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Substitution Treatment of Opioid Users

in Prison Institutions

Levan Jorbenadze
Legal Advisor/Attorney
March 29, 2009

On December 8, 2008 with the support of international donor organizations the first substitution treatment for opioid users started in Tbilisi, which than for years paved the way throughout Georgia and for 25 December of 2008 it has been launched in prison institutions. Georgia shared the experience of European Union member states and took the progressive step for the aim of reintegration of prisoners who use opioid drugs. The treatment program will be financed with state, local, charity and private resources.

The joint order of 12-15 December, 2008 of the Ministers of Labor, Health and Social protection and Justice have created the basis norms of substitution treatment in prison institutions. 

The goal and the tasks of substation treatment are:
a) the ipioid users' health and psychological improvement; 
b) prevention of HIV infection, viral hepatitis and other infections;
c) stable remission achievement in patients with the help of substitution treatment and medical-social rehabilitation; 
d) injecting way of drug use prevention and improvement of psychological-somatic condition;
e) awareness raising of injecting drug users in the field of health improvement and medical examination; and raising the treatment motivation
In order to be eligible a person should be 18 years old, diagnosed as dependent on opioids (an active dependence) and satisfying one of the below mentioned criteria:
HIV/AIDS infected;
Prior involvement in the Methadone substitution treatment;
Infected with viral hepatitis, tuberculoses and parental born infections or/and having other health related exaggerated difficulties
Every patient has an individual prescribed treatment which is compiled by doctor and has a confirmation of special “Medical-Counseling Commission”. An individual treatment program is conceded with patients who in his turn signs the contract with the other side as mentioned “Medical-Counseling Commission”.
A patient can be excluded from the program if one breaches the contract obligations - for example: breaches the treatment regime; using drugs without a doctor’s prescription; performs incorrect activities against the medical stuff and is reluctant to the prescribed treatment.

The period of Opioid substation treatment is divided till one, six or more than six month. The types of Opioid substation treatment are: i) short term detoxication no more than one moth with the substitutive drug; ii) long term detoxication with decreasing the doses of substitutive drug - more than one month; iii) short term substitutive maintenance treatment with a stable doses of substitution drugs no more than six months; iiii) long term substitutive maintenance treatment with a stable doses of substitution drugs more than six months.

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