• Drug use among the general population and young people
• Prevention
• Problem drug use
• Treatment demand
• Drug-related infectious diseases
• Drug-related deaths
• Treatment responses
• Harm reduction responses
• Drug markets and drug-related offences
• National drug laws
• National drug strategy
• Coordination mechanism in the field of drugs
• References

Georgia is a presidential republic, located at South Caucasus; in the longitude of 40–47 ° E, in the latitude 41–44 ° N.

56 % of the population is urban, 44 % rural. The country is divided into 9 regions, 65 districts, 5 towns of Republic Dependence (without Abkhazia and Tskhinvali). 288 000 persons are internally displaced in Georgia, 118 000 persons are Georgian refugees in Russia. Capital: Tbilisi (population 1 253 000). Principal towns: Kutaisi (241 100), Rustavi (158 000), Batumi (137 100), Zugdidi (105 000 including internally displaced people from occupied Abkhazia), Chiatura (70 000), Gori (70 000), Poti (50 900).

State language is Georgian, on the territory of Abkhazia — Georgian and Abkhazian. Main religion is Greek Orthodoxy; other confessional groups include Shiite and Sunni Muslims, Armenian Gregorians, Catholics, Baptists, Judaists.

Drug use among the general population and young people

There are currently no reliable estimates on the extent of drug use in Georgia. Available figures are generally unrealistically high and suffer with ambiguous case definitions. A frequently cited figure of unknown origin asserts that there are 200 000 drug users in the country, of which 35 000 are drug addicts and 80 000 are problem drug users. These figures do not seem to be based on any evidence.

Marijuana is cited to be the most widely used illegal drug in the world, and Georgia is probably no exception, as suggested by data contained in the narcologic register that was operational in Georgia until 2005, as well as according to the findings of local youth surveys. According to the youth survey conducted by National Center for Disease Control (NCDC) in the framework of Southern Caucasus Anti Drug Programme (SCAD), 17 % of the surveyed adolescents (31 % of boys and 4 % of girls), in the age of 13–18 reported use of marijuana at least once during their life (Baramidze, L., Sturua, L., The Alcohol and Other Drug Use in Georgian Students, 2009).

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Prevention

Another direction in demand reduction, which first appeared in the 1990s in Georgia, is primary prevention. In 1995, the first non-governmental NGO was founded by a group of professionals (NGO Bemoni), which began to implement small-scale community and school prevention programmes. From the early 1990s until late 2007, efforts in drug demand reduction by the Georgian government and international donors paid little attention to drug prevention. The period was often marked by sporadic activities, insufficient funding, limited projects and beneficiaries, and a lack of quality control mechanisms (in 2005: 100 direct beneficiaries, budget — EUR 10 000; in 2006: 30 direct beneficiaries, budget — EUR 20 000; in 2007: no programmes at all; in 2008: 300 direct beneficiaries, budget — up to EUR 100 000).

The Ministry of Labour, Health and Social Affairs (MoLHSA) of Georgia has played a key role in governmental prevention activities for years, though the main accent of the programme was done on drug intoxication examination of those individuals who were apprehended by police for suspicion in drug use.

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Problem drug use

Concerning injecting drug use, the drugs most frequently used are opioids, of which heroin was the most widespread drug used in early 2000s. Since 2004, buprenorphine, which is commercially known as Subutex®, became common. Subutex® is a medical product used for the substitution therapy of opioid addiction widely available through substitution therapy services in the European Union, United States, Australia, India, China and elsewhere, Subutex® entered the black market in Georgia and started to compete with heroin. According to experts’ estimations, approximately one third of treated injection drug users (IDUs) asked for treatment because of problems resulting from the non-medical use of Subutex®. Subutex® has been legally unavailable in Georgia; black-market buprenorphine is used through injections almost exclusively. From the end of 2008, the overall use of Subutex®, has reportedly been decreasing in favor of other, more readily-available injecting drugs, such as ephedrone (jeff, methathinone) and pervitin (vint, methamphetamine) based home-made drugs prepared through a chemical refinement process of pseudo/eophedrine containing medicines that are used for treatment of respiratory disorders and easily available from drugstores without a prescription. The use of cocaine and amphetamines remains very low; there are few signs of presence of these drugs on the black market (i.e. 0.02 g of cocaine seizured by the MoI in 2008).

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Treatment demand

In 2008, six addiction (narcological) clinics operated in the country and detoxified 841 patients altogether (in 2007 the corresponding number was 1 092). According to the staff of the clinics, the decrease in number of the detoxification patients could be explained by increase of capacity of methadone substitution programmes in the country. The majority of the detoxification patients were men (only 11 women). Traditionally, the majority of patients who came to addiction clinics for treatment were opioid users, most of them heroin addicts. The percentage of buprenorphine (Subutex®) users (used as either primary or secondary drug) in the four clinics which provided data for the given report was 35 %. In 2007 as well as in 2008, there was an increase in the number of detoxification patients whose principal drug was home-made methamphetamines (Todadze, K.H., 2009a).

In 2008, 73 % (91 % in 2007) of 841 (1092 in 2007) patients were detoxified in clinics. 37 % (9 % in 2007) received outpatient/ambulatory detoxification. Most of the inpatient detoxifications (97.4 % in 2008 and 93 % in 2007) were provided in clinics in Tbilisi, whereas only 2.6 % (7 % in 2007) were detoxified in Adjara region, at the newly-opened addiction clinic.

Substitution treatment of opiate addiction in 2008 covered 552 patients (311 in 2007), 550 male and 2 female drug users, including 51 patients with HIV from the beginning of the pilot programmes in 2005 to the end in 2008. By the end of 2008, 330 more people were on the waiting list. There is an increasing trend clearly observed in the field of people treated both with and without opioid agonists in Georgia: The above figure shows that from 2003 to 2008 the number of treated IDUs increased. In 2008, the number of treated IDUs in detoxification schemes slightly decreased, which could possibly be explained by the increased capacity of the methadone substitution programme in the country (detoxification, together with substitution, are the only treatment modalities provided in Georgia on routine basis — see below).

The increase in treatment demand in the period 2003–07 could be explained by several factors: In 2003 there were only three clinics in the country providing detoxification treatment followed by a short-term medical and psychological rehabilitation course. By 2008, there were six such clinics, which mean that treatment capacity increased. It is also possible that the awareness of treatment options among addicts increased during the past five years. Finally, there is a possibility that the number of IDUs increased in the country within the last five years. However, none of the two possible aforementioned reasons are evidence-based and they both remain hypotheses for further research. The majority of detoxified patients belong to the age group from 25 to 39 (580 out of 841).

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Drug-related infectious diseases

By 20 February 2009, the Infectious Pathologies, AIDS and Clinical Immunology Research Centre (the AIDS Centre) had registered 1 899 cases of HIV, including 1 429 men (75 %) and 470 women (25 %). Most patients (60 %) were 25 to 40 years of age at the time of diagnosis. Altogether, 999 have developed AIDS and 417 have died. Forty-seven cases of HIV have been registered in children (as of 30 July 2008); the average age is 11 years at the time of diagnosis. Forty-one people living with HIV/AIDS (PLHIV) are foreign citizens, and 163 live in prisons. There were 1 850 PLHIV registered by the beginning of January 2009 (prevalence rate of 30.1/100 000 inhabitants), including 351 new cases (incidence 8.16/100 000); in 2007, the prevalence rate of registered persons was 26.9/100 000 inhabitants and 7.8 new cases/100 000 inhabitants.

Injecting drug use is the most frequent route of HIV transmission among all registered PLHIV (60 %): in 2008, out of 32 244 patients (in 2007, 32 614) tested for HIV at the AIDS Centre, 351 (in 2007, 380) were injecting drug users. HIV/AIDS Distribution by Routes of Transmission (AIDS Center, 2008): 60 % injecting drug use; 33 % heterosexual contacts; 3 % homosexual contacts; 1 % blood transfusion; 2 % MTCT; 1 % unknown.

Prevalence of hepatitis C virus (HCV) among HIV positive patients is high according to a study determining the prevalence of and risk factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV). Almost half (48.57 %) HIV positive patients are co-infected with HCV. Men were more likely than women to be co-infected with HCV (60.80 % and 18 %, respectively). The prevalence of HCV among injecting drug users was 73.40 %. Drug users were at a risk 3.25 times higher (PR 3.25; 95 % CI; CL--1.89-5.26; p<0.01) to be infected with HCV compared to non-Injecting Drug Users (non-IDUs). The prevalence of infection with HBV (Anti-HBc – serological marker) among HIV positives was 43.42 % (76/175) and the prevalence of chronic HBV infection (HBsAg positive) was 6.86 % (12/175). The prevalence rate of HBsAg among IDUs was 8.51 % and among non IDU participants 5.26 %. Triple infection (HIV, hepatitis C and chronic form of hepatitis B--HBsAg) was found among 9 patients (5.14 %). Infections were associated with injection drug use (88.88 %) and were mainly related to the sharing of needles/syringes and other injecting medical devices (Badridze, N. et al, 2008).

In 2008, out of the 1 602 IDU clients of harm reduction programme tested for HIV in Voluntary Counselling and Testing (VCT) centres functioning within the framework of Global Fund-supported harm reduction programmes, 13 people were found to be HIV+ (0.8 %). Out of 1 605 injecting drug users tested for hepatitis B, 124 were positive (7.7 %). Of 1 595 clients of HR programmes tested for hepatitis C, 778 were positive (58.7 %) (Kirtadze, I., 2008).

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Drug-related deaths

No data on drug related deaths were recorded in Georgia from the 1990s to 2007. One reason was systemic: all former Soviet registration and monitoring systems were destroyed after Georgia regained independence and the creation of new systems took time.

In 2004, the Forensic Expertise Bureau was established within the Ministry of Justice, which re-started registering drug-related deaths. The Bureau gathers data that relate only to cases investigated and tested by the Bureau in Tbilisi, which was 26 cases of drug overdose deaths, i.e. approximately 1 % of all unnatural deaths in Tbilisi in 2008 (39 cases in 2007). Though the data do not cover the country in general and cannot be broken down according to the type of drug/s that caused the overdose, it is the first time when the Bureau broke the long drug death-related silence in Georgia. Data on the whole of Georgia are not yet available.

In 2004, SCAD set up a task force to conduct a special drug-related mortality study based on crossing the historic register of narcology patients and the register of the general population/ general mortality register. The study was conducted by the Georgian Research Institute on Addiction. According to the results of the study, mortality among men of reproductive age that had a record of any drug use in Georgia in 2003 was double as high as the mortality rate among men of the same age with no such record (Javakhishvili, D.J. et al, 2005).

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Treatment responses

In the early 1990s, the first two narcological clinics emerged, though both had very limited capacity (Georgian Research Institute on Addiction’s clinic with 25 beds and Bemoni clinic with six beds). Since then, treatment capacity has developed in the country: there are presently six clinics with 60 beds and capacity to detoxify more than 1 000 patients during the year. The average stay of the inpatient client in the clinic is up to two weeks and detoxification is the main service provided. However, such service is generally considered to not be enough support to overcome the problem of addiction as such services tend to be oriented not on recovery but on temporary abstinence.

All treatment procedures are presently paid by patients directly and are not covered by any form of health insurance (except substitution treatment of opioid addiction — see below). Starting from the end of 2008, the national budget began to co-fund substitution treatment. The Ministry of Labour, Health and Social Affairs now pays for pharmaceutical methadone while patients pay for services (the work of doctors, nurses and other staff).

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Harm reduction responses

Harm reduction does not receive any state funding. However, due to the threat of HIV/AIDS and thanks to the attention of international donors (Global Fund, other United Nations (UN) agencies, European Union and its Member States, Open Society Institute and other private donors), harm reduction is a relatively developed strategy in the field of drug demand reduction in the country as documented by the increasing number of NGOs active in the field of harm reduction, and the other following facts. By the end of 2008, 14 NGOs were united in the Georgian Harm Reduction Network, which aims to represent members’ interests as well as the interests of clients. The harm reduction programmes served a total of 3615 different clients (1 200 regular clients, 690 IDUs engaged in needle exchange, 2093 Voluntary Counselling and Testing (VCT) consultations and 1 527 HIV screenings) in 2008. Harm reduction interventions were diversified; they transformed from needle exchange and distribution projects in the early 2000s to drug policy development, advocacy, awareness raising measures and voluntary counseling countrywide by 2008.

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Drug markets and drug-related offences

Traditionally, Georgia has not been considered to be a drug producing country, given that the majority of narcotic drugs with plant precursors (with the exception of marijuana) are produced in neighbouring or distant countries. Concerns exist over the potential for Georgia and the South Caucasus in general to become an area of greater drug transit of Afghan opiates headed to Europe.

Drugs with the largest presence on the black market include heroin, opium, and marijuana, recently supplemented by Subutex®, which contains buprenorphine (Todadze et al., 2008d, Todadze, 2009b, Kirtadze, 2008b, Vadachkoria, 2008).

Socioeconomic changes in Georgia over the recent decade have resulted in the transformation of the behavioral patterns of drug users. According to a study (Japaridze, 2008), the launch of the bank credit systems made it easier for drug users to buy drugs by taking loans, if employed, which temporarily reduces the probability of their criminal activity for the purpose of buying drugs, yet; this, in fact, transforms them into drug dealers and they become subject to different criminal liabilities.

According to the information provided by the Ministry of Internal Affairs of Georgia, the following types of drug substances were seized in 2008: heroin 12.12 kg, opium 53.6 g, marijuana 28.3 kg, tramadol 739.2 g, Subutex ® 13 757 tablets, cannabis plants 41.563 kg, methadone 328.27 g, morphine 38.049 g, codeine 1.675 g, cannabis resin 88.230 g, cocaine 1.375 g, methamphetmine 2.907 g, dypheniloxidate 0.7 g.

The costs indicated by these data of the MoI do not always correspond to the costs known from other informal sources (i.e. from the patients treated at the ‘narcological hospitals’, from clients of low threshold services, etc.). At the same time, the methodologies used for gathering data on the prices of drugs is not clearly formulated by the MoI, thus, the systematic bias in reported data cannot be excluded.

Drug prices 2008 — information provided by the MoI: heroin EUR 338–460 (per gram), opium EUR 20–33 (per gram), marijuana EUR 2–3.35 (per gram), morphine EUR 20 (per ampoule), Subutex ® EUR 200–215 (per 8 mg tablet). Information provided by clinics and low-threshold services, based on the reports of patients and service users: heroin EUR 100–140 (1 pack), opium EUR 100 (1 pack), marijuana EUR 2.4–3.2 (per gram), morphine EUR 10 (per ampoule), Subutex ® EUR 200 (per 8 mg tablet).

According to the Ministry of Internal Affairs of Georgia (MIA), in 2006, criminal proceedings for drug-related crime were initiated against 2 667 persons (13 women and 2 654 men). Of those, 26 persons were previously convicted for drug-related crimes and 24 cases involved juvenile suspects. In 2007, criminal proceedings were brought against 8 066 people (71 women and 7 995 men), including 64 who were previously convicted and 11 juvenile cases. In 2008, criminal proceedings were initiated against 9 151 persons (117 women, 9 034 men of whom 193 were previously convicted and 24 were juvenile cases).

8 699 cases of drug-related crime were registered in 2008 (8 493 in 2007 and 3 542 in 2006). Cases qualified as major crime (¹) out of those registered were as follows: 2 103 in 2008, 1 970 in 2007 and 1 926 in 2006 (Mol). A comparison of data from 2006, 2007 and 2008 reveals a sudden and sharp increase in the number of drug-related criminal proceedings in Georgia. The disproportionate increase in minor crimes compared to a very little increase in what is classified as major crime suggests that the first increase resulted from intensified police activity generated by the practice of massive random searches of young men and their testing for the presence of illegal drugs. However, this hypothesis needs to be further tested by a detailed breakdown of the types of drug-related crimes investigated by the police and by a careful assessment of court decisions. Thus far, existing information from the police and courts provides the following: 1 285 people were sentenced to imprisonment for illegal drug distribution in 2006; 1 625 people were sentenced to imprisonment for illegal drug distribution in 2007; 2 817 people were sentenced to imprisonment for illegal drug distribution in 2008.

(¹) A case classifies as major crime if it is a premeditated (deliberate) crime, punishable by a term of imprisonment not exceeding 10 years according to the Criminal Code, also an unpremeditated crime punishable by imprisonment for a term of over five years.

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National drug laws

According to existing Georgian legislation, drug use is an administrative offence with a penalty of GEL 500 (approximately EUR 220). Yet, the same person apprehended as a drug user for a second time offence within one year of his/her first drug offence bears criminal responsibility. In this case, punishment may be either imprisonment or ‘at least double the administrative fine’. At the same time, a maximum amount of fine is not defined in the criminal code, which means that such a decision is at the discretion of the judge and could imply a ten-fold increase. Due to this ‘rubber law’, there are cases of fines as high as GEL 4 000 (approximately EUR 1 800) for simple drug use (i.e. for urine test positive for metabolites of illegal drugs).

The Criminal Code of Georgia does not differentiate between illicit manufacture, production, purchase, storage, transportation, forwarding and sale of narcotic drugs, their analogues or precursors. All such criminal activities are placed under one paragraph/definition of crime rather than a differentiated approach to different drug offences.

Based on Article 45 of the Administrative Code of Georgia, the Ministry of Internal Affairs and the Ministry of Labor, Health and Social Affairs of Georgia issued joint Decree No 1049–233/n in 2006. According to the decree, in case of ‘reasonable suspicion’ (which is not specified/defined and thus allows for vague interpretation) that a person is in a state of inebriation caused by narcotic drugs or/and psychotropic substances, and/or has consumed a narcotic drug, law-enforcement officers can demand that the person undergo a test that should determine if the person used drugs or alcohol. According to the Beckley Foundation Briefing Paper XV: ‘[in 2007] ... there was a tenfold increase in the number of people force-tested for drugs during the seven months following the introduction of high penalties compared to the same period preceding this amendment: 22 755 vs. 2706). In all 12 months of 2007, over 57 000 people were brought in for forced testing; only 38 % tested positive for (metabolites of) illegal drugs, compared to 78 % for the similar indicator in the previous year’.

In 2008, important activities and initiatives aimed at improving/updating the drug law occurred. This included advocating for the revocation of criminal responsibility for (simple) drug use, and for the creation of institutional mechanisms for the implementation of drug legislation (i.e. an interagency governmental body coordinating system of responses in the country).

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National drug strategy

The period preceding 2008 is characterised by increased drug policy discussions in Georgia. In 2006, the State Drug Policy Council, established by the Ministry of Labour, Health and Social Affairs of Georgia, was charged with drafting a National Anti-Drug Strategy. The Georgian Parliament debated the respective strategy in February 2007. The same year, the non-governmental organisation (NGO) Alternative Georgia drafted an alternative proposal for an anti-drug strategy, as well as an action plan, with the support of the Open Society Georgia Foundation. However, neither of the documents was approved by the Government or Parliament of Georgia as a normative act, rendering the documents non-legally binding and barred from implementation. The passing of a national anti-drug strategy and action plan remains a target for policy makers.

In spite of increase of funding since its dramatic fall in 2006, it should be taken into consideration, that inflation of the Georgian Lari over the last 10 years as well as the modest budgeted proportion of drug demand reduction services in the Ministry of Health budget reveal certain limitations. More specifically, the same sums mean effectively less resources than what was spent on drug treatment and prevention yearly in the beginning of the 2000s. The percentage of drug demand reduction in the total budget of the Ministry of Health remains substantially lower than in 2000–03. In 2008, the funds allocated by the Ministry of Labour, Health and Social Security for drug demand reduction measures were EUR 250 000 (EUR 200 000 in 2007 and EUR 25 000 in 2006); the allocated funds varied between EUR 275 500 (2002) and EUR 75 000 (2005) in the years 1997–2005.

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Coordination mechanism in the field of drugs

Since there is no anti-drug strategy in Georgia, accordingly there is no body/institution responsible for implementing the strategy as well as there is no responsible institution for the evaluation of the strategy prescribed.

Though non-governmental sector is utilising networking and coordination to achieve harmony and synergy of the efforts; since 2003, under facilitation of SCAD programme, the Georgian Anti Drug Coalition was formed, uniting key non-governmental organisations in the field of drug demand reduction; in 2007, the National Harm Reduction network was founded, uniting 14 organisations working in the field of harm reduction for 2008.

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References

Ministry of Labor, Health and Social Affairs of Georgia. Antinarcotics Strategy of Georgia, 2006, Tbilisi.

Ministry of Internal Affairs. Analysis of Recorded Crime for 12 months 2007. Retrieved 5 June 2008.

Ministry of Internal Affairs. Analysis of Recorded Crime for 12 months 2006. Retrieved 5 June 2008.

Otiashvili, D., Sárosi, P., and Somogyi, G. (2008), ‘Drug control in Georgia: Drug testing and the reduction of drug use?’, Beckley Foundation, London, 15.

AIDS Center (2008), Annual report.

Alternative Georgia (2008), Analysis of drug examination practice in Georgia, Tbilisi.

Badridze, N., Chkhartishvili, N., Abutidze, A., Gatserelia, L. (2008), ‘Prevalence of hepatitis B and C among HIV positive patients in Georgia and its associated risk factors’, Georgian Medical News, 12, pp. 54–59.

Chirikashvili, N., Usharidze, D., Petriashvili, T., Bidzinashvili, K., Tsurtsumia, Z. (2008), ‘Assessment of drug dependence treatment in Georgia’, Tbilisi, CIDA, OSI.

GFATM (2008), ‘Draft Package of Drug Legislation Changes. Drug Legislation’, Tbilisi.

Javakhishvili, D., Lejava, G., Stvilia, K., Todadze, K.H., Tsintsadze, M. (2006), ‘Drug situation in Georgia, 2005’, Annual Report. In Javakhishvili, D. (Ed.).

Kirtadze, I., (2008b), ‘Experience of implementation of HR interventions’.

Lejava, G., Todadze, K.H., Sirbiladze, T. (2008), Personal communication on marijuana use scale in Georgia, expert’s estimations. Tbilisi.

NCDC & PH (2007), Health Care in Georgia (statistics book), Tbilisi.

NCDC & PH (2008a) ‘Research of HIV-supporting factors’, Tbilisi, NCDC.

NCDC & PH (2008b), Statistical Book, National Centre for Disease Control and Public Health Tbilisi.

Otiashvili, D., Todadze K.H., Usharidze D. (2008), Personal communication on problem drug use trends. Tbilisi.

Otiashvili, D., Sarosi, P., Somogyi, L.G. (2008a), ‘Drug control in Georgia: Drug control and reduction of drug use’, in Foundation, B. (Ed.) ‘Beckley Foundation briefing paper XV’, Beckley Foundation.

Otiashvili, D., Zabransky, T., Kirtadze, I., Pirashvilli, G., Chavchanidze, M., and Miovsky, M. (2008b), ‘Non-medical use of buprenorphine (Subutex) in the Republic of Georgia — a pilot study’, NIDA International Forum: Globally Improving and Applying Evidence-Based Interventions for Addictions — Book of Abstracts, pp. 69–70.

Parliament of Georgia (2007), Regulation on Approval of Principal Directions of Georgia’s National Anti-Drug Strategy (Regulation Number #4334 I-s).

Pertaia, T., Information Coordinator, Global Fund Project (2008), ‘Personal communication on effective implementation of HIV/AIDS prevention and control in Georgia’, in Kirtadze, I. (Ed.).

Radzimecki, J. (2006), Georgian Drug Strategy, Tbilisi.

Save the Children Federation (2007–08), ‘Baseline behavioral surveillance survey with biomarker component (2002–04 in Tbilisi; 2004–06, in Batumi, 2007, in Kutaisi)’, Tbilisi, Batumi, Kutaisi, Save the Children.

SCAD School Prevention Project (2008), Meeting on elaboration of drug prevention strategy in school setting, Tbilisi.

Sikharulidze, Z., Vadachkoria, D. (2008), Personal communication on problem drug use, Tbilisi.

Sirbiladze, T, Baramidze, L., Baratashvili, P., Javakhishvili, J., Machavariani, M., Nadashvili, N., Todadze, K.H.., Tsitskishvili, D., Zakarashvili, T. (2006), Georgian Anti-Drug Strategy, Tbilisi.

Skhvitaridze, Z. (2008), Needs for improvement in Georgian Drug Legislation, Tbilisi.

Todadze, K.H. (2008a), ‘A special analysis of methadone substitution programme peculiarities for SCAD Dug Annual Report’, Tbilisi.

Todadze, K.H. (2008b), ‘Strengths and weakness of methadone treatment in Georgia’, Tbilisi.

Todadze, K.H. (2008c), Unpublished report on implemented VCTs in the framework of the GFTAM Harm Reduction Programme, 2008, Tbilisi, GRIA.

Todadze, K.H. (2009a), Personal communication on the share of Buprenorphine use by IDUs, Tbilisi.

Todadze, K.H. (2009b), Unpublished report of Substitution therapy programme. Tbilisi.

Todadze, K.H., Kavtiashvili, E., Khintibidze, K. (2008d), Assessment of drug dependence treatment in Georgia, 1st ed. Tbilisi, CIDA, OSI, GRIA, NW.

Vadachkoria, D., Kavsadze, R. (2008), Co-morbidities among drug users according to the observations of the addict logy clinics medical doctors, Tbilisi.

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