Understanding changing patterns of drug use in georgia
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This document summarizes a presentation given in Piza, Italy on understanding changing patterns of drug use in Georgia and their implications. It provides background information on Georgia including drug use statistics showing a shift from traditional opioids to homemade stimulants and opioids. It describes features of Georgia's drug scene, how trends are shaped by socioeconomic factors, and associated health harms like HIV. The response has been inadequate treatment and disproportionate spending on enforcement versus healthcare. Major policy reforms are needed including developing a national drug strategy with healthcare professional engagement.
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Understanding changing patterns of drug use in georgia
- 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”)
- 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!