ADVOCACY ON DRUG USE IN GEORGIA: PUBLIC HEALTH AND HARM REDUCTION ARGUMENTS MAY PRODUCE BETTER RESULTS

Author:

Tinatin Zardiashvili

Article Type:

Article Number: 7

ABSTRACT In Georgia, the government supports opioid substitution therapy programs at the same time as it enforces repressive drug policies and laws on the use of illicit drugs. Activists have been using human rights arguments to convince the government to change its repressive policies. In this commentary, Tinatin Zardiashvili argues that a public health and harm reduction approach might prove more effective.

According to an article in the journal BioMed Central, the approach to the illicit use of drugs in Georgia since the mid-2000s has been both repressive and ineffective. The article was based on a study carried out by a team of experts at an NGO, Alternative Georgia, involving a large-scale review of the literature, and legislative and juridical practices between 2002 and 2014.

The article said that “intensive policing, wide-scale street drug testing, and measures aimed at limiting availability of specific drugs have been seen by the government as a solution to the country’s drug problem.” The authors stated that each year, tens of thousands of people are detained in the streets and subjected to drug testing. Positive tests resulted in an administrative fine (double an average monthly salary) if it was a first time offence; or in criminal sanctions, including imprisonment, for subsequent offences.

“Supporters of this approach argued that fear of drug testing and following punishment compelled drug users to stop using, and prevented youth from initiating drug use,” the authors said. “[A] reduction in availability of specific drugs should be seen as an indication of the overall success of law enforcement measures.”

However, the study found that “intensive 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. The 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 … of new toxic preparations and subsequent harm to the physical and mental health of drug consumers.”

Alternative Georgia is a member (and one of the six founders) of the Georgian Harm Reduction Network (GHRN), one of the leading organizations providing low-threshold harm reduction services to people who inject drugs, and a sub-recipient of a grant funded by the Global Fund since 2008. The GHRN has been advocating for the liberalization of Georgia’s restrictive drug laws. It frames its arguments in terms of the human rights of drug users. But despite some small successes in the last few years, the network is finding it difficult to convince the government of the merit of its arguments.

Paradoxically, there is a government-run harm reduction program in Georgia which has been very successful. In 1999, a campaign by donors such as Open Society Georgia Foundation and the Global Fund, and by local experts and communities, convinced the government to adopt an opioid substitution therapy program (OST) for drug users. In 2014, the program had a budget of about $2.6 million. Currently, the GHRN is operating four OST sites and the government another 12. In July 2015, 70 prisoners were on OST.

The OST program has been financed by the Global Fund. However, in 2014, the government agreed to gradually assume responsibility for funding the program.

How is it that a government that recognizes the effectiveness of harm reduction services such as OST can at the same time enforce restrictive drug laws that are ineffective and that have been shown to cause harm?

The emphasis by activists on human rights arguments is understandable, given that one of the objectives of the Global Fund’s new Strategy is to “integrate human rights considerations throughout the grant cycle and in policies and policy-making processes.” But the government is resisting the human rights arguments, which is not surprising given that drug users are highly stigmatized in Georgia. In such a setting, would it not be more effective to focus on the harms caused by the repressive drug laws? That approach might serve to convince government officials and society in general that drug use is a public health and a medical issue, not a criminal one.

Parliamentary elections are expected in October. This is a good opportunity for activists to re-shape their arguments against repressive drug laws, focusing first and foremost on the harms these laws cause to the health of drug users and the well-being of their families; and to efforts to limit the spread of HIV and hepatitis C.