or
inhaling)
• Daily dose is low
• Opioids combined with sedatives
• Unstructured poli-drug use is common

7. Drug use trends shaped by socio-
economic and policy context
• Buprenorphine abuse
• Home-made stimulants
• Home-made opioids
• Poppy seeds, Coaxil, Lyrica

8. New drugs – new harms
• Injection risk behavior
• Toxicity
• Overdose

9. New cases of HIV infection, 1990-
2011

10. 306 300
609
911
1082
841
584
338 270
0 0
8
130
285
552 1200
2118 2352
0
500
1000
1500
2000
2500
3000
2003 2004 2005 2006 2007 2008 2009 2010 2011
OST
detox
Treatment response

11. Treatment response
• No comprehensive treatment approach
– Treatment planning
– Case management
– Continuum of care
• No gender-focused services

12. 12
Drug legislation
• Drug use (trace of controlled substance in urine) is punishable under
the Administrative Code
• Repeated drug use is punishable under the Criminal Code (up to 1
year imprisonment)
• Possession of ANY amount of drugs, regardless of purpose, is
punishable under the Criminal Code
• Tables of quantities of drugs (any amount of amphetamine – 7 to 14
years)

13. Prison population
0
5000
10000
15000
20000
25000
30000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

14. Disproportionate resource allocation
• Coverage of treatment – 6%
• 6,500 adults received health service vs 27,000
episodes of drug testing and police investigation

15. Major policy reform needed
• 2013 – Drug Policy Coordination Council
• National Drug Strategy
• Action Plan
• Legislative proposal
HEALTH CARE PROFESSIONALS’
ENGAGEMENT CRITICAL!

16. Thank you
dato@altgeorgia.ge
datohupo@yahoo.com
www.altgeorgia.ge