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Table 1 Timeline of major policy events and changes in drug use patterns
From: Policing, massive street drug testing and poly-substance use chaos in Georgia – a policy case study
| Timeline | Legal changes | Enforcement measures/practice | Drug use patterns | Factors influencing users behavior |
|---|---|---|---|---|
| Mid 1990s | • Widespread corruption among police • Drug users - subjects to harassment and extortion of bribes | • Opium↓ replaced by heroin↑ • Tramadol + sedatives↑ | ||
| Late 1990s | • Tramadol scheduled | |||
| Early 2000s | • Heroin↓ replaced by buprenorphine (Subutex®)↑ • 40 % of treatment clients say Subutex® is primary drug • More than half report they use Subutex® to substitute opium or heroin • Home-made ATS (vint, jeff)↑ | • Buprenorphine not detected by police urine testing • External signs of intoxication less visible • Increased mobility to Russia and Ukraine • Recipes via internet | ||
| 2002–2003 | • New Frame Law on Narcotics allowed substitution therapy • Poppy seeds scheduled | • Poppy seeds↑ | • Price/availability | |
| 2005–2008 | • Tianeptin (Coaxil®)↑ • Home-made ATS↑ | • Price/availability • Not detected in police urine tests | ||
| 2005 | • Tianeptin scheduled | • First OST programme opened (GFATM) | • Subutex® and heroin - leading drugs | |
| 2006 | • War on crime - war on drugs • Adm. fine for drug use increased 5 fold • Drug testing facility moved to MIA | • Massive street drug testing launched • 12 fold increase in persons tested in 2007 vs 2006 | ||
| 2007 | • New law on Drug Crime (restrictions on civil rights) | |||
| 2007–2009 | • Subutex-enemy #1 • Public campaigns “Anything but Subutex”, “Killer in the city” | |||
| 2008 | • First state supported OST opened | |||
| 2009–2013 | • Victory over Subutex® and heroin announced | • Subutex®↓last month use from 75 % in 2007 to 7 % in 2013) • Heroin↓ • Poly-subs use↑ (90 % of injectors use 2 or more drugs, 75 % use 3 or more drugs) | • Availability (police claimed they successfully collaborated with French counterparts to restrict smuggling of buprenorphine) | |
| 2009 | • PDU size estimation - 40,000 | |||
| 2010 | • Pregabalin scheduled | • State funded OST scaled up - 17 sites • 4,600 patients treated in 2013 • Testing↓, imprisonment↓ | • Pregabalin (Lirica®)↑ | • Substitute for injectable opioids • Not in narcotics list • Not detected by police tests |
| • Desomorphine (krokodil)↑ | • Availability • Price • No need to engage with dealer/illicit market | |||
| 2011 | • Presidential Decree- Interagency Coordinating Council established | |||
| 2012 | • Krokodil - leading inj. drug • PDU size estimation - 45,000 | |||
| 2013 | • National (anti)Drug. Strategy and Action Plan 2013–2015 • New Government came to power • Codeine tablets moved under strict control | • 60,000 tested • Testing↑, Imprisonment↑ • Krokodil named as most dangerous drug | ||
| 2014 | • Law on New Psychoactive Drugs | • Victory over krokodil announced • MIA reported 90 % reduction in Krok. use (based on seizures and urine tests) • MIA reported 90 % reduction in NPS use (based on seizures and urine tests) | • Krokodil ↓( from 53 % in 2013 to 34 % in 2014, GHRN) • Heroin ↑ (heroin driven commuting to Turkey) • Buprenorphine ↑ • Tropicamide injection ↑ | • Attempts to compensate for reduced desomorphine |
| 2015 | • PDU size estimation - 49,000 |
