David Otiashvili Johns Hopkins University
Today, the drug abuse is one of the most severe problems of Georgia. Since the 1990s, there is a marked escalation of drug abuse and drug addiction throughout the country. This was a result of the disruption of existing antidrug-abuse system of the totalitarian regime. On the other hand, ongoing political transformation, civil war, unprotected borders, the escalated criminal situation, unemployment, social pessimism, the disruption of a system of common values, and the existing crisis prepared a good background for the wide-scale revival of drug abuse in Georgia. Parallel to that, the economic crisis caused a marked decrease in the state budget, and drug abuse disease treatment was transferred to the private sector. All the above had a disruptive impact on the drug abuse control system and contributed to the wide spread of drug addiction. On the whole, disease prevention and rehabilitation, which was in the embryonic stage of development, were totally disrupted. According to the Georgian Research Institute on Addiction, a total of 18,000 persons were registered by the end of 2003 including 6,000 drug dependents (so called abusers) and 12,000 drug users. Unfortunately, this picture cannot give the real situation. According to the healthcare and legal experts, the multiplication coefficient for Georgia should equal a minimum of 8 to 10. This means that the estimated number of drug users equals 120,000. It is estimated that among drug users, 30,000 to 35,000 are drug addicts and 85,000 to 90,000 are drug users, with 85 percent of registered drug users estimated to be heroin injection drug users (IDUs). Among registered HIV-infected persons 69 percent are IDUs. According to a survey conducted by the Research Institute on Addiction, among injecting heroin users, 55.5 percent have used an injecting instrument that was already used by others, and 41.3 percent used a drug that was taken out from a bowl that already had contact with another bloody needle. Use of drugs is highly stigmatized in Georgian society, and addicts are reluctant to be approached. The only possible way to deal with drug users is in treatment facilities or in prisons. Very few drug users come for treatment and usually do not stay there for a long time. The existing data clearly show that there is a need for extensive epidemiologic research in the Republic of Georgia.