Q&A: International Experts on Georgia’s Drug Policy Reform

How would you assess Georgia’s national drug policy?

Georgian drug policy is experiencing turbulence now. [The policy] was bad, then the civil society developed very good, comprehensive approach, which was positively evaluated by all international partners, but unfortunately it did not pass the parliament. It’s like it was one step [made] forward and now two steps [made] back.

So, the feeling among the community and among international supporters of the drug policy reform is currently not very optimistic… [but] we still hope that the knowledge, understanding, which was gained among the civil society, community of people using drugs, different sub-groups of people using drugs, [as well as the] experience of working together, advocating together, dancing together and creating the legislative initiatives together – this experience will work for [making] the next step forward.

Criminalization [of drug use], all the testing, the lack or shortage of services for people using new drugs and no availability of naloxone [medication designed to rapidly reverse opioid overdose – Civil.ge] without prescription – is a harsh environment [to work in]. But the harshest part is keeping people imprisoned for the usage and possession [of drugs] for personal use.

And actually that’s why I am accenting the comprehensive approach. You can’t change [the approach] by bits and pieces, you need to have comprehensive change and to implement it all along.

Why should the state finance harm reduction?

In Georgia the key state players know why harm reduction is working. AIDS center, National Center for Disease Control, the Ministry of Health… they know why harm reduction is working, and what it is working for: for disease prevention.

For the state the public health interests are the most important. So, harm reduction is very effective for reducing the level of new cases of HIV among people using drugs, it is very effective in testing and treatment of tuberculosis – main cause of death of people using drugs, in testing and treatment of Hepatitis C and other viruses.

The question is about [providing] sufficient funding for the complex social help, which is needed if the harm reduction is to fulfil the public health needs.

Harm reduction is standing on the two legs: first, we need to provide something, which is valuable for people using drugs and this is social support, is counseling – psychological, or legal; and safe place for usage, for communication, for self-support. And, with this will come understanding of self-efficiency and self-esteem by people using drugs. If I feel proud of myself and ok with myself, then of course I will care about testing, about clean needles, about being safe with the opioid substitution treatment, or being safe in case of overdose by other drugs or in checking drugs I’m using. That’s the point of harm reduction – it is changing the way of thinking about myself as a person using drugs.

Georgia is ready to go forward [in this direction] and is going forward.

How would you assess Georgia’s national drug policy?

I think Georgia is at crossroads: you have very, very harsh, punitive drug laws, that have been a case study in what does not work, but it has also been a case study in promoting a social response of young people, which is inspiring many of us around the world who are looking at drug law reform.

So, I think Georgia is this very conflicting story, [with] very extreme criminalization and very positive response of young people, who are saying it is time to change, it is time to move on.

I think you need to have incremental model of change. I think you start by decriminalization of people who use drugs, then you remove us from the criminalization, then slowly we move towards a greater regulation, probably with drugs like cannabis, the softer drugs.

I think we have to understand that a huge revolution of drug laws is going to be challenging to manage. But an incremental change is going to be something that is much more possible.

Why should the state finance harm reduction?

The reason to fund harm reduction is that it saves money.

If you have someone living with HIV, you have someone living with Hepatitis C, you have to deal with the financial consequences of someone dying and lost productivity that the society has, that is the cost of bad drug policy.

Harm reduction gives people their lives back. It has the individual benefit of making someone healthy and … [able to] live with families, live with dignity, [being able] to also contribute to society. Many drug users are highly thoughtful, intelligent, creative people, and we are pushed out of society when in fact we want to do is be active, vibrant, committed citizens.

How would you assess Georgia’s national drug policy?

For the cannabis I think… it’s the opportunity to think of drug policy, look differently with lesser repressive action and more services and maybe regulation… at the same time I think they should really decriminalize drug use first, because it’s very difficult to make good access to health services when [drug use] is criminalized.

And we see a lot of people who don’t talk about their addiction, they don’t go to the health services – with Hepatitis C or other infections – they don’t go because they are [believed to be] criminals, in fact. And we have the same problem in France. We have a drug consumption room but it’s only in the perimeter [of the harm reduction institution] but otherwise it’s still criminal to take drugs.

Why should the state finance harm reduction?

Nowadays, all over the world we realize that drugs exist, people are taking drugs and some among these people – around ten percent – will have problems and illness, which is a burden of the health system.

We cannot put these people apart, because they are living in the society, they have families, and so if we want to integrate them in the society, we need to offer also some special services as we offer for other illness…

I think it is important to do both things: to decriminalize all drug use not only cannabis; they [state] must finance harm reduction services also because one goes with the other.

We need some place to welcome drug users, talk to them, and to deliver harm reduction services… And maybe with decriminalization people will go more for the [health] services and maybe it will need more funding.

But if they will put some money [into the system] at the end they will have this money back, because people won’t have for example Hepatitis C. This was the main problem in Georgia. There are a lot of other infections, a lot of psychological problems going with drug use. If people are not coming to the services you cannot help them.