Tbilisi, Georgia — Georgia’s ruling party, Georgian Dream (GD), has enacted sweeping legislative changes that ban private entities from offering opioid replacement therapies and importing or distributing psychotropic drugs. The controversial amendments, passed during an extraordinary session of the GD one-party parliament on July 1-2, transfer the full responsibility for these critical services exclusively to the state.
The move signifies a significant centralization of drug treatment and supply under government control and was foreshadowed by remarks from Prime Minister Irakli Kobakhidze. Announcing the planned changes on June 25, Mr. Kobakhidze sharply criticized what he termed “pseudoliberal ideology” and accused private drug treatment programs of being driven by commercial interests that he alleged “legally supply narcotics.”
Details of the Legislation
The core of the new policy lies in amendments made to the Law on Narcotic Drugs, Psychotropic Substances and Precursors, and Narcological Assistance. Under the revised statute, private clinics and healthcare providers are explicitly prohibited from engaging in opioid replacement therapy, a widely recognized method for treating opioid addiction. Furthermore, the private sector is now barred from the import and distribution of psychotropic substances, tasks previously undertaken under state regulation but now solely the domain of state entities.
The extraordinary parliamentary session stretched over two days, culminating in the passage of these significant changes on July 2. Critics argue that the rapid passage through a parliament dominated by the ruling party limited substantive debate and oversight on a matter with potentially broad public health implications.
Government’s Rationale and Accusations
Prime Minister Kobakhidze’s public comments prior to the vote laid bare the government’s justification for the ban. His characterization of private programs as operating under a “pseudoliberal ideology” and engaging in commercially motivated practices that “legally supply narcotics” framed the legislative action as necessary to combat drug use and illicit supply chains, despite these programs operating within the previous legal framework.
The government maintains that centralizing these services under state control will lead to more effective and ethical delivery of treatment, removing profit motives from healthcare for vulnerable populations. However, this perspective is contested by some experts and practitioners who point to existing regulatory mechanisms.
Concurrent Policy Shift: Marijuana Criminalization
Notably, in the same July 2 session that saw the ban on private drug treatment and psychotropic imports, Georgian Dream lawmakers also took steps to tighten penalties related to marijuana. They voted to criminalize the possession of more than five grams of marijuana, making it punishable by a prison sentence of up to six years.
This legislative action occurred despite previous steps toward decriminalization in Georgia. The government has characterized this reversal and the broader treatment changes as part of its “uncompromised” fight against drug dealers and a general tightening of drug policy across the board.
Impact and Expert Concerns
The shift to a state-only provision of opioid replacement therapy affects a significant number of individuals. Narcologist Zurab Sikharulidze estimates that approximately 14,000 individuals are currently utilizing the state drug replacement program. In contrast, about 2,500 individuals were receiving treatment through private programs prior to the ban.
The transfer of care for these 2,500 patients, and potentially future patients seeking these services, entirely to the state raises questions about the capacity and readiness of state facilities to absorb the additional demand without compromising access or quality of care. Concerns are particularly acute for those currently enrolled in private programs who may face disruption in their treatment.
Some experts in the field have publicly questioned the necessity of the ban on private provision. They point out that the import and sale of psychotropic substances were already subject to regulation by the Health Ministry, suggesting that existing oversight mechanisms could have been strengthened rather than eliminating private sector involvement entirely. These experts voice apprehension that restricting access to treatment options could have negative consequences for individuals struggling with addiction.
Conclusion
The legislative changes spearheaded by Georgia’s ruling Georgian Dream party represent a fundamental restructuring of the country’s approach to drug treatment and psychotropic substance control. By prohibiting private engagement in opioid replacement therapy and the import/distribution of psychotropic drugs, the government has asserted a state monopoly over these services. While authorities frame the move as a necessary step to combat illicit practices and ideological influences, experts and practitioners raise concerns about the potential impact on patient access and the justification for removing private providers entirely, especially given existing regulatory frameworks. The concurrent re-criminalization of marijuana possession underscores a broader trend towards a more stringent drug policy under the current administration.
