ATS injection in the Republic of Georgia a pilot study

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ATS injection in the Republic of Georgia a
pilot study

• David Otiashvili (1), Tomas Zabransky (2), Irma
  Kirtadze (1), Gvantsa Piralishvili (1), Marina
  Chavchanidze (1), Michal Miovsky (2)
• 1 Addiction Research Center, Union Alternative
  Georgia, Tbilisi, Georgia
• 2 Centre for Addictology, Psychiatric Clinic,
  1st Medical Faculty, Charles University, Prague,
  Czech Republic
• 1st global conference on methamphetamine
  Science, Strategy and Response
• Prague, Czech Republic
• 15th September, 2008

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Background

• 2005 - Country Annual Report on Drug Situation
  identifies ATS injection as an emerging trend (1)
• 2006 IDUs social network study 30 lifetime-
  and 6 last month prevalence
• 2006-2007 - 11 of study participants (no
  medical treatment receiving opioid dependent men)
  admit current use of home-made stimulants (2)
• 2007 study of the risk behavior among IDUs in
  NEPs 98 lifetime- and 45 last month prevalence
  (3)
• (1) Javakhishvili, J., Kariauli, D. , Lejava, G.,
  Stvilia, K., Todadze, Kh. and Tsintsadze, M.
  (2006) Drug Situation in Georgia - 2005.
  Tbilisi, Georgia Southern Caucasus Anti-Drug
  Programme.
• (2) Otiashvili D, Jones HE, Chavchanidze M,
  Kirtadze I, Tuten M. (2007) First Republic of
  Georgia randomized controlled trial (RCT) for
  drug abuse treatment The process and initial
  results of developing a couples treatment for
  drug abuse, CPDD 69 Annual Conference, Poster
  PresentationI, http//biopsych.com81/CPDD07_Web/F
  MPro
• (3) Kirtadze I., 2008, Evaluation of risky
  behavior among injection drug users, unpublished
  research data

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Method

• Setting
• NEP and VCT centers in Tbilisi, Gori, Zugdidi
  and Batumi
• Population
• IDUs (clients of NEP and VCT)
• Instrument
• Self-completed paper-based structured
  questionnaire (13 questions, 9 of them
  multi-choice)
• Data collection period
• August-September 2007

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Results

• 381 IDUs (13 female)
• Mean age 32.6 (SD 7.6)
• The mean history of regular (at least twice a
  week) injecting use of any drugs was 98 months
  (SD 72.6)

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Lifetime prevalence of ATS injection - 67.2
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(No Transcript)
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Home-made stimulants were injected most often in
the last 30 days compared to other drugs (1,874
cumulative days, 11.5 days on average)
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Results
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What is injected?

• Vint from Solutan, Teophedrine
• Ephedrine benzine, red phosphor, crystal
  iodine ? pervitin (methamphetamine)
• Jeff, boltushka from Teophedrine, Ephedrine
  Hydrochloride, Coldact, Effect, Fervex
• Ephedrine, pseudoephedrine, phenylpropanolamine
  potassium permanganate ? methcatihnone

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Discussion

• Injected more frequently (than opioids)
• Increased injection and sexual risk behavior
• Severe neurological complications (Parkinson-like
  syndrome, cognitive impairment, ..)
• No age differences
• Neither really preferred nor popular, but widely
  used (because of easy availability and relative
  polyvalence / remarkably low doses of drugs
  used by Georgian IDUs?)

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Discussion

• Lack of data on evidence-based methods for ATS
  use prevention and treatment
• Lack (absence) of treatment and harm reduction
  programs targeting ATS users
• Most programs are targeting opioid users

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Conclusions

• The injecting use of home-made stimulants (HMS)
  represents an emerging public health issue in the
  Republic of Georgia
• Research priorities to assess the medical and
  social consequences and associated risks of the
  use of home-made stimulants
• Harm reduction services 1) develop strategies to
  engage home-made stimulants users into the low
  threshold programs, and 2) develop and implement
  specific programs to prevent harmful consequences
  of HMS use

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Thank you

• David Otiashvili
• dato_at_altgeorgia.ge
• datohupo_at_yahoo.com