Policing, massive street drug testing and poly-substance use chaos in Georgia – a policy case study

Abstract

BackgroundSince early 2000, intensive policing, wide scale street drug testing, and actions aimed at limiting the availability of specific drugs have been implemented in Georgia. Supporters of this approach argue that fear of drug testing and resulting punishment compels drug users to stop using and prevents youth from initiating drug use. It has been also stated that reduction in the availability of specific drugs should be seen as an indication of the overall success of counter-drug efforts. The aim of the current review is to describe the drug-related law enforcement response in Georgia and its impact on illicit drug consumption and drug-related harm.MethodWe reviewed relevant literature that included peer-reviewed scientific articles, stand-alone research reports, annual drug situation reports, technical reports and program data. This was also supplemented by the review of relevant legislation and judicial practices for the twelve year period between 2002 and 2014.ResultsEvery episode of reduced availability of any “traditional” injection drug was followed by the discovery/introduction of a new injection preparation. The pattern of drug consumption was normally driven by users’ attempts to substitute their drug of choice through mixing together available alternative substances. Chaotic poly-substance use and extensive utilization of home-made injection drugs, prepared from toxic precursors, became common. Massive random street drug testing had little or no effect on the prevalence of problem drug use.ConclusionsIntensive harassment of drug users and exclusive focus on reducing the availability of specific drugs did not result in reduction of the prevalence of injecting drug use. Repressive response of Georgian anti-drug authorities relied heavily on consumer sanctions, which led to shifts in drug users’ behavior. In most cases, these shifts were associated with the introduction and use of new toxic preparations and subsequent harm to the physical and mental health of drug consumers.

Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

“…The drug scene has changed dramatically in the Republic of Georgia over reent years in response to policy interventions such as legislative changes and enforcement measures against specific drugs. These interventions do not lead to the reduction of consumption but rather development of new sources of supply and increase use of other drugs [28] as a result of a switch from one drug to another by PWID. As expected in our analysis we did not observe any association between HIV infection and the type of drug, nor with the frequency of drug injection.…”

Hepatitis C Risk and Protective Factors Associated With Drug Policies in the Republic of Georgia

“…In 2014, Georgia significantly expanded the list of pharmaceuticals for which a person needs a prescription in an effort to reduce the illicit use of prescription drugs (e.g., Subutex). As a result of the decrease in access to pharmaceutical drugs, there has been a concomitant increase in the development and use of homemade drugs, most of which are injection drugs (Otiashvili, Tabatadze, Balanchivadze, & Kirtadze, ). On the one hand, Georgia's policies appear to have greatly reduced access to pharmaceutical opioid‐based drugs; however, the strict policies are also indicated as a catalyst for increased development of homemade synthetic drugs, which are often injection drugs (Kirtadze & Otiashvili, ; Kirtadze et al, ; Van Hout, ).…”

“…On the one hand, Georgia's policies appear to have greatly reduced access to pharmaceutical opioid‐based drugs; however, the strict policies are also indicated as a catalyst for increased development of homemade synthetic drugs, which are often injection drugs (Kirtadze & Otiashvili, ; Kirtadze et al, ; Van Hout, ). The most common form of administration for homemade drugs is injection and the most prevalent injection drugs are homemade opioid desomorphine (“krokodil” or “krok”), homemade stimulants (“Vint” and “Jeff”), and heroin (Otiashvili et al, ). Use of injection drugs increases risks of infection and transmission of blood‐borne illnesses such as HIV and HCV (Kirtadze et al, ; Van Hout, ).…”

“…Individuals who test positive for drugs for the second time within a 12‐month period are subject to higher fines and imprisonment (Javakhishvili, Otiashvili, Tabatadze, & Bergen‐Cico, ). Implemented in 2006, Georgia's random street urine drug testing policy was based on the premise that such strict punitive measures would serve as a means of primary prevention to keep people from experimenting with illicit drugs and serve as a means of tertiary prevention by prompting people who use illicit drugs to stop using (Otiashvili et al, ). Since 2006, law enforcement have used Article No.…”

“…Inability to pay fines for drug‐related offenses may also result in imprisonment. Policy violations for drug use may result from observed consumption of drugs, possession of used drug paraphernalia, or detection through a urine screening test demanded by police based on suspicion of drug use (Javakhishvili, Sturua, Otiashvili, Kirtadze, & Zabransky, ; Javakhishvili et al, ; Otiashvili et al, ).…”