• 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

Drug use among the general population and young people

To date, there have been no general population surveys carried out in Georgia. Hence, there are no valid data on the prevalence or incidence of drug use among the general population, including various subpopulation groups. There has been only one survey conducted among schoolchildren in 2006 (SCAD programme, 2006), which assessed knowledge of, and attitudes to drug use, but this did not estimate prevalence of drug use.

top of page

Prevention

Since 1990, only a few NGOs have implemented small-scale prevention projects in schools and various community settings, with the financial support of international donors. These interventions were mainly directed at raising awareness of the drug problem and on developing healthy lifeskills.

To date, interventions in the field of universal prevention have often been fragmentary and subject to the availability of external funds. Prevention is the least funded area in the field of demand reduction in the country. In the period from 1997 to 2007 there were only 18 school prevention projects implemented in Georgia. In 2005–06, the situation was slightly better with funding of EUR 30 000 and 130 direct beneficiaries. The donors of these projects included the World Bank, the European Union, and USAID.In 2007, a universal prevention strategy for the Ministry of Education and Science (MoES) was elaborated by a task force involving representatives of the MoES, MoLHSA, Academy of Continuous Pedagogical Education, and the Georgian Anti-Drug Coalition in the framework of SCAD. However, the strategy has not been accepted yet by the MoES and the corresponding action plan has not been elaborated. Currently, the MoES made two important steps in the field of drug primary prevention: (i) a short chapter on the harm of drug abuse that is incorporated in the handbook of civic society classes for 10th grade students; and (ii) information on drugs’ harmful influence on the neurological system that is incorporated into a biology handbook for 8th grade students. So the elaboration of a strategy is still necessary.

In 2006, the Patriarchy of Georgia (the superior autority in the Georgian Orthodox Church) declared its intention to support universal prevention. The Patriarch established a special unit on prevention of addiction under his foundation in 2007. At the end of 2007, this unit, in cooperation with the International Orthodox Christian Charities (IOCC) began a project funded by the US Government, focusing on a drug information campaign and the training of school teachers and priests in drug issues. The project also aims to establish (pilot) ‘orthodox Christian youth clubs’ with anti-drug activities forming a part of their curriculums. Finally, the project plans to create and broadcast a number of social videos focusing on drug use prevention.

Since 2003, SCAD has begun to mobilise and coordinate the professional community by establishing mechanisms for the circulation of drug-related information, and by planning and implementing joint anti-drug campaigns. One of the direct results of SCAD’s actions was the emergence of the Georgian Anti-Drug Coalition, which united a number of organisations working in the field of drug addiction and HIV/AIDS. Since 2003, the Georgian Anti-Drug Coalition has been implementing drug information campaigns. Several other anti-drug campaigns were implemented, however less successfully, and in a response to minimise further mistakes, the Georgian Anti-Drug Coalition, with the support of the German Government, has published and distributed a booklet on how not to conduct anti-drug campaigns, how to avoid mistakes and how to follow the ‘do no harm’ principle. Thus far, interventions in the field of universal prevention in Georgia generally lack qualitative indicators and impact evaluation systems.

top of page

Problem drug use

There are no data available on the extent of problem drug use. The only available estimate is based on experts’ opinions, which estimate that there are 80 000 injecting drug users in Georgia (Ministry of Labour, Health and Social Affairs of Georgia, 2006).

top of page

Treatment demand

Despite the increasing number of detoxifications in recent years (rising from 306 cases in 2003 to 1 092 in 2007), the figure does not meet existing demand for detoxification in the country. A significant proportion of patients are not able to receive treatment, mainly for financial reasons. Currently the cost of addiction treatment (except for substitution therapy) is paid for by the patient, and costs GEL 100–120 (EUR 45–55) per day on average, and free-of-charge programmes are not available for patients.

Addiction clinics in Georgia mainly deal with opioid dependence, and the proportion of patients using stimulants (ephedrone, ‘vint’, ‘jeff’) is been significantly lower (Research Institute on Addiction 2008, personal communication, 5 June 2007). Cannabis addiction treatment is relatively rare, and is mainly associated with toxic psychoses. In total, 1 092 detoxification episodes were conducted countrywide in 2007. Data collection according to diagnosis and gender is currently underway.

All of the three existing substitution therapy (ST) programmes in Georgia provided services to 230 patients in total by June 2008. In 2007, 285 patients underwent ST programmes (284 male and one female). From the beginning of the substitution programmes to the end of 2007, the programme covered 294 patients (289 male and five female drug users), including 48 HIV-positive patients.

Existing capacity is not sufficient to meet the need for substitution therapy in the country. By the end of March 2008, 250 persons were on waiting lists. Among them, 86 satisfied the programme’s eligibility criteria. There are three psychosocial rehabilitation centres in Georgia today, but so far they do not have appropriate registration systems and thus are not able to provide data on patients and treatment episodes.

top of page

Drug-related infectious diseases

By the end of 2007, the cumulative number of registered HIV cases amounted to 1 500 in Georgia (National AIDS Centre 2008, personal communication, 5 June 2007). It is believed, however, that official data/known cases do not reflect the real situation, and informed guesses of experts usually quote the total number of cases at around 3 500 (National AIDS Centre 2008, personal communication, 5 June 2007). Over the last 12 years, newly-reported cases have increased steadily, from low numbers in the late 1990s (e.g. 25 in 1998, 35 in 1999), to a strong rise in the 2000s (163 in 2004, 242 in 2005, 276 in 2006, 344 in 2007. The highest cumulative incidence of HIV infection for 1996–2007 was reported in the Adjara region (57.1 cases per 100 000 inhabitants), followed by the regions of Tbilisi (53.1 cases), Samegrelo (49.6 cases) and Imereti (22.6 cases).

The majority of people registered as living with HIV/AIDS are between 25 and 40 years of age (38 % aged 31 to 40 years,18 % aged 25 to 30 years). Most of the registered cases have been males (up to 80 %). However, there has been an increasing trend in the proportion of females over the past seven years, and the distribution of cases by gender has changed across age groups: the increase in the proportion of females has been more prominent among the 15–25 years of age bracket.

The reported transmission of infection within the registered HIV/AIDS cases in Georgia follows the following major routes: 60 % (900) are injecting drug users (IDUs); 32.9 % (493) contracted the disease through heterosexual contacts and 2.7 % (40) through homosexual contacts; 2.4 % (36) through perinatal mother to child transmission; 0.7 % (11) through blood transfusion; and 1.3 % (20) where the mode of transmission is unknown.

In 2006, the reported incidence of hepatitis C was 24.2 per 100 000 inhabitants in Georgia. The respective figure for hepatitis B was 20.1 (there are no data on the incidence by gender and age groups). According to expert opinion (National AIDS Centre 2008, personal communication, 5 June 2007), the true incidence may be significantly higher, taking into account the under registration of cases. While realising the limitations of official health statistics data, it can be still speculated that over the last five years Georgia has experienced an increased trend in the incidence of hepatitis B/C (from 6 cases per 100 000 inhabitants in 2000 to 24.2 cases in 2006 for hepatitis C, and from 10 cases per 100 000 inhabitants in 2000 to 20.1 in 2006). An increase in the incidence of hepatitis B/C can be partly related to the increase in injecting drug use (specifically type C, which is mostly related to IDUs).

top of page

Drug-related deaths

Since the 1990s, for a number of reasons (stigma, structural problems, corruption), there was no system in place either to register cases of drug-related deaths or to reveal drug-related mortality in the country. In 2004, the first steps were made towards filling this gap within the framework of the South Caucasus Anti-Drug Programme. In particular, an epidemiology training providing professionals with the relevant methodology was organised; the task force uniting key experts from the relevant fields (pathologist anatomist, addiction specialist, toxicologist, statistician, etc.) was created.

There were 39 drug-related overdose death cases registered in Tbilisi in 2007 (National Forensic Bureau of Ministry of Justice, 2008, personal communication, 5 June 2007). For the whole of Georgia, the data on fatal drug overdoses are so far unavailable.
top of page

Treatment responses

Institutional capacities in the area of addiction treatment are very limited in Georgia. Only six specialised clinics for addiction treatment were functioning in the year 2007 (five in Tbilisi and one in Batumi). All existing inpatient addiction treatment facilities in the country have a total of 60 hospital beds.
Despite improvements, the addiction treatment available today fails to meet modern therapeutic requirements. The treatment mainly focuses on 10- to 15-day inpatient detoxification with only some patients receiving comprehensive follow-up psychological rehabilitation, and no social rehabilitation.

The choice of treatment methods is limited. There are some attempts to use comparatively new detoxification approaches, e.g. rapid detoxification, yet the range of detoxification methods and medications is very restricted. No clinic is currently using strong pain-relieving narcotics, and patients are mainly detoxified using clonidine and strong psychotropic substances, also frequently in large amounts, which frequently complicates the treatment process and limit the possibilities for using cost-effective methods, such as outpatient detoxification.

At present there are three centres providing methadone substitution treatment (ST) in Georgia, including two centres in Tbilisi and one in Batumi. Starting from September 2008, an additional substitution therapy centre will be opened in one of Georgia’s regions (Shida Kartli-Gori) as part of the programme of the Global Fund to Fight against AIDS, Tuberculosis and Malaria (GFATM). The same programme will also include a pilot ST programme in the penitentiary system. By the end of 2008, the GFATM’s ST programmes plan to simultaneously serve up to 330 patients throughout Georgia. In addition to GFATM supported programmes, in July 2008 the government will begin funding five new ST centres (two in Tbilisi and three in the regions) to provide relevant services to 300 patients.

There are only three psychosocial rehabilitation centres in the country, whose resources and services are very limited. There are no residential-type rehabilitation centres, and there is no system for social rehabilitation of drug users or corresponding funding mechanisms.

Since 2007, the Swiss Migration Service has been implementing a programme which envisages training of social workers and other staff involved in addiction medical treatment, and the implementation of pilot employment programmes for people with drug dependencies. The programme is implemented in close cooperation with MoLHSA and the professional addiction medicine community.

According to the Round 6 GFATM Project, to be launched in the first quarter of 2008, a Psychosocial Rehabilitation Consultation and Training Centre will be set up to establish communities oriented at: the psychosocial rehabilitation of drug users in cathedrals and monasteries; providing training for priests, psychologists and social workers to implement addiction rehabilitation programmes in cathedrals and monasteries; preparing clergymen to cooperate with methadone programme centres; establishing a drug users’ support network; and counseling and training drug users.

In 2007, after gap of several years (2005–06, when funding was reduced to GEL 50 000 for treamtent), an increased amount of funds were allocated by MoLHSA for addiction treatment for 2007 (GEL 750 000) and 2008 (GEL 900 000). Further increase in the budget allocation is scheduled for 2009 too, to cover new treatment approaches and by including them into existing ST programmes.

Traditionally, from the MoLHSA’s limited budget in the drug addiction field, the highest proportion was spent on drug testing. Only a small portion of the budget (about 15 %) was spent on treatment, namely on psychoses and other socially dangerous conditions caused by alcohol and drug addiction. However, theis situation has changed and in 2008 EUR 430 000 was allocated to cover the costs of addiction treatment using both the ST and detoxification-related treatments.

top of page

Harm reduction responses

There have been a number of projects implemented within the framework of the ‘Strengthening the existing national responses for implementation of effective HIV/AIDS prevention and control in Georgia 2003–07 Programme’ (the ‘HIV/AIDS prevention among IDUs’ component of the GFATM programme).

A syringe exchange programme was implemented by local NGOs in Tbilisi, Batumi, Zugdidi, Gori, and Sokhumi. This programme distributed syringes a total of 376 480 syringes (16 146 returned), 387 077 alcohol swabs; 40 149 condoms and 4 845 informational materials. Professional consultants conducted the following consultations within harm reduction programmes: (i) 406 medical consultations; (ii) 81 legal/juridical consultations; (iii) 269 psychological consultations. In total, 359 HIV tests were conducted, and among these, 26 turned out to be positive.

Voluntary Counselling and Testing Centres have been operated by local NGOs in Tbilisi and Zugdidi. In total, 2 426 users were consulted (among them 67 female users) of whom 1 503 received primary consultations and 923 received secondary consultations. 743 users were provided with telephone consultations; 1 402 patients were tested for HIV, and hepatitis B and C, among whom 18 cases were found to be HIV positive, 827 hepatitis C positive and 76 hepatitis B positive. In total, 38 training sessions were conducted among peer-educators. During these training sessions, 260 peer-educators were trained. With the joint efforts of peer-educators and social workers 7 248 persons were reached (among them 4 949 were reached by social workers, and 182 by peer-educators.

top of page

Drug markets and drug-related offences

One of the major trafficking routes begins in Afghanistan and enters western Europe via Georgia. There is little or no exchange of information between the de facto governments of the territories of South Ossetia and Abkhazia and the Government of Georgia on possible trafficking routes through these areas.

The number of recorded drug-related criminal cases dramatically increased during 2007 and totaled to 8 493 cases (Ministry of Internal Affairs, 2007) in comparison with 3 542 cases in 2006 (Ministry of Internal Affairs, 2006).

In 2007, the quantity of seized heroin, buprenorphine (Subutex®) and methadone increased when compared to 2006. In 2007, the total amount of heroin seized increased by twofold when compared to 2006. In 2006, the quantity of seized heroin was 8.6 kg, whereas in 2007 a quantity of 16.15 kg of heroin was seized. As regards marijuana, opium and cannabis, the quantity seized in 2007 was less when compared to 2006. In 2007, the quantity of seized cannabis decreased by almost twofold, when compared to 2006. In 2006, the quantity seized of cannabis was 123.35 kg, whereas in 2007 the quantity seized was 64.86 kg.

As regards drug use, there is an administrative fine for the first detected use and criminal liability for a drug crime defined as ‘illicit use’ upon the second detection. There has been a dramatic increase recorded in drug use offences; after the increase of the administrative fine for drug use from EUR 43 to EUR 215 in 2006. This was followed by a tenfold increase in forced random drug tests, from 2 706 in the first ten months of 2006 to 22 755 in the same period of 2007, and a sharp decrease in the percentage of positive findings to 38 % as compared to 78 % in 2006 (Otiashvili et al., 2008).

top of page

National drug laws

The (administrative) penalty for drug use is a fine of at least EUR 652, corrective labour for 120–180 hours or imprisonment for up to a year. Possession of a controlled drug is a criminal offence prescribed by Chapter XXXIII of the Criminal Code of Georgia.

The penalty for trafficking of narcotic substances, its analogues (defined as ‘the natural or synthetic unknown substance, which is not included in the drug schedules, but with its psychotropic nature is analogous to narcotic drug) and precursors is six to nine years’ imprisonment. The same crime committed in large quantities or by prior consent of a group is punishable by 8 to 12 years’ imprisonment. The same crime committed by using one’s official position, repeatedly, or if the felon previously committed one of the offences referred to in the chapter, is punishable by 11 to 15 years’ imprisonment. The same crime committed by an organised group, or in especially large quantities, is punishable by 15 to 20 years’ imprisonment or by life imprisonment.

Cannabis has no special status in Georgia, as illegal substances are not classified differently in the national law and for the purposes of criminal liability or punishments, and there is no differentiation in types of illegal drugs in the Georgian Criminal Code. Thus, cannabis-type drugs can be used only for educational, scientific-research and diagnostic purposes.

top of page

National drug strategy

The document adopted by the Parliament of Georgia in February 2007 is entitled ‘The basic directions of the national anti-narcotic strategy of Georgia’, and was passed as a resolution of the Parliament. It is not a strategic, binding political document but rather a proclamation/list of general guiding principles that should lead to a formal strategy. The resolution outlined the anti-narcotic action plan to be elaborated by the Government of Georgia and presented to the Parliament by April 2008. Because of the absence of a strategy, no action plan is yet available in Georgia.

top of page

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. In addition, there is no responsible institution for the evaluation of the strategy prescribed.

top of page

References

Georgian Ministry of Internal Affairs (2008), Analysis of recorded crime for 12 months 2007, retrieved 5June, 2008. http://www.police.ge/statistika/statistika2007.mht

Georgian Ministry of Internal Affairs (2008), Analysis of recorded crime for 12 months 2006, retrieved 5 June, 2008. http://www.police.ge/statistika/statistika2007.mht

Ministry of Labour, Health and Social Affairs of Georgia (2006), Anti-narcotic strategy of Georgia, 2006, Tbilisi.

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

SCAD Programme (2006), Primary prevention of drug use among youth, Project implementation report, 2006, Tbilisi.

top of page