wliuri angarisi 2014 - altgeorgia.gealtgeorgia.ge/2012/myfiles/drug report geo 2014.pdf · 1....

narkoviTareba saqarTveloSi 1

2 0 1 4wliuri angariSi

Tbilisi

2016

wliuri angariSi, 20142

avtorebi:

sofo alaviZe eqimi, daavadebaTa kontrolis erovnuli centri

nino duCiZe fsiqologiis magistri, ilias saxelmwifo universiteti

irma kirTaZe eqimi, ilias saxelmwifo universiteti, damokidebulebis kvleviTi centri „alternativa jorjia“

daviT oTiaSvili eqimi, doqtori, damokidebulebis kvleviTi centri „alternativa jorjia“

mariam razmaZe fsiqikuri janmrTelobis magistri, ilias saxelmwifo universitetis adiqtologiis instituti

lela sturua medicinis doqtori, sazogadoebrivi janmrTelobis magistri; daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centri

mzia tabataZe eqimi, sazogadoebrivi jandacvis magistri, ilias saxelmwifo universiteti, damokidebulebis kvleviTi centri „alternativa jorjia“

jana (darejan) javaxiSvili ilias saxelmwifo universitetis adiqtologiis instituti, fondi „globaluri iniciativa fsiqiatriaSi - Tbilisi“

redaqtori:

desa bergen-siko doqtori, sazogadoebrivi jandacvisa da adiqciis kvlevebis departamenti, sirakuzis universiteti, niu iorki, aSS;

daviT oTiaSvili eqimi, doqtori, damokidebulebis kvleviTi centri „alternativa jorjia“;

mzia tabataZe eqimi, sazogadoebrivi jandacvis magistri, ilias saxelmwifo universiteti, damokidebulebis kvleviTi centri „alternativa jorjia“;

jana (darejan) javaxiSvili ilias saxelmwifo universitetis adiqtologiis instituti, fondi „globaluri iniciativa fsiqiatriaSi – Tbilisi“;

referirebisTvis:

javaxiSvili j., oTiaSvili d., tabataZe m., bergen-siko d., narkoviTareba saqarTveloSi, wliuri angariSi 2014, Tbilisi 2016

ISBN: 978-9941-0-8803-2

am angariSis momzadeba SesaZlebeli gaxda evrokomisiis / tempusis, aSS saerTaSoriso ganviTarebis saagentos (USAID), da CexeTis ganviTarebis saagentos finansuri mxardaWeriT.

angariSSi warmodgenili mosazrebebi ekuTvnis mxolod angariSis avtorebs da SesaZloa, ar asaxavdes donori organizaciebis an saqarTvelos mTavrobis pozicias.


sarCevi

mokle Sinaarsi ...................................................................................................................................... 5

madlobas vuxdiT ................................................................................................................................. 8

1. narkopolitika: kanonmdebloba, strategiebi da ekonomikuri analizi ......... 9

1.1. Sesavali ....................................................................................................................................... 9

1.2. samarTlebrivi CarCo ........................................................................................................... 9

1.3. ekonomikuri analizi ........................................................................................................... 13

2. narkotikebismoxmareba zogad populaciasa dakonkretul samiznejgufebSi ............................................................................................................................ 15

2.1. Sesavali ....................................................................................................................................... 15

2.2. narkotikebis moxmareba zogad populaciaSi ......................................................... 15

2.3. narkotikebis moxmareba skolaSi da axalgazrdebs Soris ............................. 15

2.4. narkotikebis moxmareba sxvadasxva samizne jgufSi erovnul da adgilobriv doneze .................................................................................... 16

3. prevencia.............................................................................................................................................. 18

3.1. Sesavali ....................................................................................................................................... 18

3.2. prevenciis sistema, strategia, politika ................................................................ 18

3.3. garemoze mimarTuli prevencia ..................................................................................... 19

3.4. universaluri prevencia .................................................................................................... 20

3.5. seleqciuri da mizanmimarTuli prevencia ............................................................. 21

3.6. centralur da adgilobriv doneze ganxorcielebuli kampaniebi ............. 21

4. narkotikebis maRali riskis moxmareba .............................................................................. 23

4.1. Sesavali ....................................................................................................................................... 23

4.2. narkotikebis ineqciuri moxmarebis prevalentoba ........................................... 23

4.3. narkotikebis maRali riskis momxmarebelTa maxasiaTeblebi ..................... 24

5. wamaldamokidebulebis mkurnaloba .................................................................................... 30

5.1. Sesavali ....................................................................................................................................... 30

5.2. mkurnalobis strategia da politika ......................................................................... 30

5.3. mkurnalobis sistema da mkurnalobaze xelmisawvdomoba .............................. 31

6. narkotikebTan dakavSirebuli jandacvis korelatebi da Sedegebi ................. 38

6.1. Sesavali ....................................................................................................................................... 38


6.2. narkotikebTan dakavSirebuli infeqciuri daavadebebi ............................... 38

6.3. narkotikebTan dakavSirebuli sxva avadoba .......................................................... 46

6.4. narkotikebTan dakavSirebuli sikvdili da sikvdiloba ............................... 47

7. reagireba janmrTelobis korelatebsa da Sedegebze ................................................ 48

7.1. Sesavali ....................................................................................................................................... 48

7.2. narkotikebTan dakavSirebuli gadaudebeli situaciebisa da sikvdilis prevencia ...................................................................................................... 48

7.3. narkotikebTan dakavSirebuli infeqciuri daavadebebis prevencia da mkurnaloba ................................................................................................... 49

7.4. reagireba narkotikebis momxmarebelTa janmrTelobis sxva korelatebze ................................................................................................................... 51

8. socialuri korelatebi da socialuri reintegracia ................................................ 52

8.1. Sesavali ....................................................................................................................................... 52

8.2. socialuri gariyva da narkotikebis moxmareba ................................................... 53

8.3. socialuri reintegracia .................................................................................................. 55

9. narkotikebTan dakavSirebuli danaSauli, narkotikebTan dakavSirebuli danaSaulis prevencia da cixe ............................................................... 59

9.1. Sesavali ....................................................................................................................................... 59

9.2. narkotikebTan dakavSirebuli danaSauli .............................................................. 59

9.3. narkotikebTan dakavSirebuli danaSaulis prevencia ..................................... 64

9.4. narkotikebis moxmareba da problemuri moxmareba sasjelaRsrulebis dawesebulebebSi ......................................................................... 64

9.5. narkotikebTan dakavSirebul janmrTelobis sakiTxebze reagireba cixeebSi ............................................................................................................... 65

9.6. narkotikebis momxmareblebis reintegracia cixidan gaTavisuflebis Semdeg ...................................................................................................... 66

10. narkobazari ..................................................................................................................................... 67

10.1. Sesavali..................................................................................................................................... 67

10.2. narkotikebis xelmisawvdomoba ................................................................................... 67

10.3. amoReba ....................................................................................................................................... 68

10.4. fasi/siwminde ......................................................................................................................... 69

indeqsi ...................................................................................................................................................... 70

abreviaturebi ....................................................................................................................................... 72

cxrilebi .................................................................................................................................................. 74

diagramebi ............................................................................................................................................... 76

bibliografia ........................................................................................................................................ 78

danarTi 1: saqarTvelos sisxlis samarTlis kodeqsis XXXIII Tavi: narkotikuli danaSauli......................................................................................... 81

danarTi2: informacia samkurnalo dawesebulebebis Sesaxeb.................................... 83


mocemuli angariSi erToblivi Zalisxmevis Sedegia da momzadebulia multidisciplinuri gundis mier, romelic aerTianebs eqspertebs adiqtologiis, epidemiologiisa da fsiqologiis dargebSi.

wliuri angariSis SemuSavebis procesi da struqtura efuZneba evropis narkotikebisa da narkomaniis monitoringis centris (EMCDDA) standartebs. informacia gadmocemulia xuT sakvanZo epidemiologiur indikatorze, Zalovani struqturebis indikatorebsa da qveyanaSi xelmisawvdom, narkotikebis ukanono brunvis problemis sapasuxo RonisZebebis monacemebze dayrdnobiT.

angariSSi asaxulia 2014 wels saqarTveloSi arsebuli narkoviTareba. sadac SesaZlebloba mogveca, vaCveneT ama Tu im indikatoris dinamikac.

2014-2015 wlebi saqarTveloSi ar gamoirCeoda didi cvlilebebiT narkoviTarebis TvalsazirisiT: narkotikuli saSualebebis moxmareba qarTuli kanonmdeblobiT kvlav kriminalizebulia, narkotikuli saSualebebis momxmareblebi isev farul populaciad rCeba, grZeldeba quCis narkotestirebis praqtika da kanoniT dadgenili sasjelis Semsubuqebis erTaderTi meqanizmi kvlav saproceso garigebaa, romelic prokuraturis doneze xorcieldeba.

2014 wlidan qveyanaSi gansakuTrebuli yuradReba daeTmo axal fsiqoaqtiur saSualebebs, ris Sedegadac miRebul iqna maTi maregulirebeli specialuri kanoni („axali fsiqoaqtiuri nivTierebebis Sesaxeb“). Sesabamisad, saqarTvelos sisxlis samarTlis kodeqss daemata debulebebi, romelTa Tanaxmadac kriminalizebulia axali fsiqoaqtiuri saSualebebis ukanono warmoeba, Sesyidva, Senaxva da a.S. kanonSi ganisazRvra axali fsiqoaqtiuri nivTierebebis qimiuri SenaerTebis 9 klasi da dasaxelda Sesabamisi 20 nivTiereba.

mocemuli angariSis gamoqveynebis momentisaTvis dasrulda gaxmaurebuli sasamarTlo saqme, romelic, eqspertebis azriT, Sesabamisi sakanonmdeblo cvlilebebis katalizacias moaxdens. saqme exeboda axalgazrda musikoss beqa wiqariSvils, romelsac 2013 wels, Cxrekis safuZvelze, samarTaldamcavebma upoves 70 gr. marixuana, rac, kanonmdeblobis mixedviT, did odenobadaa kvalificirebuli da, saqarTvelos sisxlis samarTlis kodeqsis 260-e muxlis meore nawilis safuZvelze, piradi moxmarebisTvis Senaxva-SeZenis gamo 7-dan 14 wlamde patimrobas iTvaliswinebs. samoqalaqo sazogadoebam daiwyo beqa wiqariSvilis mxardamWeri mudmivmoqmedi kampania. bolo etapze saqmem gadainacvla saqarTvelos sakonstitucio sasamarTloSi. sasamarTlom daakmayofila beqas dacvis mxaris mier saqarTvelos parlamentis winaaRmdeg wayenebuli sarCeli, romelic saqarTvelos

mokle Sinaarsi


sisxlis samarTlis kodeqsis 260-e muxlis meore nawilis „a“ punqts ganixilavda, rogorc antikonstituciurs (konstituciis 42-e muxlis sawinaaRmdegos).

angariSis momzadebis momentisaTvis qveyanaSi ar moipoveboda informacia axalgazrdebsa da zogad mosaxleobaSi fsiqoaqtiuri nivTierebebis moxmarebis Taobaze. erovnuli masStabis Sesabamisi kvlevebi qveyanaSi pirvelad 2015-2016 wlebSi Catarda da narkoviTarebis Semdgom angariSSi iqneba asaxuli.

2014 wlisTvis saqarTveloSi narkotikebis maRali riskis momxmarebelTa savaraudo raodenoba, Sesabamisi kvlevis safuZvelze, ganisazRvra rogorc 49,700 (49,208 – 50,192), prevalentoba 18-64 asakobrivi kategoriis mosaxleobaze – 2,02%-iT (2,00% - 2,04%), xolo zogad populaciaze – 1,33%-iT (1,32% - 1,35%)(saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2015b).

2014 wels, qveynis 10 qalaqSi, zianis Semcirebis saqarTvelos qselis Tanaswori-Tanaswors principze dafuZnebuli intervenciis mosargebleTa Soris Catarebuli kvlevis safuZvelze gamovlinda, rom programis mosargebleebs Soris, bolo Tvis manZilze moxmarebuli narkotikuli saSualebebis TvalsazrisiT, yvelaze gavrcelebulia kustaruli stimulatorebi (30.5%), dezomorfini (31.2%), heroini (30.9%) da subuteqsi (18.1%) (gogia 2015).

qveyanaSi kvlav Canasaxovan mdgomareobaSia rogorc prevenciuli saqmianoba, aseve socialuri reabilitacia. Sesabamisad, jerjerobiT ar aris sakmarisad ganviTarebuli narkotikebis avadmoxmarebis problemis marTvisaTvis auclebel RonisZiebaTa uwyveti jaWvi/sistema, romelic prevencias, mkurnaloba-reabilitacias, zianis Semcirebasa da socialur reabilitacias unda aerTianebdes.

mkurnalobis udidesi xvedriTi wili kvlav pacientebis jibidan finansdeba. mkurnalobis wamyvani formebia abstinenciaze orientirebuli – rogorc stacionaruli, iseve ambulatoriuli – mkurnaloba da CanacvlebiTi Terapia. ukanaskneli 10 wlis ganmavlobaSi iklo abstinenciaze orientirebul mkurnalobaSi CarTul pacientTa raodenobam da imatebs CanacvlebiT mkurnalobaSi CarTul pirTa ricxvi. 2014 wlis ganmavlobaSi abstinenciaze orientirebuli mkurnaloba qveyanaSi sul 663-ma pacientma gaiara, xolo opioidebiT Canacvlebis Terapiuli programebiT, jamSi, 3,968 pirma isargebla.

istoriulad saqarTveloSi narkotikebis ineqciuri gziT moxmareba aiv epidemiis gavrcelebis wamyvani gza iyo, magram 2010 wlidan situacia Seicvala da infeqciis gadacemis mTavari gza heteroseqsualuri kontaqtebi gaxda. 2014 wlisaTvis narkotikebis inecqiuri moxmarebiT dainficirebis xvedriTma wilma iklo 34.9%-mde, xolo heteroseqsualuri kontaqtebiT dainficirebis xvedriTma wilma 52.8%-mde imata.

2014 wels qveynis 7 qalaqSi Catarebulma kvlevam gamovlina, rom aiv-is prevalentoba narkotikebis ineqciurad momxmarebelTa Soris varirebs qalaqebis mixedviT – yvelaze dabali maCvenebeli hqonda rusTavs – 0.9%, xolo yvelaze maRali – zugdids – 4.8% (sandoobis intervali 95%CI, 0.2%-11%) (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2015a).


qveyanaSi ar arsebobs sarwmuno monacemebi narkotikebis moxmarebasTan dakavSirebuli sikvdilisa da sikvdilobis Sesaxeb. levan samxaraulis saxelobis sasamarTlo eqspertizis erovnuli biuros monacemebiT, 2014 wels narkotikebis zedozirebiT 7 adamiani gardaicvala, maSin, roca zianis Semcirebis saqarTvelos qselis monacemebiT, amave wels letaluri zedozirebis sul cota 39 SemTxveva dafiqsirda (gogia 2015).


saavtoro gundi madlobas uxdis yvela im profesionals, uwyebasa da dawesebulebas, romlebmac wvlili Seitanes mocemuli angariSis momzadebaSi, kerZod:

evrokomisias, CexeTis ganviTarebis saagentosa da amerikis SeerTebuli Statebis saerTaSoriso ganviTarebis saagentos, romelTa mier dafinansebuli proeqtebis farglebSic moxda mocemuli angariSis gamocema1;

kolegebs praRis Carlzis universitetis medicinis pirveli fakultetis adiqtologiis departamentidan da CexeTis narkotikebisa da damokidebulebis monitoringis erovnuli centridan – meTodologiuri, teqnikuri, instituciuri da kolegialuri mxardaWerisTvis;

adgilobriv partniorebsa da amave dargSi moRvawe organizaciebs: zianis Semcirebis saqarTvelos qsels, saqarTvelos adiqtologTa asociacias, saerTaSoriso fonds „kuracio“, fsiqikuri janmrTelobisa da narkomaniis prevenciis centrs, kerZo klinikebs „bemoni“ da „uranti“, arasamTavrobo organizaciebs „Tanadgoma“, „axali gza“, „axali veqtori“, „hepa plusi“, „peoni“ da „kamara“;

da bolos, Semdeg erovnul uwyebebs: iusticiis saministrosa da narkomaniasTan brZolis uwyebaTaSoris sabWos; Sromis, janmrTelobisa da socialuri dacvis saministrosa da mis daqvemdebarebaSi myof daavadebaTa kontrolis erovnul centrsa da Sinagan saqmeTa saministros, ganaTlebisa da mecnierebis saministros, saqarTvelos uzenaes sasamarTlos.

1 angariSi gamoica ramdenime qveynis monawileobiT, ori proeqtis farglebSi – „adiqtologiis dargSi adamianuri resursebis, mtkicebulebaze dafuZebuli midgomisa da Tvisebrivi standartebis SemuSaveba saqarTveloSi“ (TEMPUS, ADDIGE; donori European Union) da „adiqtologiis dargSi kvlevebis ganviTarebis proeqti saqarTveloSi“(Addiction Research Development Project in Georgia; donori - US Agency for International Development; Czech Develop-ment Cooperation).

madlobas vuxdiT


1.1. Sesavali

saqarTvelos narkopolitika, tradiciulad, met Zalisxmevas mimarTavs miwodebis Semcirebaze, vidre moTxovnis Semcirebaze. Sesabamisad, moxmarebaze sapasuxod dasja gadaswonis sazogadoebrivi jandacvisa da socialuri zrunvis midgomebs.

ukanasknel wlebSi qveyanaSi gadaidga mniSvnelovani nabijebi narkopolitikis ganxorcielebis instituciuri meqanizmebis gansaviTareblad. kerZod, 2011 wlidan iusticiis saministros xelmZRvanelobiT amoqmedda narkomaniasTan brZolis uwyebaTaSorisi sakoordinacio sabWo, 2012-2013 wlebSi SemuSavda da sabWos mier damtkicda narkomaniis winaaRmdeg brZolis saxelmwifo strategia da Sesabamisi samoqmedo gegma, 2014 wels daigegma narkoviTarebis monitoringis erovnuli centris daarseba.

1.2. samarTlebrivi CarCo

1.2.1. narkotikebTan dakavSirebuli kanonebi da normatiuli aqtebi

qveyanaSi moqmedi rogorc administraciuli, aseve sisxlis samarTlis kanonmdeblobiT, narkotikebis moxmareba samarTaldarRvevaa. administraciul samarTaldarRvevaTa kodeqsis 45-e muxlis Tanaxmad, wlis ganmavlobaSi samedicino daniSnulebis gareSe narkotikebis ukanono moxmarebis pirveli SemTxveva an mcire odenobis narkotikebis floba realizaciis ganzraxvis gareSe iTvaliswinebs jarimas 500 laris odenobiT an, gamonaklis SemTxvevebSi, administraciul patimrobas 15 dRemde vadiT. imave wels ganmeorebiT Cadenili qmedeba eqvemdebareba sisxlis samarTlis pasuxismgeblobas (saqarTvelos sisxlis samarTlis kodeqsis 273-e muxli).

administraciul samarTaldarRvevaTa kodeqsis 1162-e muxli aregulirebs satransporto saSualebis marTvas narkotikuli an/da fsiqotropuli simTvralis mdgomareobaSi, an narkotikuli simTvralis dasadgenad SemowmebisTvis Tavis aridebas. sasjeli iTvaliswinebs satransporto saSualebis marTvis uflebis SeCerebas 3 wliT.

quCaSi narkotikuli Trobis Semowmebas 2006 wlidan aregulirebs saqarTvelos Sinagan saqmeTa da saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministrebis erToblivi brZaneba #1244-278/n, gamocemuli saqarTvelos admin

2 2014 wlamde moqmedebda 117-e muxlic; 2014 wlis Semdeg am muxlis dispozicia 116-e muxlSi gadavida.

1. narkopolitika: kanonmdebloba, strategiebi da ekonomikuri analizi


istraciul samarTaldarRvevaTa kodeqsis 45-e muxlis safuZvelze. 2013 wlamde, brZanebis Tanaxmad, policias hqonda ufleba, daekavebina moqalaqeebi quCaSi narkotikuli Trobis eqspertizis Catarebis mizniT e.w. „gonivruli eWvis“ safuZvelze, romelic ar iyo saTanadod ganmartebuli da amdenad, subieqturi interpretaciis SesaZleblobas iZleoda. 2013 wels „kanonSi policiis Sesaxeb“ „gonivruli eWvi“ Seicvala formulirebiT „sakmarisi safuZveli varaudisTvis“.amis miuxedavad, aRniSnuli procedura isev iZleva subieqturi interpretaciis saSualebas.

quCaSi dakavebuli pirebis mier narkotikuli nivTierebis moxmarebis faqti dgindeba laboratoriis mier swrafi testebis saSualebiT an/da klinikuri SemowmebiT, rac saTanadod dasabuTebul pasuxs ar iZleva.

sisxlis samarTlis kanonmdeblobiT dasjad samarTaldarRvevebSi Sedis narkotikuli saSualebebiT an/da fsiqotropuli nivTierebebiT ukanono vaWroba, narkotikuli saSualebebis, aseve fsiqotropuli nivTierebebis ukanono damzadeba, Senaxva, warmoeba, gasaReba, qveyanaSi Semotana an qveynidan gatana (ufro detaluri informaciisTvis ix. danarTi 1: saqarTvelos sisxlis samarTlis kodeqsis XXXIII Tavi: narkotikuli danaSauli). 2015 wlidan saqarTvelos sisxlis samarTlis kodeqsis 260-e muxlidan3 amoRebulia gasaReba, ramac SedarebiT (6 wlamde) daswia sasjeli damzadeba/warmoeba/SeZena/gadazidvisTvis.

sisxlis samarTlis kodeqsiT narkodanaSaulisaTvis gaTvaliswinebuli sanqciebis simkacre damokidebulia samarTaldarRvevebis damamZimebel garemoebebze, romelTa Sorisaa amoRebuli nivTierebebis odenoba. kontrols daqvemdebarebuli nivTierebebis odenobebs aregulirebs 2012 wlis 22 maiss ganaxlebuli kanoni „narkotikuli saSualebebis, fsiqotropuli nivTierebebis, prekursorebisa da narkologiuri daxmarebis Sesaxeb“ (e.w. „CarCo kanoni“), romlis #2 danarTiT dadgenilia mcire, didi da gansakuTrebiT didi odenobebi 200-ze meti narkotikuli saSualebisa da 67 fsiqotropuli nivTierebisaTvis. dResdReobiT saqarTveloSi farTod gavrcelebuli mTeli rigi iseTi nivTierebebisTvis, rogoricaa amfetamini, metamfetamini da dezomorfini (ix.me-2 Tavi) mcire odenobebi dadgenili jerjerobiT ar aris. am nivTierebebis nebismieri raodenoba – SpricSi darCenili minimaluri raodenobac ki – did odenobad miiCneva, rac mniSvnelovanwilad amkacrebs sasjels.

axali fsiqoaqtiuri nivTierebebis ukanono brunvasTan brZolisa da mosaxleobis janmrTelobisaTvis potenciuri zianis Tavidan aridebis mizniT, 2014 wlis 16 aprils ZalaSi Sevida kanoni „axali fsiqoaqtiuri nivTierebebis Sesaxeb“. kanonis Sesabamisi debulebebi daemata saqarTvelos sisxlis samarTlis kodeqss da maT Tanaxmad kriminalizebuli gaxda axali fsiqoaqtiuri saSualebebis ukanono warmoeba, Sesyidva, Senaxva da a.S. kanonSi gansazRvrulia axali fsiqoaqtiuri nivTierebebis qimiuri SenaerTebis 9 klasi da CamoTvlilia 20 axali fsiqoaqtiuri nivTiereba.

axali, kodeinis Semcveli abebisgan kustarulad damzadebuli, opioid dezomor

3 2015 wlamde ssk 260-e muxli JRerda, rogorc „narkotikuli saSualebis, misi analogis an prekursoris, an axali fsiqoaqtiuri nivTierebis ukanono damzadeba, warmoeba, SeZena, Senaxva, gadazidva, gadagzavna an gasaReba“. 2015 wlidan „gasaReba“ amoRebulia.


finis („niangi“ anu „krakadili“) moxmarebis problemaze sapasuxod, 2014 wels Sinagan saqmeTa saministrosa da Sromis, janmrTelobisa da socialuri dacvis saministros erToblivi iniciativiT, kanonSi „narkotikuli saSualebebis, fsiqotropuli nivTierebebis, prekursorebisa da narkologiuri daxmarebis Sesaxeb“ Sevida cvlilebebi, rac iTvaliswinebs sisxlis samarTlis pasuxismgeblobas kodeinis, efedrinis, norefedrinisa da fsevdoefedrinis Semcveli wamlebiT kanondarRveviT vaWrobisTvis.

„narkotikuli danaSaulis winaaRmdeg brZolis Sesaxeb kanonis“4 Tanaxmad, „narkotikuli saSualebis momxmarebel pirs“5 CamoerTva mTeli rigi uflebebi (maT Soris, satransporto saSualebis marTvisa, saeqimo, saadvokato, saxelmwifo da adgilobrivi TviTmmarTvelobis organoebSi saqmianobisa, da a.S.). CamorTmeva xorcieldeba sasamarTlos gadawyvetilebis safuZvelze 3 wliT an ufro meti vadiT. kanonSi Sesworebebi ramdenjerme Sevida; uknasknelad - 2014 wels. mniSvnelovan cvlilebebaTa Sorisaa: farmacevtuli saqmianobis an afTiaqis dafuZnebis uflebis CamorTmeva, uflebebis aRdgena an uflebis CamorTmevis periodis Semcireba Sesabamisi vadis erTi mesamedis gasvlis Semdeg „kargi qcevis“ safuZvelze, saproceso SeTanxmebis dadebis SemTxvevebSi, uflebebis CamorTmevis vadis Semcireba an uflebis CamorTmevisgan srulad ganTavisufleba.

1.2.2. kanonis ganxorcieleba

sasamarTlo praqtika axorcielebs kanons samarTlebrivi CarCosa da saqarTvelos uzenaesi sasamarTlos rekomendaciebis Sesabamisad (ix.javaxiSvili, oTiaSvili, tabataZe 2013).

saqarTveloSi kanoniT dadgenili sasjelis Semsubuqebis meqanizmia saproceso garigeba, romelic prokuraturis doneze xorcieldeba. narkotikebis moxmarebisa da SeZena-Senaxvis gamo dakavebulTa didi nawili patimrobas Tavs aridebs swored saproceso garigebis wyalobiT, ris Sedegadac biujetSi yovelwliurad sagrZnobi Tanxa Sedis (ix. me-9 Tavi).

Tu saproceso garigeba ama Tu im mizeziT (vTqvaT, moqmedi samarTlebrivi strategiebis gamkacrebis gamo) ver xerxdeba da amoRebuli (piradi moxmarebis mizniT SeZenil-Senaxuli) nivTierebis odenoba kvalificirebulia, rogorc „didi odenoba“, ganurCevlad imisa, Tu ra nivTierebasTan gvaqvs saqme, sasjeli SesaZloa mravalwlian (magaliTad, 7-dan 14 wlamde) patimrobas gulisxmobdes. ukanasknel xanebSi am mxriv viTareba Secvala gaxmaurebulma sisxlis samarTlebrivi devnis saqmem, romelic axalgazrda mamakacis, beqa wiqariSvilis winaaRmdeg aRiZra 2013 wlis zafxulSi, grZeldeboda mTeli 2014 wlis manZilze da dasrulda 2015 wlis oqtomberSi. dakavebisas beqa wiqariSvilisgan, Cxrekis safuZvelze, samarTaldamcavebma amoiRes 70 gr marixuana, rac did odenobad aris kvalificirebuli da, saqarTvelos sisxlis samarTlis kodeqsis 260-e muxlis meore nawilis safuZvelze, piradi moxmarebisTvis Senaxva-SeZenis gamo 7-dan 14 wlamde patimrobas iTvaliswinebs. beqa wiqariSvilsa da mis mravalricxovan mxardamWerebs es sasjeli

4 kanoni ZalaSi Sevida 2007 wels.5 piri, romelmac saqarTvelos sisxlis samarTlis kodeqsis 273-e muxliT gaTvaliswinebuli danaSauli Caidina.


araproporciulad mZimed, sastikad da Sesabamisad, adamianis pativisa da Rirsebis Semlaxvelad miaCndaT. moewyo mudmivmoqmedi farTomasStabiani sazogadoebrivi kampania „beqa kriminali ar aris“, romelmac mniSvnelovani gavlena moaxdina saqmis msvlelobasa da gamosavalze. bolo etapze saqmem ukve saqarTvelos sakonstitucio sasamarTloSi gadainacvla. sarCeli, wayenebuli saqarTvelos parlamentis winaaRmdeg, 260-e muxlis meore nawilis „a“ punqts ixilavda, rogorc antikonstituciurs (konstituciis 42-e muxlis sawinaaRmdegos). sabolood beqas mxarem gaimarjva. eqspertebis azriT, es gaxmaurebuli saqme ara marto datovebs kvals kanonis aRsrulebis praqtikaze, aramed Sesabamisi sakanonmdeblo cvlilebebis katalizatoric gaxdeba.

1.2.3. erovnuli samoqmedo gegma, strategia da Sefaseba

„narkomaniis winaaRmdeg brZolis saxelmwifo strategia“ da Sesabamisi samoqmedo gegma daamtkica narkomaniasTan brZolis uwyebaTaSorisma sakoordinacio sabWom 2013 wlis 4 dekembers. orive dokumenti dainteresebuli subieqtebis, maT Soris eqspertTa Temisa da saerTaSoriso da adgilobrivi arasamTavrobo organizaciebis, aqtiuri monawileobiT SemuSavda. strategiis mTavari Tematuri mimarTulebebia: miwodebis Semcireba, moTxovnis Semcireba, zianis Semcireba, stigmisa da diskriminaciis daZleva, koordinacia da saerTaSoriso TanamSromloba, aseve kvleva da informaciis analizi. 2015 wlis bolosTvis es dokumentebi jer kidev ar aris damtkicebuli qveynis parlamentis mier.

miuxedavad imisa, rom 2014 wlis samoqmedo gegma detaluradaa gawerili – pasuxismgebeli da monawile instituciebis, saWiro xarjebis, droiTi CarCosa da Sedegebis Sefasebis gazomvadi indikatorebis miTiTebiT – misi Sesafasebeli kvleva ar Catarebula arc saxelmwifos, arc arasamTavrobo seqtoris mxridan, rac naklebad iZleva gegmis ganxorcielebis dinamikaze msjelobisa da daskvnebis gamotanis saSualebas.

1.2.4. koordinaciis meqanizmebi

qveyanaSi narkotikebis ukanono brunvis problemaze muSaobisTvis wamyvani sakoordinacio meqanizmia narkomaniasTan brZolis uwyebaTaSorisi sakoordinacio sabWo, romelic Seiqmna 2011 wels, saqarTvelos prezidentis brZanebiT. sakoordinacio sabWos mTavari amocanebia: fsiqoaqtiuri nivTierebebis avadmoxmarebis prevencia, adamianis uflebaTa dacvaze dafuZnebuli narkopolitikis gansazRvra, saxelmwifo narkostrategiisa da Sesabamisi samoqmedo gegmebis SemuSaveba, perioduli ganaxleba da Sesrulebis monitoringi da bolos, uwyebaTaSorisi saqmianobis koordinacia narkomaniis winaaRmdeg brZolis saxelmwifo strategiis implementaciis procesSi. sabWos koordinacias saqarTvelos iusticiis saministro axorcielebs. samTavrobo uwyebebis garda, sabWos muSaobaSi monawileoben e.w. mowveuli (xmis uflebis armqone) saerTaSoriso organizaciebis, arasamTavrobo seqtorisa da saeqsperto Temis warmomadgenlebi. sabWom aseve unda daaarsos narkotikebis erovnuli monitoringis centri, raze


muSaobac dawyebulia 2014 wels. Tumca, 2016 wlis pirveli naxevrisTvis, aRniSnuli centri jer ar daarsebula.

kidev erTi uwyebaTaSorisi sakoordinacio meqanizmi – „axali fsiqoaqtiuri nivTierebebis gavrcelebis aRkveTis xelSewyobis saxelmwifo komisia“ – Seiqmna axali fsiqoaqtiuri nivTierebebis moxmarebis problemaze sapasuxod, „axali fsiqoaqtiuri nivTierebebis Sesaxeb“ kanonis me-6 muxlisa da sami ministris erToblivi brZanebis6 safuZvelze. komisiis SemadgenlobaSi Sedian saqarTvelos Sinagan saqmeTa saministros, Sromis, janmrTelobisa da socialuri dacvis saministrosa da finansTa saministros warmomadgenlebi. zemonaxsenebi uwyebaTaSorisi sabWos analogiurad, komisiis muSaobaSi monawileobis misaRebad, saWiroebisda mixedviT, periodulad iwveven xolme dargis eqspertebs.

erovnul doneze moqmedi kidev erTi sakoordinacio meqanizmia farmacevtuli bazris kontrolis mizniT Seqmnili samuSao jgufi, romelic moqmedebs 2013 wlidan, Sss-sa da jandacvis saministroTa Soris dadebuli memorandumis safuZvelze.

1.2.5. sxva mimarTulebebi narkopolitikis sferoSi

2014 wlis agvistoSi, profesiuli Temis, narkopolitikis reformaze momuSave aqtivistebisa da samoqalaqo sazogadoebis organizaciebis grZelvadiani saadvokacio Zalisxmevis Sedegad, Sromis, janmrTelobisa da socialuri dacvis saministrom gamosca brZaneba, romlis Tanaxmadac jandacvis momsaxurebis mimwodeblebs moexsnaT zedozirebaze eWvis SemTxvevaSi policiisTvis Setyobinebis valdebuleba7. mosalodnelia, rom aRniSnuli cvlileba gazrdis zedozirebis SemTxvevaSi gadaudebeli samedicino momsaxurebis gamoyenebis albaTobasa da masStabs, rac, Tavis mxriv, Seamcirebs narotikebis mizeziT sikvdilobas.

1.3. ekonomikuri analizi

tradiciulad saqarTveloSi narkotikebTan dakavSirebuli problemebis sapasuxo RonisZiebebis dafinansebis srulyofili aRricxva ver xerxdeba. amis mTavari mizezi aris is, rom am RonisZiebebisaTvis gamoyofili an/da daxarjuli Tanxebi samTavrobo uwyebebis biujetebSi da xarjTaRricxvis angariSebSi ar aris identificirebuli, rogorc narkotikebis problemasTan dakavSirebuli Tanxebi. SedarebiT ufro naTelia am mimarTulebiT saerTaSoriso organizaciebis (donorebis) da Sromis, janmrTelobisa da socialuri dacvis saministroebis mier gaweuli danaxarjebis aRricxva, vinaidan am SemTxvevaSi gaweuli xarjebi Tematurad aris kvalificirebuli, rogorc narkotikebTan dakavSirebuli xarjebi.

6 saqarTvelos Sinagan saqmeTa ministris, saqarTelos Sromis, janmrTelobisa da socialuri dacvis ministrisa da saqarTvelos finansTa ministris 2014 wlis 13 maisis brZaneba №344/№01-30/n/№147 (komisiis Seqmnas safuZvlad daedo „axali fsiqoaqtiuri nivTierebebis Sesaxeb“ saqarTvelos kanoni da mocemuli brZanebis pirveli muxlis pirveli punqti).

7 2014 wlamde amgvar valdebulebas gansazRvravda Sromis, janmrTelobisa da socialuri dacvis ministris 5/12/2000 #239/n brZaneba.


jandacvis kuTxiT gamovyofT dafinansebis sam ZiriTad wyaros (ix. cxrili1) – sajaros (erovnuli biujeti), saerTaSorisos (metwilad SidsTan, tuberkulozTan da malariasTan brZolis globaluri fondi) da kerZos. aRsaniSnavia 2014 wels wina wlebTan SedarebiT yvela wyaros mier gaweuli xarjebis mkveTri zrda. 2014 wels saxelmwifo biujetidan da pacientebis jibidan gadaxdili Tanxebi daaxloebiT ormagad gaizarda wina welTan SedarebiT, imave periodSi saerTaSoriso donorebis mier gaweuli xarjebi ki 3-jer da metad gaizarda.globaluri fondis mier narkotikebis ineqciur momxmareblebze gaweuli danaxarjebis mkveTri mateba SesaZloa ganpirobebuli iyos fondis prioritetebis cvlilebebiT da meti yuradRebis gadataniT sakvanZo samizne jgufebsa da efeqtur da xarjTefeqtur intervenciebze. rac Seexeba kerZo danaxarjebis mkveTr matebas, SesaZloa wina wlebSi es danaxarjebi ar iyo saTanadod aRricxuli da angariSebSi asaxuli. sxvanairad rTulia imis axsna, Tu ratom SeiZleba gaormagebuliyo pacientebis mier Tanagadaxdili jamuri Tanxebi (fiqsirebuli Tanxa 110 lari 1 pacientze TveSi), maSin, rodesac mkurnalobis gawevis masStabi mniSvnelovnad ar gazrdila.

cxrili 1: narkotikebTan dakavSirebuli jandacvis danaxarjebi 2012-2014 wlebSi (saqarTvelos janmrTelobisa da socialuri dacvis saministro 2015)

sajaro saerTaSoriso kerZo

2012 2013 2014 2012 2013 2014 2012 2013 2014

zianis Semcireba agonisturi CanacvlebiTi Terapiis CaT-

vliT1,3171 1,2721 3,773.51 1,416 1,228 5,272.5 6142 1,2682 3,572.92

nebayoflobiTi testireba da konsultacia (VCT)3 125 105 580.5 676 453 489.2 0 0 0

ufaso stacionaruli da ambulatoriuli mkurnaloba da detoqsikaciis pirveladi

reabilitacia

n/k 628 615 0 0 0 n/k4 n/k4 n/k4

jami 1,442 2,005 4,388.5 2,092 1,681 5,761.7 614 1,268 3,572.90

1 - faravs agonisturi CanacvlebiTi Terapiis mkurnalobas; sajaro dafinanseba ar moicavs Spricebis gacv-lis programas;

2 - pacientis mier gadaxdili Tanxa agonisturi CanacvlebiTi Terapiis mkurnalobaSi;

3 - moicavs agreTve seqsmuSakebsa da mamakacebTan seqsis mqone mamakacebs Soris Catarebuli nebayoflobiTi testirebisa da konsultaciis dafinansebas;

4 - ar mogvepoveba pacientebis mier stacionarul da ambulatoriul mkurnalobaze gaweuli danaxarjebis Canaweri. aRniSnuli xarji mkurnalobis kerZo mimwodeblisTvis aris gadaxdili da Sesabamisi Canaweri ar moipoveba;


2.1. Sesavali

zogadi mosaxleobis gamokiTxva narkotikebis moxmarebis Temaze pirvelad saqarTveloSi 2015 wlis dekembridan xorcieldeba, USAID-s mier dafinansebuli proeqtis farglebSi. kvlevas axorcielebs damokidebulebis kvleviTi centri „alternativa jorjia“, daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnul centrTan TanamSromlobiT da praRis Carlzis universitetis adiqtologiis departamentis meTodologiuri mxardaWeriT. kvlevis Sedegebi xelmisawvdomi iqneba 2016 wels.

analogiurad, saqarTveloSi pirveli erovnuli masStabis gamokiTxva axalgazrdebSi fsiqoaqtiuri nivTerebebis (alkoholis, Tambaqosa da aralegaluri narkotikebis) moxmarebis Temaze 2015 wlis Semodgomaze Catarda daavadebaTa kontrolis erovnuli centris mier, evropis narkotikebisa da narkomaniis monitoringis centris (EMCDDA) meTodologiuri da finansuri mxardaWeriT. kvlevis Sedegebi xelmisawvdomi iqneba 2016 wels.

2.2. narkotikebis moxmareba zogad populaciaSi

monacemebi xelmisawvdomi iqneba 2016 wlis ivlisisTvis.

2.3. narkotikebis moxmareba skolaSi da axalgazrdebs Soris

bolo (2012 wlis) monacemebi saqarTvelos ramdenime qalaqSi axalgazrdebs Soris fsiqoaqtiuri nivTierebebis moxmarebis Taobaze, mopovebuli sxvadasxva organizaciebis mier Catarebuli kvlevebidan, SegiZliaT ixiloT qveynis narkoviTarebis 2013 wlis angariSSi (javaxiSvili, oTiaSvili, tabataZe 2013).

2. narkotikebis moxmareba zogad populaciasa da konkretul samizne jgufebSi


2.4. narkotikebis moxmareba sxvadasxva samizne jgufSi erovnul da adgilobriv doneze

2.4.1. narkotikebis moxmareba komerciuli seqsis muSakebSi

aiv-isa da sisxlis gziT gadamdebi sxva infeqciebis maRali riskis populaciebSi qcevaze zedamxedvelobis kvlevebi saqarTveloSi 2002 wlidan mimdinareobs8. 2014 wels komerciuli seqsis muSakebSi qcevaze zedamxedvelobis kvleva ganaxorciela saerTaSoriso fondma kuraciom, sainformacio samedicino-fsiqologiur centr TanadgomasTan erTad. kvleva Catarda saqarTvelos or qalaqSi: baTumsa da TbilisSi. igi miznad isaxavda aiv-infeqciis, C hepatitis, gonoreisa da sifilisis prevalentobis gazomvas mocemul samizne jgufSi, aseve, aiv-infeqciasTan dakavSirebuli ZiriTadi sarisko qcevebis Seswavlas. kvleva Catarda droisa da adgilis mixedviT SerCevis meTodiT; gamoikvlies 280 mdedrobiTi sqesis seqsmuSaki (160 TbilisSi da 120 baTumSi). seqsmuSakebis medianurma asakma Seadgina 40 weli TbilisSi da 38 – baTumSi; cdis pirTa TiTqmis naxevari miekuTvneboda 40 welze zeviT asakobriv jgufs (50.6% TbilisSi da 42.5% baTumSi). respondentTa umravlesoba eTnikurad qarTveli iyo (83.8% TbilisSi da 92.5% baTumSi), saSualo an profesiuli ganaTlebiT (79.4% TbilisSi da 82.5% baTumSi). gamokvleul seqsmuSakTa sacxovrebeli adgili gansxvavdeboda maTi samuSao adgilisgan: TbilisSi gamokiTxul seqsmuSakTa 71.9%-ma, xolo baTumSi gamokiTxulTa 93.3%-ma aRniSna, rom saqarTvelos sxva qalaqebidan arian. cdis pirTa umetesobam (TbilisSi 70%-ma da baTumSi 67.5%-ma) aRniSna, sul mcire, erT winamorbed qcevaze zedamxedvelobis kvlevaSi monawileoba. orive qalaqSi gamokiTxulTa 60%-ze meti ganqorwinebuli an meuRlisgan gancalkevebiT mcxovrebi iyo.

fsiqoaqtiuri saSualebebis moxmarebis TvalsazrisiT kvlevam Semdegi suraTi gamovalina (ix. cxrili 2): bolo 12 Tvis manZilze alkoholis yoveldRiurad moxmareba TbilisSi miuTiTa respondentTa 9.4%-ma (15 respondenti), xolo baTumSi – 21.7%-ma (26 respondenti); cxovrebaSi erTxel mainc narkotikis ineqciur moxmarebaze SekiTxva kvlevis dros ar dasmula; bolo 12 Tvis ganmavlobaSi narkotikebis ineqciuri gziT moxmareba TbilisSi aRniSna respondentebis 1.9%-ma (3 respondenti), xolo baTumSi – 0.8%-ma (1 respondenti); es oTxi respondenti ekuTvnoda SedarebiT axalgazrda asakobriv jgufs; ineqciurad moxmarebuli narkotikebi subuteqsi da heroinia; araineqciuri gziT moxmarebam cdis pirTa Soris Seadgina 6.3% TbilisSi da 5.8% baTumSi. yvelaze xSirad moxmarebul araineqciur narkotikebad dasaxelda saZile/damamSvidebeli saSualebebi.

8 organizaciis „gadavarCinoT bavSvebi“ saqarTvelos ofisma, aSS saerTaSoriso ganviTarebis saagentos finansuri mxardaWeriT saqarTveloSi danerga meore Taobis epidzedamxedveloba da Caatara seqsmuSakebs Soris pirveli epidzedamxedvelobis kvleva TbilisSi 2002 wels, xolo Semdeg msgavsi kvlevebi 2004 da 2006 wlebSi Catarda Tbilissa da baTumSi. 2009 wlidan globaluri fondis finansuri mxardaWeriT gagrZelda qcevaze zedamxedvelobis momdevno talRebi Tbilissa da baTumSi da Catarda samjer: 2009, 2012 da 2014 wels. wina wlebis epidzedamxedvelobis kvlevebis Sedegebi SegiZliaT ixiloT Sesabamisi wlebis narkoviTarebis angariSebSi.


cxrili 2: bolo 12 Tvis manZlze alkoholisa da aralegaluri narkotikebis moxmareba seqsmuSak qalebSi, 2014 wels (saerTaSoriso fondi kuracio da sa

medicino-fsiqologiuri centri Tanadgoma 2014)

alkoholis da narkotikebis moxmareba % n/N

alkoholis yoveldRiuri moxmareba 14.64 41/280

narkotikis araineqciuri moxmareba 6.07 17/280

sedaciuri/saZile abebis moxmareba 4.29 12/280

narkotikebis ineqciuri moxmareba 1.43 4/280

subuteqsis moxmareba 1.43 4/280

heroinis moxmareba 0.71 2/280

2.4.2. narkotikebis moxmareba mamakacebs Soris, romelTac sqesobrivi kavSiri aqvT mamakacebTan

saerTaSoriso fond kuraciosa da sainformacio samedicino-fsiqologiur centr Tanadgomis mier 2012 wels Catarda jvaredin-seqciuri kvleva, respondentze orientirebuli midgomiT, mamakacebs Soris, romlebsac sqesobrivi kavSiri aqvT mamakacebTan (msm). kvlevis mizani iyo aiv-infeqciis sarisko qcevis Sefaseba msm populaciaSi. gamoikiTxa TbilisSi mcxovrebi 218 msm. respondentTa medianurma asakma Seadgina 27 weli, naxevarze mets (55%, 120 respondenti) hqonda umaRlesi ganaTleba, didi umravlesoba (90%, 196 repondenti) iyo eTnikurad qarTveli; respondentTa 72% (156 piri) arasdros yofila qorwinebaSi. kvleva gviCvenebs, rom narkotikebis ineqciuri moxmareba msm populaciaSi ar aris farTod gavrcelebuli: kerZod, bolo 12 Tvis manZlze alkoholis yoveldRiurad moxmareba aRniSna 20-ma respondentma, xolo narkotikebis moxmareba bolo 12 Tvis manZlze aRniSna 39-ma respondentma; kanafi dasaxelda, rogorc yvelaze xSirad moxmarebuli narkotiki. bolo 12 Tvis manZlze narkotikebis ineqciuri moxmareba aRniSna mxolod eqvsma respondentma, romelTagan oTxma miuTiTa buprenorfinis moxmareba; mxolod erTma respondentma aRniSna bolo ineqciisas ziari Spricis gamoyeneba. cxrili 3 gviCvenebs kvlevis Sedegebs procentul maCveneblebSi:

cxrili 3: alkoholisa da aralegaluri narkotikebis moxmarebis prevalen-toba msm-ebs Soris(saerTaSoriso fondi kuracio da samedicino-fsiqologiu

ri centri Tanadgoma 2012)

indikatori % (N=218)

alkoholis yoveldRiuri moxmareba 9.2narkotikis araineqciuri moxmareba bolo 12 Tvis manZilze 17.9

narkotikis ineqciuri moxmareba bolo 12 Tvis manZilze 2.8


3.1. Sesavali

dReisaTvis saqarTveloSi saTanado yuradReba ar eqceva prevenciis mecnierebas. Sedegad, qveyanaSi mimdinare prevenciuli aqtivobebi umeteswilad ar efuZneba samecniero mtkicebulebas da ar fasdeba efeqtianobis, eTikisa Tu xarisxis TvalsazrisiT, gaeros standartebis Sesabamisad (UNODC 2015). imisTvis, rom prevenciuli programa efeqtiani iyos, igi unda eyrdnobodes mecnierebas, guldagul dainergos da xelmisawvdomi iyos populaciisTvis mTeli cxovrebis manZilze (The National Centre on Addiction and Substance Abuse 2015; Inaba and Cohen 2014; Saxena, Llopis, and Hosman 2006; UNODC 2015).

ukanasknel aTwleulSi erovnul saswavlo gegmaSi gamaxvilda yuradReba cxovrebis jansaR wesze, 2013 wlidan 15-18 wlis moswavleebisaTvis dainerga biologiis swavlebisas informaciis miwodeba aiv-Sidsis TvalsazrisiT sarisko qcevebze (maT Soris, narkotikebis moxmarebaze). magram skolis kurikulumSi jer kidev ar arsebobs prevenciuli ganaTlebis uwyveti jaWvi. masSi ar aris Seyvanili mtkicebulebaze dafuZnebuli iseTi programebi, romlebic nivTierebebis avadmoxmarebis riskebis gacnobierebaSi daexmareboda bavSvebs jer kidev mozardobis asakamde (15 wlamde). am periodis Semdeg damaxasiaTebeli opoziciuri ganwyobebi sarisko qcevaze miwodebuli informaciis mimarT winaRobas zrdis, amitomac, prevenciis efeqtianobisTvis, intervencia am asakamde unda moxdes (National Institute of Drug Abuse 2003; Levi et al. 2015; Wittchen et al. 2008). mozardobis asakamde prevenciis egidiT mimdinare RonisZebebs umeteswilad eqstrakurikuluri, fragmentuli da kampaniuri (konkursi, konferencia, da a.S.) xasiaTi aqvs. kvlevebis Tanaxmad, msgavsi programebi araefeqtiania, mozardebs ar aZlevs saTanado informacias risk-faqtorebis Sesaxeb da ar iZleva damcavi faqtorebis Camoyalibebis saSualebas (The National Centre on Addiction and Substance Abuse 2015; National Institute of Drug Abuse 2003; O’Connell, Boat, and Warner 2009).

3.2. prevenciis sistema, strategia, politika

ganaTlebis saministros monacemebiT, 2014 wlisTvis sajaro da kerZo skolebSi sxvadasxva disciplinebSi (sabunebismetyvelo mecnierebebi [VIII, IX klasebi], samoqalaqo ganaTleba [IX-X klasebi]) Setanilia antinarkotikuli da antinikotinuri Temebi, aseve ganxorcielda Tematuri konkursebi, konferenciebi da kampaniebi. monacemebi am aqtivobebSi CarTul bavSvebs Soris fsiqoaqtiuri saSualebebis moxmarebis gavrcelebaze Tu maT ganwyobebsa da codnaze fsiqoaqtiuri saSualebebis Sesaxeb RonisZiebamde da RonisZiebis Semdgom ar moipoveba.

3. prevencia


ganaTlebis da mecnierebis saministros organizebiT Seiqmna zogadi ganaTlebis politikis axali dokumenti, romlis mixedviTac 2014 wels 10 sapilote skolaSi dainerga saskolo garemos politika – jansaRi cxovrebis wesis meTodologia. 2015 wels igegmeba yvela sajaro skolis CarTva.

3.3. garemoze mimarTuli prevencia

Tambaqosa da alkoholis moxmarebasa da gavrcelebas administraciul samarTaldarRvevaTa kodeqsi aregulirebs.

Tambaqos SemTxvevaSi akrZalulia Semdegi: Tambaqos produqciis moxmareba sajaro da samedicino dawesebulebebsa da skolebSi, misi miyidva 18 wlamde asakis pirebisTvis da/an maTi Tambaqos biznesSi (mag. distribuciaSi) CarTva, sigaretis gayidva Rerebad, TambaqoTi vaWroba skolamdeli aRzrdis dawesebulebebisa da skolebis axlos, agreTve savaWro centrebis bavSvTa ganyofilebebis maxloblad; akrZalulia Tambaqos moxmareba samedicino da saswavlo dawesebulebebSi, sazogadoebriv transportsa da TavSeyris adgilebSi (daxurul Senoba-nagebobebSi), 18 wlamde asakis pirebisaTvis gankuTvnil dawesebulebebSi. aseve, akrZalulia Tambaqos moxmarebis reklamireba da Cveneba masmediiT, Tumca es dResdReobiT daSvebulia qalaqebSi gakrul did xilvad bilbordebze. administraciul samarTaldarRvevaTa kodeqsi aregulirebs agreTve gamafrTxilebeli warwerebis gakeTebis aucileblobas Tambaqos produqtebze/maT SefuTvaze.

rac Seexeba alkohols, misi moxmareba akrZalulia sajaro TavSeyris adgilebSi, xolo miyidva akrZalulia 18 wlamde asakis pirebisTvis. kodeqsis 116-e muxli krZalavs avtomobilis marTvas alkoholisa Tu sxva fsiqoaqtiuri nivTierebebis zemoqmedebis qveS.

saxelmwifo uwyebasa da sajaro samsaxurSi miRebisas momaval (an ukve arsebul) TanamSromels dawesebulebis xelmZRvanelma SesaZloa mosTxovos samedicino-narkologiuri Semowmebis cnoba an samedicino daskvna janmrTelobis mdgomareobaze, ramdenadac es gaTvaliswinebulia saqarTvelos kanonmdeblobiT (saqarTvelos kanoni sajaro samsaxuris Sesaxeb, saqarTvelos parlamenti 1997).

usafrTxo skolis koncefciis farglebSi, ganaTlebis da mecnierebis saministros daqvemdebarebaSi 2010 wlidan funqcionirebs ssip mandaturis samsaxuri, romlis mizania „sazogadoebrivi wesrigisa da usafrTxoebis dacva. saganmanaTleblo dawesebulebis mandaturis samsaxuri, ... saganmanaTleblo dawesebulebis teritoriaze Zaladobis aRmofxvrisa da jansaRi cxovrebis wesis damkvidrebis mizniT, uzrunvelyofs saganmanaTleblo dawesebulebis teritoriaze moswavleTa/studentTa mier civi da cecxlsasroli iaraRis tarebis, alkoholuri da narkotikuli saSualebebis gavrcelebis aRmofxvras“ (saqarTvelos ganaTlebisa da mecnierebis saministro 2014).

2010 wlis Semdeg mandaturebis instituti yvela sajaro da zogierT kerZo skolaSi funqcionirebs. mandaturebma gaiares specialuri momzadeba, romlis erT-erTi sakiTxi iyo narkotikebis moxmarebis SemTxvevebis pirveladi niSnebis amocnoba.


3.4. universaluri prevencia

saqarTvelos ganaTlebisa da mecnierebis saministros informaciiT, narkomaniasTan brZolis saxelmwifo strategiis Sesabamisi 2013-2015 wlebis samoqmedo gegmis farglebSi ganxorcielda universaluri prevenciis Semdegi RonisZiebebi:

erovnul saswavlo gegmaSi (kerZod, sabunebismetyvelo da sazogadoebriv mecnierebebsa da sportis saswavlo gegmebSi), aisaxa „mavne CvevebTan brZolasTan“ dakavSirebuli sakiTxebi. gegmis veb-portalze aitvirTa Sesabamisi masala, romelsac SeuZlia gaecnos nebismieri dainteresebuli piri (http://elibrary.emis.ge/ge; http://ncp.ge/ge/home). momzadebis procesSia gzamkvlevi „cxovrebis jansaRi wesi“, romelic, dasrulebis Semdgom, aseve aitvirTeba rogorc erovnuli saswavlo gegmis veb-portalze, aseve ganaTlebisa da mecnierebis saministros eleqtornul biblioTekaSi.

uklebliv yvela skolas gadaeca „samarTlebrivi kulturis“ saxelmZRvanelo, sadac erT-erTi Tavi eTmoba „mavne Cvevebisa da maTi saxifaTo Sedegebis Sesaxeb“ moswavleTa informirebas (saqarTvelos ganaTlebisa da mecnierebis saministro 2015).

skolebSi sadamrigeblo programebs daemata prioritetuli Temebi, romlebic exeba cxovrebis jansaR wess, magaliTad: „sakuTari janmrTeloba, rogorc faseuloba“, „cxovrebis jansaRi wesi, sporti“, „ra ziani moaqvs mavne Cvevebs“, „swori da araswori saqcielis Sefaseba“, „aras“ Tqmis unaris ganviTareba“ da sxva.

2014 wlidan sajaro samarTlis iuridiuli piri (ssip) maswavlebelTa profesiuli ganviTarebis erovnuli centri amzadebs pedagogebs sadamrigeblo programaSi damatebuli prioritetis – jansaRi cxovrebis wesis – skolaSi dasanergad. 2014 wels centrSi gadamzadda 350-mde pedagogi.

ganaTlebisa da mecnierebis saministros informaciiT, prevenciis dafinansebis prioriteti 2013-2015 wlebisaTvis iyo cxovrebis jansaRi wesis sxvadasxva iniciativa, SemoTavazebuli saganmanaTleblo dawesebulebebis, arasamTavrobo da kerZo organizaciebis mier. magaliTad, saqarTveloSi aiv-is prevenciis proeqtis farglebSi aRmoCenili teqnikuri mxardaWeriT 2013-2014 ww saministrom danerga jansaRi cxovrebis wesis saswavlo gegma, kerZod: gamoqveynda specialuri saxelmZRvanelo biologiis maswavleblebisTvis da biologiis gakveTilebze 15-18 wlis mozardebi iReben informacias aiv/Sidsis, aralegaluri narkotikebis, Tambaqosa da alkoholis avadmoxmarebasTan dakavSirebuli zianisa da naadrevi orsulobis riskebis Sesaxeb. GHPP programis samizne jgufi iyo 15-18 wlis mozardebi. prevenciis mecnierebis Tanaxmad, kritikulad mniSvnelovania, rom prevenciuli muSaoba skolis kurikulumis farglebSi integrirebuli iyos ara mxolod mozardobis asakis saswavlo gegmaSi, aramed uwyvet jaWvad, bavSvis skolaSi SemosvlisTanave, raTa man SeZlos cxovrebis jansaRi wesis Sesabamisi unar-Cevebis ganviTareba mozardobamde – rodesac pirovnebas opoziciuri ganwyobebi da qceva uCndeba (The National Centre on Addiction and Substance Abuse, 2015;UN-ODC, 2015).


3.5. seleqciuri da mizanmimarTuli prevencia

2013 wlidan saqarTvelos ganaTlebisa da mecnierebis saministros daqvemdebarebaSi arsebul mandaturis samsaxurSi funqcionirebs bavSvze zrunvisa da fsiqologiuri daxmarebis centri, rogorc mizanmimarTuli prevenciis ganxorcielebis instituciuri meqanizmi. centris momsaxurebiT sargebloben skolis maswavleblebis, administratorebisa da mandaturebis mier gadamisamarTebuli, qceviTi problemebis mqone bavSvebi da mozardebi. 2014 wlidan bavSvze zrunvisa da fsiqologiuri daxmarebis centris filialebi, Tbilisis paralelurad, gaixsna baTumis, quTaisis, foTis, Telavis da goris mandaturis samsaxuris regionul ofisebSi.

arasrulwlovani msjavrdebulebisTvis, probacionerebisa da riskis qveS myofi sxva mozardebisTvis sasjelaRsrulebis saministros xelSewyobiT 2013 wlidan dainerga fsiqo-socialuri ganaTlebis prevenciuli programa, romelic mizanad isaxavs jansaRi cxovrebis wesis popularizacias, aiv/Sidsisa da fsiqoaqtiuri nivTierebebis avadmoxmarebis prevencias (saqarTveloSi aiv prevenciis proeqti 2012).

3.6. centralur da adgilobriv doneze ganxorcielebuli kampaniebi

antinarkotikuli kampaniebi saqarTveloSi prevenciuli RonisZiebebis yvelaze gavrcelebuli formaa, rasac, rogorc wesi, ar axlavs moxmarebis masStabisa da sxva maxasiaTeblebis kvlevebi intervenciamde da intervenciis Semdeg, romlebic maTi efeqtianobis gazomvis, Sesabamisi mtkicebulebis mopovebisa da maT efeqtianobaze darwmunebuli msjelobis SesaZleblobas mogvcmda.

Sromis, janmrTelobisa da socialuri dacvis saministro, kerZod – mis daqvemdebarebaSi myofi daaavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centri, yovelwliurad atarebs (Catarda 2014 welsac) Tambaqos sawinaaRmdego sainformacio kampanias, romlis farglebSic Cveulebriv ibeWdeba da farTod rigdeba sainformacio bukletebi Tambaqos mavneblobaze.

saqarTvelos ganaTlebisa da mecnierebis saministros monacemebiT, ministris 2014 wlis 6 martis #233 brZanebiT damtkicebuli „gansakuTrebiT niWieri axalgazrdebis waxalisebis“ programis „saskolo konkursebis qveprogramis“ farglebSi Catarda eseiebisa da naxatebis konkursi antinarkotikul Temaze. SerCeuli eseiebis avtorebma erTwuTiani moxsenebebiT mimarTes Tanatolebs.

Sinagan saqmeTa saministro 2014 wlidan axorcielebs farTomasStabian antinarkotikul kampanias „ara bionarkotiks – erTad SevcvaloT damokidebuleba!“ kampania emsaxureba informaciis gavrcelebas narkotikebis moxmarebisa da aralegaluri brunvis uaryofiTi Sedegebis Taobaze. misi gansakuTrebuli yuradRebis sagania axali fsiqoaqtiuri saSualebebi. Sss-is moncemebiT, kampaniis farglebSi ganxorcielda Semdegi RonisZebebi: momzadda antinarkotikuli socialuri videoebi, saministros warmomadgenlebi Sexvdnen skolis moswavleebsa da universi


tetis studentebs; gaimarTa specialuri konkursi saukeTeso antinarkotikuli mediaproduqtis gamosavlenad, sadac Tbilisis saxelmwifo universitetis Jurnalistikis fakultetis studentebi iRebdnen monawileobas. Sss-s Tanaxmad, „antinarkotikuli kampaniis mTavarma gzavnilebma mosaxleobis yvela segmentamde, gansakuTrebiT, am kuTxiT yvelaze mowyvlad jgufamde – axalgazrdobamde miaRwia, ramac, bunebrivia, xeli Seuwyo narkotikebis moxmarebis klebasa da narkomoxmarebis prevencias qveyanaSi“ (saqarTvelos Sinagan saqmeTa saministro 2014).

2014 wlis martSi mTavrobis mier damtkicda saqarTvelos sportisa da axalgazrdobis saqmeTa saministros koordinaciiT, sxvadasxva Sesabamisi uwyebis monawileobiT 2013 wels SemuSavebuli saqarTvelos axalgazrduli politikis saxelmwifo dokumentis axali versia, sadac xazgasmulia cxovrebis jansaRi wesis danergvis aucilebloba.sportisa da axalgazrdobis saqmeTa saministros informaciiT, maT prioritetul mimarTulebas 2014 wlis ganmavlobaSi warmoadgenda „cxovrebis jansaRi wesis damkvidrebisa da kulturul-SemoqmedebiT saqmianobaSi axalgazrdebis CarTvis programa“, romlis erT-erTi mizani iyo janmrTelobis Sesaxeb axalgazrdebis cnobierebis donis amaRleba da cxovrebis jansaRi wesis popularizacia. programis farglebSi gaimarTa sxvadasxva kulturul-SemoqmedebiTi, inteleqtualuri da sportuli aqtivobebi: studenturi dReebi, saganmanaTleblo RonisZiebebi, inteleqtualuri konkursebi, sportuli RonisZiebebi sloganiT „airCie jansaRi cxovrebis wesi“ da sxv. aseve, 2014 wlis ganmavlobaSi, sportisa da kulturis saministrom Caatara Tambaqos sawinaaRmdego sainformacio kampania: moamzada da dabeWda Tambaqos sawinaaRmdego sainformacio masala, romelic cxovrebis jansaRi wesis popularizaciis zemoCamoTvlil RonisZiebebze gavrcelda (saqarTvelos sportisa da axalgazrdobis saqmeTa saministro 2015).


4.1. Sesavali

termini „narkotikebis maRali riskis moxmareba“ saqarTveloSi ixmareba „narkotikebis problemuri moxmarebis“ analogad, rac gulisxmobs narkotikebis ineqciurad moxmarebas. aRniSnuli ufro viwro definiciaa, vidre evropis narkotikebisa da narkodamokidebulebis monitoringis centris mier SemoTavazebuli termini9. narkotikebis maRali riskis moxmarebis indikatorze informacias viRebT Semdegi wyaroebidan: qcevaze zedamxedvelobis kvlevebi da narkotikebis ineqciuri moxmarebis prevalentobis Semswavleli kvlevebi, romlebic qveyanaSi regularulad, or weliwadSi erTxel (2002 wlidan) xorcieldeba arasamTavrobo organizaciebis sazogadoebrivi gaerTianeba bemonis da saerTaSoriso fondi kuracios mier, saerTaSoriso donorebis mxardaWeriT; da zianis Semcirebis servisebis mier mowodebuli informacia narkotikebis momxmarebelTa sxvadasxva maxasiaTeblis Taobaze. qvemoT moyvanili aRwera samive am wyaros eyrdnoba.

4.2. narkotikebis ineqciuri moxmarebis prevalentoba

2014 wels, saqarTveloSi narkotikebis maRali riskis momxmarebelTa prevalentobis dasadgenad, Catarda kvleva qveynis 7 qalaqSi, sazogadoebrivi gaerTianeba bemonisa da saerTaSoriso fondi kuracios mier, SidsTan, malariasa da tuberkulozTan brZolis globaluri fondis mxardaWeriT. kvlevaSi gamoyenebuli iyo respondentze orientirebuli SerCeva (N=1,951). kvlevis ZiriTadi instrumenti iyo qcevaze zedamxedvelobis kiTxvari. prevalentobis dasadgenad mkvlevarebma gamoiyenes mamravli koeficientebis teqnologia, CaWera-ukuCaWeris modificirebuli versia da qselis zomis gansazRvris meTodi. kvlevis ZiriTad instruments daemata kiTxvebi qselis zomis gansasazRvrad. saboloo maCveneblebi miRebulia CamoTvlili ramdenime meTodiT mopovebuli monacemebis triangulaciis gziT. kvlevis Sedegebis gansaxilvelad Sedga saeqsperto konsensusis Sexvedra, romelzec 2014 wlisTvis saqarTveloSi narkotikebis maRali riskis momxmarebelTa savaraudo raodenoba ganisazRvra 49,700-iT (49,208 – 50,192), prevalentoba 18-64 asakobrivi kategoriis mosaxleobaze - 2,02%-iT (2,00% - 2,04%), xolo zogad populaciaze - 1,33%-iT (1,32% - 1,35%) (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2015b).

viTarebis dinamikaze samsjelod moviyvanT 2012 wels, kvlav sazogadoebrivi gaerTianeba bemonisa da saerTaSoriso fondi kuracios mier Catarebuli analogiuri

9 The European Monitoring Centre for Drugs and Drug Addiction, http://www.emcdda.europa.eu/activities/hrdu

4. narkotikebis maRali riskis moxmareba


kvlevis Sedegebs. 2012 wels qveynis masStabiT ineqciuri narkotikebis momxmarebelTa savaraudo raodenobisa da prevalentobis gadaTvla moxda multivariaciuli indikatorisa da koeficientebis oTxi sxvadasxva midgomis gamoyenebiT, aseve faruli populaciis gamokiTxviT (nominaciuri teqnikis gamoyenebiT, saqarTvelos 6 qalaqSi, N=1,791), respondentze orientirebuli SerCevis meTodiT. kvlevis Semdgom aseve Catarda saeqsperto konsensusis Sexvedra. miRebuli maCveneblebi Seadgenda 45,457 maRali riskis momxmarebels, xolo prevalentoba 15-64 asakobriv kategoriaSi - 1,65%-s (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2012b). ramdenadac orive kvlevaSi gamoyenebuli iyo identuri meTodologia, maTi Sedarebis safuZvelze SesaZlebelia daskvnis gamotana10 maRali riskis moxmarebis prevalentobis zrdaze saqarTveloSi (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2012b).

4.3. narkotikebis maRali riskis momxmarebelTa maxasiaTeblebi

4.3.1. zianis Semcirebis saqarTvelos qselidan miRebuli monacemebi

zianis Semcirebis saqarTvelos qseli yovelwliurad agrovebs rutinul monacemebs aiv-Sidsis prevenciis programebSi CarTuli mosargebleebis Taobaze. amis safuZvelze, 2014 wels qselma Caatara Tanaswori-Tanaswors principze dafuZnebuli intervenciis (TTpdi) mosargebleTa kvleva, fsiqoaqtiuri saSualebebis moxmarebis prevalentobisa da ineqciur moxmarebasTan dakavSirebuli sarisko qcevebis Sesaswavlad. kvlevaSi CarTuli iyo sul 1,728 narkotikebis ineqciuri momxmarebeli (maTgan 6% qali) saqarTvelos 10 qalaqidan (Tbilisi, gori, Telavi, zugdidi, baTumi, quTaisi, samtredia, foTi, ozurgeTi, rusTavi). respondentTa medianuri asaki iyo 34 weli (mean= 34.76; min=18; max=75, SD=10.8), narkotikebis ineqciuri moxmarebis gamocdileba saSualod – 10 weli (mean=10.92; min=1; max=40, SD=8.1). respondentebis 41.5% arasdros yofila qorwinebaSi, 39.6%-s aqvs arasruli saSualo an umaRlesi ganaTleba, kvlevis momentisTvis 73.4% iyo umuSevari.

10 2009 wels saqarTvelos 5 qalaqSi - Tbilisi, baTumi, Telavi, gori, zugdidi - narkotikebis ineqciur momxmarebelbebs Soris Catarebuli kvlevis Tanaxmad (N=1,127) miRebulia Semdegi maCveneblebi: 39,000-41,000 maRali riskis momxmarebeli, xolo prevalentoba15-dan 64 wlamde asakis populaciaSi - 1.5% (1.48% -1.52%) (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2010); magram, meTodologiuri sxvaobis gamo, am monacemebis Sedareba 2012 da 2014 wlebis kvlevebTan SeuZlebelia: 2009 wels mamravli koeficienti gamoyvanilia respondentze orientirebuli SerCeviT Catarebuli kvlevis da narkotikebis ineqciuri moxmarebis Sesaxeb sxvadasxva wyaroebidan miRebuli informaciis safuZvelze.


diagrama 1: bolo 30 dReSi moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebis prevalentoba (gogia 2014; gogia 2015)

rogorc zemoT moyvanili diagramidan Cans, 2014 wels, 2013 wlisgan gansxvavebiT, zianis Semcirebis TTdp intervenciis mosargebleebs Soris kustaruli stimulatorebis, heroinisa da dezomorfinis moxmarebis maCveneblebi TiTqmis Tanabaria (30-31%), rac dabalia 2013 wlis analogiur maCveneblebze (kustarulad damzadebuli dezomorfini – 45%, xolo stimulatorebi – 36%). subuteqsis moxmarebas gamokiTxulTa mTeli populaciis 18% aRniSnavs, rac aRemateba gasuli (2013) wlis subuteqsis moxmarebis maCvenebels. moyvanili gansxvavebebi statistikurad sarwmunoa (χ² 0.000).

qalebSi kustaruli stimulatorebis ineqciuri moxmareba sxva fsiqoaqtiuri saSualebebis ineqciur moxmarebasTan SedarebiT ufro gavrcelebulia (ix. qvemoT moyvanili diagrama 2).

diagrama 2: qalebis mier bolo 30 dRis manZilze moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebi, 2014 weli (gogia 2015)

1

diagrama 1: bolo 30 dReSi moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebis

prevalentoba (gogia 2014; gogia 2015)

diagrama 2: qalebismierbolo 30

dRismanZilzemoxmarebulifsiqoaqtiuridanarkotikulisaSualebebi, 2014 weli

(gogia 2015)

62.9%

39.0% 36.2% 33.6%

10.9%

44.5%42.0%34.9% 30.5% 30.9%

18.1%

31.2%

2013 2014

სუბუტექსი, 15%

ჰეროინი, 21%

დეზომორფინი, 30

%

კუსტ.სტიმულატო

რი, 48%

მარიხუანა, 43%

ალკოჰოლი, 50%

1

diagrama 1: bolo 30 dReSi moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebis

prevalentoba (gogia 2014; gogia 2015)

diagrama 2: qalebismierbolo 30

dRismanZilzemoxmarebulifsiqoaqtiuridanarkotikulisaSualebebi, 2014 weli

(gogia 2015)

62.9%

39.0% 36.2% 33.6%

10.9%

44.5%42.0%34.9% 30.5% 30.9%

18.1%

31.2%

2013 2014

სუბუტექსი, 15%

ჰეროინი, 21%

დეზომორფინი, 30

%

კუსტ.სტიმულატო

რი, 48%

მარიხუანა, 43%

ალკოჰოლი, 50%


rac Seexeba asakobriv gansxvavebebs, qvemoT moyvanili diagramidan (diagrama3) naTelia, rom yvela dasaxelebuli narkotikisa Tu fsiqoaqtiuri saSualebis moxmarebis maCveneblebi yvelaze maRalia 31-40 wlis asakobriv kategoriaSi.

diagrama 3: bolo 30 dReSi moxmarebuli narkotikuli da fsiqoaqtiuri saSualebebis prevalentoba asakobrivi jgufebis mixedviT (gogia 2015)

ziari Spricis an sxva saineqcio instrumentis gamoyenebas aRniSnavs gamokiTxulTa 5.5% bolo ineqciisas, 6.8% – bolo TveSi ineqciisas, 17.6% ki – bolo 6 Tvis manZilze. maTgan, vinc bolo gaziarebis Taobaze dadebiTi pasuxi gasca, 46% aRniSnavs, rom mxolod erT adamianTan gaiziara; danarCenebi or da sam adamianTan gaziarebas aRniSnaven. miuxedavad aseTi sarisko qcevisa, aiv-infeqciaze testirebis maCveneblebi Tanabrad dabalia qalebsa da mamakacebs Soris. testireba aiv-infeqciaze arasdros Cautarebia kvlevaSi monawile qalTa 65.7%-s da mamakacTa 86.4%-s.

kvlevaSi monawileTa mxolod 7.4%-s (128 respondenti) aqvs meTadonis mxardamWeri Terapiis gamocdileba. respondentTa 50.9%-s (875 respondenti) arasdros gamoucdia zedozireba, xolo 13.7%-ma (114 respondenti) aRniSna, rom bolo 6 TveSi erTxel mainc hqonia zedozirebis SemTxveva. bolo zedozirebis ZiriTad mizezad heroinisa (54.6%) da dezomorfinis (20.5%) moxmareba dasaxelda. sakmaod maRalia im momxmarebelTa raodenoba, romelTac smeniaT naloqsonis Sesaxeb (1,522 respondenti; 88.1%). amave dros, dabalia im respondentTa raodenoba, romlebic aRniSnaven naloqsonis gamoyenebas zedozirebis dros (318 respondenti, 18.8%).

4.3.2. qcevaze zedamxedvelobis kvlevidan miRebuli monacemebi

rogorc zemoT aRvniSneT, qcevaze zedamxedvelobis kvlevebi saqarTveloSi tardeba or weliwadSi erTxel, saerTaSoriso fond kuraciosa da sazogadoe

2

diagrama3: bolo 30 dReSi moxmarebuli narkotikuli da fsiqoaqtiuri saSualebebis

prevalentoba asakobrivi jgufebis mixedviT (gogia 2015)

diagrama 4: ineqciuri narkotikebis moxmarebis tendenciebi 2009, 2012 da 2015 wlebSi

(saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri Tanadgoma

2015)

23.1%

24.7%

24.2%

28.5%

17.4%

19.7%

16.3%

15.8%

21.1%

18.0%

23.0%

15.4%

19.5%

19.5%

31.5%

29.2%

34.2%

22.8%

31.2%

34.8%

37.7%

19.4%

15.3%

16.1%

14.0%

24.7%

17.6%

17.9%

10.1%

9.8%

7.5%

11.8%

11.3%

8.4%

8.6%

ალკოჰოლი

მარიხუანა

სედაციური საშ.

კუსტ.სტიმულატორი

დეზომორფინი

ჰეროინი

სუბუტექსი

18-24 წელი 25-30 წელი 31-40 წელი 41-50 წელი 51 და მეტი

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

2008-2009

2012

2014-2015


brivi gaerTianeba bemonis mier. mocemul TavSi aRwerlia 2014 wlis noembridan 2015 wlis aprilamde saqarTvelos Svid did qalaqSi (Tbilisi, gori, Telavi, zugdidi, baTumi, quTaisi da rusTavi) Catarebuli kvlevis Sedegebi.

narkotikuli saSualebebis ineqciurad momxmareblebis jvaredin-seqciur kvlevaSi gamoyenebulia respondentze orientirebuli SerCevis meTodi (N = 2,037). respondentTa medianuri asaki (qalaqebis mixedviT) meryeobs 37-dan 42 wlamde, meti wiliT warmodgenilia “41+” asakobrivi jgufi. qalebma respondentTa 2% Seadgina – sul gamoikiTxa 41 qali, romelTagan TerTmeti SeirCa TbilisSi, xolo 30 – danarCen 6 qalaqSi. qorwinebaSi myofi respondentebis wili gansxvavdeba qalaqebs Soris da meryeobs 33.6%-dan 56.5%-mde. respondentTa umravlesoba, iseve rogorc 2009 da 2012 wlebSi Catarebul kvlevebSi, umuSevaria (69%). aseve, ar Secvlila monacemebi narkotikuli saSualebebis moxmarebis dawyebis asakis TvalsazrisiT: iseve rogorc 2012 wels, araineqciuri moxmarebis dawyebis medianur asakad 15-16 weli dafiqsirda, xolo ineqciuri moxmarebis dawyebis medianur asakad - 18-20 weli.

bolo 12 TveSi alkoholis yoveldRiuri moxmareba, yvela qalaqSi, respondentTa 6%-ze naklebma aRniSna; sxva qalaqebTan SedarebiT, yvelaze maRali proporciuli wili TelavSi (5.8%) dafiqsirda; alkoholis kviraSi erTxel moxmarebis proporciulad yvelaze mcire maCvenebeli dafiqsirda TbilisSi (7.1%), xolo yvelaze maRali – quTaisSi (16.3%).

2012 wlis kvlevis Sedegebis msgavsad, narkotikebis araineqciuri moxmarebis TvalsazrisiT yvelaze xSirad moxmarebad saSualebebad dafiqsirda marixuana da centraluri nervuli sistemis (cns) depresantebi. gamokiTxulTa 72.5% (n=1.476) miuTiTebs narkotikebis araineqciurad moxmarebas, maT Soris 69%-s miRebuli hqonda iseTi medikamentebi, rogoricaa baklofeni, gabapentini, pregabalini da sxvebi. axali fsiqoaqtiuri saSualebebis – e.w. bios, bio-kanafis, kristalis, abazanis marilebis – moxmareba aRniSna kvlevaSi monawileTa 10%-ma.

ineqciuri narkotikebis moxmarebis suraTi mniSvnelovnad Seicvala 2012 welTan SedarebiT. heroinis moxmareba, romelic 2012 wlisTvis dabali iyo (35.9%), daubrunda moxmarebis 2008-2009 wlebis niSuls (58.1%). analogiurad, dafiqsirda buprenorfinis moxmarebis mateba (26%). aRsaniSnavia, rom 2012 welTan SedarebiT daklebulia kustaruli narkotikebis (dezomorfinisa da efedronis) moxmarebis maCvenebeli (ix. diagrama 4).


diagrama 4: ineqciuri narkotikebis moxmarebis tendenciebi 2009, 2012 da 2015 wlebSi (saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri

Tanadgoma 2015)

yvelaze xSirad ineqciurad moxmarebuli narkotikuli saSualebebidan liderobs heroini – 45.1% rusTavSi da 67.6% baTumSi. sxva narkotikuli saSualebebis moxmarebaSi SeimCneva gansxvavebebi: mag., buprenorfinis ineqciuri moxmareba gorSi Seadgens 13.4%-s, maSin roca baTumSi is 44%-ia.

qalaqebs Soris mniSvnelovani gansxvaveba aRiniSna narkotikis zedozirebis gamocdilebis TvalsazrisiT – im respondentTa raodenoba, visac hqonia zedozireba bolo 12 Tvis ganmavlobaSi, meryeobs 5.6%-dan (rusTavi) 11.8%-mde (quTaisi).

respondentTa Sefardeba, visac arasdros Cautarebia mkurnaloba narkotikebis ineqciuri moxmarebis gamo, meryeobs 63.3%-sa (baTumi) da 85.6%-s (gori) Soris. im narkotikebis ineqciuri gziT momxmareblebs (nim) Soris, vinc bolo 12 Tvis ganmavlobaSi daxmarebis misaRebad mimarTa specializebul samkurnalo dawesebulebebs, baTumeli nim-ebi sWarboben (14.7%).

mocemuli kvlevis angariSSi prevenciuli programebiT mocva gansazRvrulia, rogorc aiv-testirebis Catarebis SesaZleblobis Sesaxeb informireba da bolo 12 Tvis ganmavlobaSi steriluri saineqcio masaliTa da kondomebiT uzrunvelyofa. prevenciuli programebiT minimaluri mocva gansazRvrulia Semdegnairad: mosargeblem icis, sad SeiZleba aiv testirebis Catareba da miRebuli aqvs qvemoT CamoTvlili programuli produqtebidan Tundac erTi: steriluri saineqcio instrumentebi, kondomi, broSura/lifleti/bukleti aiv/Sidsis Sesaxeb da kvalificiuri informacia aiv/Sidsis Sesaxeb).

kvlevis Tanaxmad, prevenciuli paketebis Semadgenloba qalaqebis mixedviT gansxvavebulia, Tumca gori liderobs programis yvela komponentiT mocvis TvalsazrisiT. mag., steriluri nemsebi/Spricebi miRebuli aqvs gorSi respon

2

diagrama3: bolo 30 dReSi moxmarebuli narkotikuli da fsiqoaqtiuri saSualebebis

prevalentoba asakobrivi jgufebis mixedviT (gogia 2015)

diagrama 4: ineqciuri narkotikebis moxmarebis tendenciebi 2009, 2012 da 2015 wlebSi

(saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri Tanadgoma

2015)

23.1%

24.7%

24.2%

28.5%

17.4%

19.7%

16.3%

15.8%

21.1%

18.0%

23.0%

15.4%

19.5%

19.5%

31.5%

29.2%

34.2%

22.8%

31.2%

34.8%

37.7%

19.4%

15.3%

16.1%

14.0%

24.7%

17.6%

17.9%

10.1%

9.8%

7.5%

11.8%

11.3%

8.4%

8.6%

ალკოჰოლი


სედაციური საშ.

კუსტ.სტიმულატორი

დეზომორფინი

ჰეროინი

სუბუტექსი

18-24 წელი 25-30 წელი 31-40 წელი 41-50 წელი 51 და მეტი

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

2008-2009

2012

2014-2015


dentTa daaxloebiT mesameds (30.1%). sruli prevenciuli paketiT sruli mocvis maCvenebeli meryeobs 8%-sa (Telavi) da 30.9%-s (gori) Soris. zogadad, prevenciuli programebiT mocva nakvlev qalaqebSi (Telavis garda) ufro dabalia, vidre prevenciuli programebiT minimaluri mocva.

respondentTa daaxloebiT mexuTedma (22.1% TbilisSi) aRniSna, rom smenia/unaxavs informacia Spricebis/nemsebis programis Sesaxeb. unda aRiniSnos, rom nakvlev populaciaSi meTadoniT Canacvlebis programis cnobadoba bevrad ufro maRalia (meryeobs 91.4%-dan TelavSi 99.7%-mde zugdidSi), vidre Spricebis/nemsebis programisa.

kvlevis Tanaxmad, respondentTa naxevari (42.5%) aRniSnavs bolo wels narkotikis ineqciur moxmarebas mudmivi sacxovrebeli adgilidan moSorebiT, sxva qveyanaSi, rac meryeobs 29.4%-dan (Tbilisi) 62.1%-mde (baTumi). bolo 12 TveSi am qveyanaTa rigSi yvelaze xSirad dasaxelebulia TurqeTi (79.5%), romelsac mosdevs ruseTi (6.1%), azerbaijani (5.9%), ukraina (5.2%) da sxva qveynebi (3.3%).


5.1. Sesavali

ukanasknel sam weliwadSi qveyanaSi gadaidga mniSvnelovani nabijebi mkurnalobaze moTxovnis indikatoris Taobaze monacemebis Segrovebis instituciuri meqanizmebis Semqnis TvalsazrisiT. kerZod, 2013 wels daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnulma centrma monacemTa Segrovebis specialuri standartuli forma SeimuSava, romelic exeba: namkurnalev wamaldamokidebul pirTa sqessa da asakobriv jgufebs, pirveladi da ganmeorebiTi mimarTvebis raodenobas, narkotikis administrirebis gzebs, upiratesad moxmarebul narkotikebsa da polinarkomanias. 2014 wlidan arsebuli forma SeZlebisdagvarad daixvewa, EMCDDA-is mkurnalobis moTxovnis indikatoris formis safuZvelze, Seicvala asakobrivi jgufebis ranJireba, aseve daemata informacia klinikaSi momarTvis gzebisa da alkoholis momxmarebel pacientTa raodenobis Sesaxeb. 2015 wels, daavadebaTa kontrolis da sazogadoebrivi janmrTelobis erovnuli centris mier momzadda cvlilebaTa paketi brZaneba №01-27/n-Si („samedicino statistikuri informaciis warmoebis da miwodebis wesis Sesaxeb“) Sesatanad, romelic daavaldebulebs narkologiur klinikebs, yovelTviurad miawodon monacemebi daavadebaTa kontrolisa da sazogadoebrivi janmrTvelobis erovnul centrs narkotikuli saSualebebisa da alkoholis momxmarebeli pacientebis Sesaxeb. aRniSnuli cvlilebebidan gamomdinare, momaval narkoviTarebis wliur angariSSi mkurnalobaze moTxovnis indikatoris Taobaze informacia ufro Tanmimdevruli da amomwuravi iqneba.

winamdebare TavSi gadmocemuli informacia eyrdnoba, erTi mxriv, daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centris mier mowodebul informacias namkurnalevi wamaldamokidebuli pirebis Taobaze (samkurnalo dawesebulebebis mier miwodebul dReisaTvis xelmisawvdom infomaciaze dayrdnobiT) da, meore mxriv, 2015 wels saqarTveloSi adiqtologiuri ganaTlebis instituciuri meqanizmebis ganviTarebaze mimarTuli tempusis proeqtis farglebSi momzadebul angariSs qveyanaSi dReisaTvis moqmedi adiqtologiuri mkurnalobis standartebis Taobaze (“Addictology Standards in Georgia” 2015).

5.2. mkurnalobis strategia da politika

wamaldamokidebulebis mkurnalobis strategia gawerilia „narkomaniis winaaRmdeg brZolis saxelmwifo strategiis“ dokumentSi (narkomaniis winaaRm

5. wamaldamokidebulebis mkurnaloba


deg brZolis saxelmwifo strategia, 2014), sadac dasaxulia iseTi strategiuli amocanebi, rogoricaa: wamaldamokidebuli pirebis samedicino, fsiqologiuri da socialuri saWiroebebis dasakmayofileblad maTTvis mtkicebulebaze dafuZnebuli mkurnalobis miwodebisa da zianis Semcirebis servisebze xelmisawvdomobis uzrunvelyofa; sasjelaRsrulebis dawesebulebebSi fsiqoaqtiuri nivTierebebis momxmareblebisTvis mkurnalobis, reabilitaciisa da zianis Semcirebis SesaZleblobebis uzrunvelyofa. strategiis dokumentSi aRniSnulia, rom aucilebelia, ganviTardes mkurnalobisa da reabilitaciis infrastruqtura, aRizardos saTanadod momzadebuli adamianuri resursebi. gamaxvilebulia yuradReba mkurnalobis xarisxis uzrunvelyofis instituciuri meqanizmebis Seqmnaze. aseve, xazgasmiTaa aRniSnuli narkotikebis moxmarebis gamo dasjis alternativebis instituciuri meqanizmebis ganviTarebis saWiroeba.

5.3. mkurnalobis sistema da mkurnalobaze xelmisawvdomoba

„saqarTvelos kanoni narkotikul saSualebebze, prekursorebsa da narkologiur daxmarebaze“ aregulirebs narkologiur mkurnalobas. kanoni adgens narkomaniiT daavadebul pirTa samkurnalo da sareabilitacio programebis dafinansebis wyaros, wess, pirobebs, narkologiuri daxmarebis nebayoflobiTobas, konfidencialobisa da anonimurobis dacvis pirobebs. kanonis 34-e muxlis me-5 punqti gansazRvravs narkomaniiT daavadebuli piris savaldebulo samedicino daxmarebis saxeebs: narkotikuli damokidebulebis moxsnas Tavisuflebis droebiTi SezRudvis an patimrobaSi yofnis SemTxvevaSi; da mkurnalobas patimrobisa da Tavisuflebis aRkveTis dawesebulebebSi.

kanonis 34-37e muxlebis Tanaxmad, stacionaris pirobebSi mkurnaloba unda warimarTos damtkicebuli an aRiarebuli klinikuri praqtikis erovnuli rekomendaciis (gzamkvlevis) da klinikuri mdgomareobis marTvis saxelmwifo standartis (protokolis) Sesabamisad.

pacientebis registraciis konkretul wesebs, narkologiur Semowmebas, eqspertizas, diagnostirebas, dispanserizacias, aRricxvianobas qveyanaSi aregulirebs saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros 2003 wlis 12 dekembris #317/n brZaneba. brZanebis Tanaxmad, narkotikebiT gamowveuli intoqsikaciis diagnostikisTvis individma unda gaiaros qimio-toqsikologiuri gamokvleva, xolo fsiqoaqtiuri nivTierebebis moxmarebiT gamowveuli fsiqikuri Tu qceviTi darRevevebis diagnozis dasma SesaZlebelia minimum sami eqimis (narkologis) mier SemTxvevaze msjelobisa da samedicino daskvnis gamotanis safuZvelze. amasTan dakavSirebiT, TiToeul, Tundac mcire masStabis, samkurnalo dawesebulebas aucilebelia hyavdes minimum sami eqimi-narkologi.

narkologiuri Semowmebisa Tu diagnostirebis SemTxvevaSi Sedgenili oficialuri sabuTi iwereba sam egzempliarad, romelTagan erTi rCeba im dawesebulebaSi, sadac pirma gaiara Semowmeba, meore igzavneba jandacvis saministros monacemTa bazaSi, xolo mesame – Sinagan saqmeTa saministros monacemTa bazaSi. Tu piri iden


tificirebulia, rogorc narkotikebis momxmarebeli, igi aRricxvaze erTi wlis manZilze imyofeba, Tu mas narkotikebis arasamedicino moxmarebis mizeziT aRmocenebuli fsiqikuri Tu qceviTi darRvevebis diagnozi daudginda, igi aRricxvaze sami wlis ganmavlobaSi imyofeba da mxolod amis mere SeuZlia aRricxvidan ganTavisufldes.

qveyanaSi wamaldamokidebul pirTa mkurnalobis jaWvi Sedgeba Semdegi rgolebisagan: abstinenciaze orientirebuli mkurnaloba (detoqsikacia) Semdgomi xanmokle stacionaruli samedicino reabilitaciiT, CanacvlebiTi Terapia, zianis Semcirebis servisebi da mocemuli angariSis daweris momentisTvis ganviTarebis Canasaxovan mdgomareobaSi myofi fsiqo-socialuri reabilitaciis ramdenime programa.

adiqtologiuri servisiT uzrunvelyofa qveyanaSi SeuZlia nebismieri samarTlebrivi formis iuridiul pirs, romelic eweva prevenciaze, diagnostikaze, mkurnalobaze, reabilitaciasa da paliatiur mzrunvelobaze mimarTul saqmianobas (saqarTvelos mTavrobis braZaneba #385, 17/12/2010 (saqarTvelos mTavroba 2010).

samkurnalo servisebis miwodeba xdeba rogorc saxelmwifo dawesebulebebSi, aseve kerZo da arasamTavrobo seqtorSi (ix.cxrili 4). magaliTad, qveyanaSi opioidebis CanacvlebiTi Terapiis (oCT) dafinansebis sami sxvadasxva modeli moqmedebs: globaluri fondis proeqti, CanacvlebiTi mkurnalobis saxelmwifo programa da kerZo komerciuli programa. rac Seexeba abstinenciaze orientirebuli mkurnalobis xarjs, mas faravs saxelmwifo (SezRuduli raodenobiT) an pacienti, sakuTari saxsrebiT. sayovelTao jandacvis farglebSi arsebuli sadazRvevo paketi da kerZo sadazRvevo meqanizmebi ar iTvaliswinebs wamaldamokidebuli pacientebis dafinansebas.

cxrili 4: samkurnalo dawesebulebebis legaluri statusi da dafinansebis wyaroebi

momsaxurebis mimwode-beli dawe-sebulebis legaluri statusi

dafinansebis wyaro

a) saerTaSoriso (SidsTan, tuberkulozTan da malariasTan brZolis globaluri fondi)

b) mxolod piradi (jibidan gadaxda)

g) mxolod saxelmwifo biujeti

d) saxelmwifo biujeti da piradi gadaxda (jibidan)

oCT abstinenciaze orientirebuli mkurnaloba




sajaro X X X X X

kerZo X X X X X X

zianis Semcirebasa da fsiqo-socialur reabilitacias umTavresad samoqalaqo seqtoris organizaciebi axorcieleben.


5.3.1. abstinenciaze orientirebuli mkurnaloba

saqarTveloSi moqmedi kanonmdeblobiT, stacionarul pirobebSi abstinenciaze orinetirebuli mkurnalobis miwodeba SeuZlia nebismier samedicino dawesebulebas, romelic flobs zogad „stacionaruli saqmianobis“ nebarTvas da hyavs minimum sami sertificirebuli eqimi-narkologi. 2010 wlamde narkologiuri stacionarebi saWiroebdnen licenzirebas, romelic gaicemoda saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros saxelmwifo saqveuwyebo dawesebulebis – samedicino saqmianobis saxelmwifo regulirebis saagentos mier, licenziis maZieblis mier Sida standartebis wardgenis safuZvelze. es aucilebloba moixsna 2010 wlidan, saqarTvelos mTavrobis #385 dadgenilebis gamosvlis Semdgom (saqarTvelos mTavrobis dadgenileba №385, 2010 wlis 17 dekemberi (saqarTvelos mTavroba 2010). dadgenileba aregulirebs rogorc samedicino saqmianobis licenziis gacemis wessa da pirobebs, aseve stacionaruli dawesebulebisTvis nebarTvis gacemis wess, procedurebsa da pirobebs. narkologiuri stacionarebisaTvis samuSaod sakmarisia am nebarTvis mopoveba.

arsebuli samuSao Sida standartiT xelmZRvanelobs yvela dawesebuleba mkurnalobis rogorc ambulatoriul, aseve stacinarul etapze. Sida standarti moicavs yvela nozologiis mkuralobis sqemas (gzamkvlevis erTgvar Semoklebul varints), daavadebaTa saerTaSoriso klasifikaciis meaTe gadaxedvis (dsk 10) mixedviT. aq, TiToeuli nozologiis mixedviT (F11 – F19), aRwerilia: standartuli gamoklevebi (1), saWiro konsultaciebi da procedurebi (2) da medikamentebis CamonaTvali, romelsac iyenebs klinika mkurnalobis Sesabamisi meTodis ganxorcielebisas (3). amis safuZvelze klinika axdens servisebis ganfasebas da aucilebeli finansuri dokumetaciis Sedgenas.

2008 wels saxelmwifo programebis ganfasebisaTvis Seiqmna erTiani standarti, romelic moicavs mxolod or nozologias (F11 da F15) da unificirebulia yvela klinikisaTvis. es standarti Seicavs 9-dRian stacionarul detoqsikaciur mkurnalobas, Semdgomi 5-dRiani stacionaruli pirveladi samedicino reabilitaciiT (jamSi – 14 stacionaruli dRe), Semdgomi 14-dRiani ambulatoriuli reabilitaciiT.

mocemuli angariSis momzadebis momentisTvis saqarTveloSi abstinenciaze orientirebul mkurnalobas uzrunvelyofs 6 klinika, aqedan xuTi TbilisSi da erTi – baTumSi (ufro dawvrilebiTi informaciisTvis am klinikebze ix. danarTi 1: informacia samkurnalo dawesebulebebis Sesaxeb). am eqvsi klinikidan ori saxelmwifos daqvemdebarebaSia, oTxi ki kerZoa. klinikebSi tardeba ambulatoriuli da stacionaruli detoqsikacia, Semdgomi moklevadiani pirveladi reabilitaciiT. eqvsidan xuTi klinika iRebs saxelmwifo dafinansebas, wamaldamokidebulebis mkurnalobis saxelmwifo programis farglebSi, rac aZlevs saSualebas, pacientTa limitirebul raodenobas ufasod moemsaxuros. mTlianobaSi, saxelmwifo dafinansebiT qveyanaSi yovelwliurad saSualod 300 adamiani gadis mkurnalobas, xolo pacientebis ufro did nawils mkurnalobis Tanxis gadaxda Tavad uwevs.

mTavrobis #279 (2013 wlis 31 ianvris) dadgenilebis Tanaxmad, stacionaruli detoqsikaciis Rirebulebam 1,250 lars ar unda gadaaWarbos, xolo pirveladi re


abilitaciis Rirebulebam – 1,000 lars. prioriteti eniWeba iseTi risk-jgufebis warmomadgenelTa dafinansebas, rogoricaa aiv-Sidsis mqone pacientebi, socialurad daucveli ojaxis wevrebi, 18-25 wlis pacientebi da isini, vinc jer ar yofilan CarTuli saxelmwifo programaSi. 2014 wels, 2013 wlis analogiurad, arsebul klinikebSi abstinenciaze orientirebuli stacionaruli mkurnalobissafasuri 1,500-dan 2,250 laramde meryeobda, xolo ambulatoriulisa – 1,200-dan 1,500 laramde.

2014 wels monacemebi namkurnalevi pacientebis Sesaxeb daavadeba Takontrolisa da sazogadoebrivi janmrTelobis erovnul centrs eqvsive moqmedma klinikam miawoda. am monacemebis Tanaxmad, wlis ganmavlobaSi abstinenciaze orientirebuli mkurnaloba saqarTveloSi gaiara sul 663-ma pirma, aqedan mxolod 12 iyo qali (1.8%). pacientebis 95.6% saangariSgebo wels pirvelad imyofeboda samkurnalo dawesebulebaSi, xolo 4.4%– ganmeorebiT. pacientTa 77.3% procenti aRniSnul dawesebulebebSi moxvda TviTdinebiT, 19.7% - meTadoniT CanacvlebiTi Terapiis programidan, xolo 3% - sxva tipis mimarTvianobiT. informacia namkurnalev pacientTa sqesisa da asakobrivi ganawilebis Taobaze ix. cxrilSi 5:

cxrili 5: 2014 wels namkurnalev pirTa asakobrivi da sqesis mixedviT ganawileba (gamyreliZe et al. 2014)

asakobrivi jgufiabsoluturi raodenoba da %

mamakaci (n = 651) qali (n = 12)

15-24 60 (9.3%) 0

25-34 228 (35%) 2

35-44 280(43%) 6

45-54 71 (10.9%) 4

55-64 10 (1.5%) 0

64< 2(0.3%) 0

2014 da 2013 wlebSi namkurnalev pirTa mier upiratesad moxmarebul narkotikul saSualebebs Tu SevadarebT, davinaxavT, rom opioidebis xvedriTi wili kvlav aRemateba sxva saSualebebis xvedriT wils; amave dros, mkveTrad imata sedaciuri saSualebebis moxmarebiT gamowveuli aSlilobebis mkurnalobis SemTxvevebma (ix. cxrili 6).


cxrili 6: abstinenciaze orientirebuli samkurnalo programebis pacientebis mier upiratesad moxmarebuli narkotikuli saSualebebi 2014

wels, procentebSi (gamyreliZe et al. 2014)

upiratesad moxmarebuli narkotiki 2013 2014

heroini 49.7% 15.8%

opiumi 0.3% 6.8%

dezomorfini 16.2% 9.8%

buprenorfini 0.7% 8.9%

meTadoni

(ineqciuri/araineqciuri)

14.9%

(5.6%/9.0% )

14%

(10%/4%)

sxva opioidebi 0.7% 7.3%

kokaini 0.5% 1%

amfet/metamfetamini

(arakustaruli)

- 1%

kustaruli stimulatorebi 6.1% 10.6%

benzodiazepinebi - 1.8%

barbituratebi - 0.6%

sxva sedaciurebi 4.8% 16.3%

kanafis preparatebi 0.2% 1.1%

polinarkomania 5.2% 5.0%

5.3.2. opioidebis CanacvlebiTi Terapia

mocemuli angariSis momzadebis momentisTvis saqarTveloSi moqmedebs opioidebis CanacvlebiTi mkurnalobis ori tipi: (1) meTadoniT Canacvlebis programa da (2) programa buprenorfinis preparatebis gamoyenebiT (buprenorfinis da buprenorfinisa da naloqsonis [suboqsoni®] kombinirebuli preparatis).

opioidebis CanacvlebiT Terapias (oCT) samarTlebrivi safuZveli qveyanaSi 2002 wels Caeyara, rodesac saqarTvelos mTavrobam miiRo kanoni narkotikul saSualebebze, prekursorebsa da narkologiur daxmarebaze. pirveli oCT programa 2005 wlis bolos amoqmedda, SidsTan, malariasTan da tuberkulozTan brZolis globaluri fondis mxardaWeriT. mas mere mkurnalobis es modaloba swrafi tempiT viTardeba. 2009 wels, Sromis, janmrTelobisa da socialuri dacvis ministris #37/n brZanebiT „opioiduri narkomaniis dros CanacvlebiTi mkurnalobis programebis ganxorcielebis Sesaxeb“ ganisazRvra oCT-s normatiuli baza – dawyebuli meTodologiidan, damTavrebuli pacientis CarTvis kriteriumebiTa da


gaweris pirobebiT. 2014 wlis 3 ivliss, zemoxsenebul brZanebaSi, jandacvis saministrom Seitana Sesworeba (brZaneba #01-41/n), romelic exeboda oCT programebis ganxorcielebas gansakuTrebul situaciebSi (mag., programis monawile pacientis hospitalizaciis dros da a. S.), agreTve CanacvlebiTi mkurnalobis dros gamoyenebadi opioidebisa da sxva wamlebis CamonaTvals.

dReisaTvis saqarTveloSi oCT sami sxvadasxva subieqtis mier xorcieldeba: globaluri fondis proeqti, CanacvlebiTi mkurnalobis saxelmwifo programa da kerZo seqtori.

saxelmwifo programa Tanadafinansebis principzea agebuli. meTadonis xarjs saxelmwifo swevs (narkomaniis mkurnalobis saxelmwifo programis biujetidan), xolo servisebis Rirebulebas pacienti Tavad (jibidan) ixdis, rac TveSi 110 lars utoldeba. mTavrobis #279 dadgenilebiT (2013 wlis 31 ianvari) regulirdeba mkurnalobis vauCeris xarji. Tanagadaxda ar exeba aiv-dadebiT, aseve siRaribis zRvars qvemoT myof pirebs. yovelTviurad saxelmwifo 1,800 mosargebles afinansebs, romelTagan 110 kombinirebul wamlebs iRebs. saqarTvelos sxvadasxva regionSi saxelmwifos daqvemdebarebaSi myofi opioidebis CanacvlebiTi Terapiis 13 programa moqmedebs; aqedan 7 – TbilisSi, TiTo-TiTo ki Semdeg qalaqebSi: foTi, quTaisi, baTumi, zugdidi, ozurgeTi da Telavi.

suboqsoniT CanacvlebiTi mkurnalobis programa moqmedebs TbilisSi 2012 wlidan. 2014 wels am programaSi CarTuli iyo 275 mamakaci da 3 qali. pacientTa asakobrivi gadanawileba aseTia: 43% miekuTvneba 35-dan 44 wlamde asakobriv jgufs, 40% – 25-dan 34 wlamde, 13 % 45-dan 64 wlamdea, 2% – 15-dan 24 wlamde, 2% ki – 55-dan 64 wlamde. erTi viziti mocemul samkurnalo centrSi pacients am angariSis daweris momentisTvis 28 lari ujdeba.

globaluri fondis proeqtis farglebSi oCT ufasoa mkurnalobaSi CarTuli pirebisTvis. aq moqmedebs CanacvlebiTi mkurnalobis oTxi centri, maTgan ori TbilisSia ganTavsebuli, erTi – gorSi da erTic – baTumSi. globaluri fondis xelSewyobiT, sasjelaRsrulebis or dawesebulebaSi (Tbilissa da quTaisSi) agreTve xorcieldeba meTadoniT moklevadiani detoqsikacia. 2014 wels am momsaxurebiT 474 patimarma, maT Soris oTxma qalma isargebla. 2014 wels opiodiebiT Canacvlebis Terapiuli programebiT, jamSi, mTels saqarTveloSi, 3,968 pirma isargebla, maT Soris, 49 qalma (ix. diagrama 5):


diagrama 5: 2003-2014 wlebSi abstinenciaze orientirebuli11 da oCT namkurnalevi pacientebi (gamyreliZe et al. 2014)

5.3.3. fsiqo-socialuri reabilitacia

qveyanaSi wamaldamokidebul pirTa fsiqo-socialuri reabilitacia Canasaxovan mdgomareobaSia. jerjerobiT ar moqmedebs Terapiuli komunebi, arsebuli fsiqo-socialuri reabilitacia ZiriTadad mimarTulia arasamedicino mkurnalobaze. globaluri fondis dafinansebiT qveyanaSi moqmedebs sami ambulatoriuli fsiqo-socialuri reabilitaciis centri: kamara, saqarTvelos sapatriarqos fsiqo-socialuri reabilitaciis centri da fsiqikuri janmrTelobis da narkomaniis prevenciis centris sareabilitacio ganyofileba. centrebi emsaxureba rogorc CanacvlebiTi Terapiis, aseve abstinenciaze orientirebuli mkurnalobis pacientebs da yofil narkomomxmareblebs; sTavazoben individualur, jgufur da ojaxur Terapias, ergo- da artTerapias, kompiuterul klasebs, religiur aqtivobebs, maT mdgomareobaSi myofi pirebis (TanasworTa) mxardaWeras da a.S. sareabilitacio centrebSi, aseve, moqmedebs nebayoflobiTi testirebisa da konsultirebis momsaxureba. samive centris gamtarunarianoba erTdroulad ar aRemateba 300-mde pirs.

wamaldamokidebul pirTa dasaqmebaze zrunva erTgvari Cavardnaa wamaldamokidebulebis sapasuxo RonisZiebaTa, kerZod, fsiqo-socialuri reabilitaciis sistemaSi. 2014 wlidan migraciis saerTaSoriso organizaciam wamaldamokidebulTa socialuri reintegraciis mizniT wamoiwyo socialuri sawarmoebis proeqti, romelic wamaldamokidebul pirTa dasaqmebis pilotur mcdelobas warmoadgens (ufro dawvrilebiT ix. TavSi: 8.2 socialuri reintegracia).

11 SeniSvna: 2012 wlis detoqsikaciuri mkurnalobis monacemebi ar moipoveba.

3

diagrama 5: 2003-2014 wlebSi abstinenciaze orientirebuli1 da oCT namkurnalevi

pacientebi(gamyreliZe et al. 2014)

diagrama 6: aiv/Sidsis incidentoba (axladgamovlenili SemTxvevebi) 2005-2014

wlebSi, 100,000 sul mosaxleze zogad populaciaSi (CxartiSvili, CokoSvili 2015)

1SeniSvna: 2012 wlis detoqsikaciuri mkurnalobis monacemebi ar moipoveba.

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

ოჩთ 0 0 8 130 285 552 1,20 2,11 2,35 2,52 4,61 3,96

დეტოქსიკაცია 306 300 609 911 1,08 841 584 338 270 656 663

0

1000

2000

3000

4000

5000

6000პა

ცი

ენტ

ები

ს რ

აოდ

ენო

ბა

5.5 6.3 7.6 7.7 7.8 9.9 9.5 11.7 10.915.116.5

21.5

28.1

35

42.1

48.5

55.1

63.2

72.1

83.2

0

10

20

30

40

50

60

70

80

90

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

ახლადგამოვლენილი

შემთხვევები

პრევალენტობა


6.1. Sesavali

narkotikebis moxmarebasTan dakavSirebuli jandacvis korelatebisa da Sedegebis Taobaze informaciis mopovebis wyaroebi diversificirebulia. kargad aris ganviTarebuli aiv-SidsTan dakavSirebuli monacemebis Segrovebisa da damuSavebis instituciuri meqanizmebi, ramdenadac, 1980-iani wlebidan, rogorc ki qveyanaSi aiv/Sidsis epidemia daiwyo, Seiqmna da moqmedebs specialuri samTavrobo instituti – infeqciuri paTologiis, Sidsisa da klinikuri imunologiis samecniero-praqtikuli centri. SedarebiT naklebad vflobT informacias narkotikebis moxmarebasTan dakavSirebul virusul hepatitebze; kidev ufro naklebad – tuberkulozze, ramdenadac am daavadebebis monitoringi ar xdeba narkotikebis moxmarebis WrilSi. yvelaze mwiri informacia moipoveba narkotikebTan dakavSirebuli araletaluri zedozirebis, aseve sikvdilisa da sikvdilobis Sesaxeb. amis erTi mizezi isaa, rom sabWoTa kavSiris daSlis Semdeg am monacemebis Segrovebis instituciuri meqanizmebi droebiT moiSala da mxolod ramdenime welia, rac ganaxlda. meore mizezi sazogadoebaSi arsebuli stigmaa, romlis gamoc, tradiciulad, qarTuli ojaxebi cdiloben, narkotikebiT gamowveuli sikvdilis mizezi SeniRbon. mesame mizezi narkotikebis zedozirebis aRricxvisTvis araxelsayreli sakanonmdeblo garemo iyo – 2014 wlamde zedozirebis SemTxvevaSi gamoZaxebuli eqimi valdebuli iyo, ecnobebina narkotikebis arasamedicino mizniT moxmarebis faqti policiisTvis, rac, faqtobrivad, mniSvnelovani barieri iyo daxmarebis ZiebisTvis. 2014 wels ganxorcielda sakanonmdeblo cvlileba, romelmac eqimis mxridan policiisTvis narkotikebis moxmarebis faqtis Setyobinebis aucilebloba gaauqma, rasac, imedi gvaqvs, mohyveba rogorc daxmarebis Ziebisa da aRmoCenis statistikis zrda, aseve aRricxvianobis gaumjobeseba.

6.2. narkotikebTan dakavSirebuli infeqciuri daavadebebi

6.2.1. aiv/Sidsis axladregistrirebuli SemTxvevebi

2014 wlis 31 dekembrisaTvis saqarTveloSi registrirebuli iyo sul aiv/Sidsis 4,695 SemTxveva, Sidsis mizeziT gardacvalebis 84 SemTxveva da aiv-is 564 axali SemTxveva. incidentobam 100,000 sul mosaxleze Seadgina 15.1, rac 38.5%-iT aRemateba 2013 wlis maCvenebels. mamakacebisa da qalebis proporcia axlad gamovlenil SemTxvevebSi iyo Sesabamisad 74% da 26%. inficirebulTa umravlesoba (90.6%) iyo 25 wlisa da zemoT.

6. narkotikebTan dakavSirebuli jandacvis korelatebi da Sedegebi


diagrama 6: aiv/Sidsis incidentoba (axladgamovlenili SemTxvevebi) 2005-2014 wlebSi, 100,000 sul mosaxleze zogad populaciaSi

(CxartiSvili, CokoSvili 2015)

istoriulad, narkotikebis ineqciuri gziT moxmareba aiv epidemiis gavrcelebis wamyvani gza iyo saqarTveloSi, magram 2010 wlidan situacia Seicvala da infeqciis gadacemis mTavari gza heteroseqsualuri kontaqtebi gaxda. 2014 wlisaTvis narkotikebis inecqiuri moxmarebis xvedriTma wilma iklo 34.9%-mde, xolo heteroseqsualuri kontaqtebis xvedriTma wilma imata 52.8%-mde (ix. diagrama 7).

diagrama 7: aiv-is gadacemis gzebi, 2012-2014 ww, procentebSi (gamyreliZe et al. 2014)

qveyanaSi diagnostirebuli aiv SemTxvevebis 35.6% vlindeba ukve Sidsis stadiaze. am problemis sapasuxod ukanasknel wlebSi saxelmwifo programis farglebSi xdeba aiv-ze testireba fexmZime qalebisa, sisxlis donorebisa, maRali riskis

3

diagrama 5: 2003-2014 wlebSi abstinenciaze orientirebuli1 da oCT namkurnalevi

pacientebi(gamyreliZe et al. 2014)

diagrama 6: aiv/Sidsis incidentoba (axladgamovlenili SemTxvevebi) 2005-2014

wlebSi, 100,000 sul mosaxleze zogad populaciaSi (CxartiSvili, CokoSvili 2015)

1SeniSvna: 2012 wlis detoqsikaciuri mkurnalobis monacemebi ar moipoveba.

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

ოჩთ 0 0 8 130 285 552 1,20 2,11 2,35 2,52 4,61 3,96

დეტოქსიკაცია 306 300 609 911 1,08 841 584 338 270 656 663

0

1000

2000

3000

4000

5000

6000

პაც

იენ

ტებ

ის

რაო

დენ

ობ

ა

5.5 6.3 7.6 7.7 7.8 9.9 9.5 11.7 10.915.116.5

21.5

28.1

35

42.1

48.5

55.1

63.2

72.1

83.2

0

10

20

30

40

50

60

70

80

90

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

ახლადგამოვლენილი

შემთხვევები

პრევალენტობა

4

diagrama 7: aiv-is gadacemis gzebi, 2012-2014 ww, procentebSi(gamyreliZe et al. 2014)

diagrama 8: aiv prevalentoba narkotikebis ineqciurad momxmareblebSi,

2014(saerTaSorisofondikuraciodasazogadoebrivigaerTianeba„bemoni,“ 2015)

0

10

20

30

40

50

60

70

2007 2008 2009 2010 2011 2012 2013 2014

ნარკოტიკების

ინექციურად მოხმარება

ჰეტეროსექსუალური

კონტაქტები

ჰომოსექსუალური


სისხლის გადასხმა

დედიდან შვილზე

უცნობია

4.6

2.9

4.65 5.3

7.8

11

0 0 00.4 0.5

1.8

0.20.9 1.2

22.4 2.6

4.44.8

0

2

4

6

8

10

12

რუსთავი თელავი თბილისი გორი ქუთაისი ბათუმი ზუგდიდი

%


sxvadasxva populaciisa da sxva jgufebisa, braldebulebisa da patimrebis CaTvliT. saqarTveloSi retrovirusuli mkurnaloba sayovelTaod xelmisawvdomia.

2014 wels saqarTvelos zianis Semcirebis qselma Caatara 20,544 aiv-infeqciaze testireba zianis Semcirebis programebis mosargebleTa Soris. maTgan 91 pirs hqonda dadebiTi pasuxi skriningze, saidanac 52 pirs es pasuxi daudasturda. Catarda testirebis Tanmxlebi konsultirebis seria: 20,543 konsultireba testamde, 20,538 konsultireba testirebis Semdgom da 54 konsultireba konfirmaciis Semdgom.

infeqciuri daavadebebis, Sidsisa da klinikuri imunologiis samecniero-kvleviTi centris monacemebiT, 2014 wels registrirebuli raodenoba HBV/HIV koinfeqciisa iyo 33, romelTagan 9 (27%) iyvnen narkotikebis ineqciuri momxmareblebi. axladregistrirebuli HCV/HIV koinfeqciis raodenoba iyo 177, aqedan 124 (70%) – narkotikebis ineqciurad momxmareblebSi. ormagi HBV/HCV infeqcia aiv pozitiur pacientebSi dafiqsirda 9 pacientTan, romelTagan 4 (44%) iyo narkotikebis ineqciurad momxmarebeli (CxartiSvili, CokoSvili 2015).

6.2.2. aiv-is sero-prevalentoba

qcevaze zedamxedvelobis kvleva narkotikebis ineqciur momxmarebelTa Soris saqarTveloSi regularulad tardeba 2002 wlidan. ukanaskneli amgvari gamokvleva 2014 wels ganxorcielda saerTaSoriso fond kuraciosa da sazogadoebrivi gaerTianeba bemonis mier, globaluri fondis mxardaWeriT. kvlevam qveynis 7 qalaqi moicva: Tbilisi, rusTavi, gori, Telavi, zugdidi, baTumi da quTaisi. kvlevis Sedegad gamovlinda, rom aiv-is prevalentoba narkotikebis ineqciurad momxmarebelTa Soris varirebs qalaqebis mixedviT - yvelaze dabali maCvenebeli hqonda rusTavs - 0.9%, xolo yvelaze maRali zugdids - 4.8% (sandoobis intervali 95%CI, 0.2%-11%) (ix. diagrama 8):

diagrama 8: aiv prevalentoba narkotikebis ineqciurad momxmareblebSi, 2014 (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015)

4

diagrama 7: aiv-is gadacemis gzebi, 2012-2014 ww, procentebSi(gamyreliZe et al. 2014)

diagrama 8: aiv prevalentoba narkotikebis ineqciurad momxmareblebSi,

2014(saerTaSorisofondikuraciodasazogadoebrivigaerTianeba„bemoni,“ 2015)

0

10

20

30

40

50

60

70

2007 2008 2009 2010 2011 2012 2013 2014

ნარკოტიკების

ინექციურად მოხმარება

ჰეტეროსექსუალური


ჰომოსექსუალური


სისხლის გადასხმა

დედიდან შვილზე

უცნობია

4.6

2.9

4.65 5.3

7.8

11

0 0 00.4 0.5

1.8

0.20.9 1.2

22.4 2.6

4.44.8

0

2

4

6

8

10

12

რუსთავი თელავი თბილისი გორი ქუთაისი ბათუმი ზუგდიდი

%


kvlevam gamoavlina, rom 40 welze zeviT asakis narkotikebis ineqciur momxmarebelTa Soris aiv prevalentoba ufro maRalia sxva asakobriv jgufebTan SedarebiT (ix. cxrili 7).

cxrili 7: aiv prevalentoba asakobrivi jgufebis mixedviT (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015)

asakobrivi jgufebi % n/N

18-24 0.6 1/162

25-30 1.3 4/302

31-40 1.7 11/642

≥41 3.1 28/916

yvela asaki 2.2 44/2022

Svidi qalaqis monacemebis kombinirebuli analizis safuZvelze gamovlenili prevalentobis saerTo maCvenebelia 2.2% (95% CI 1.53-2.99), rac didad ar gansxvavdeba 2012 wlis maCveneblisgan, romelic udrida 3%-s (95% CI 2.20-4.04).

diagrama 9: aiv-is prevalentoba %-Si narkotikebis ineqciur momxmareblebs Soris, 2009-2015 wlebSi, qalaqebis mixedviT (saerTaSoriso fondi kuracio da

sazogadoebrivi gaerTianeba bemoni, 2015)

qalaqebSi wlebis mixedviT aiv infeqciis prevalentobis mxriv Semdegi suraTia (ix. diagrama 912): TbilisSi maCvenebeli 2009 wlidan ar Secvlila da rCeba 5%-ze

12 grafikze warmodgenilia Sewonili, anu populaciaze gadaTvlili maCveneblebi. vinaidan amgvari analizi 2009 wlidan tardeba, grafikze naCvenebia 2009-2015 wlebis dinamika.

5

diagrama 9: aiv-is prevalentoba%-Si narkotikebis ineqciur momxmareblebs Soris,

2009-2015 wlebSi, qalaqebis mixedviT(saerTaSoriso fondi kuracio da


diagrama 10: C hepatiti narkotikebis ineqciuri gziT momxmareblebs Soris -

Catarebuli testirebisa da pozitiuri SemTxvevebis raodenoba (gogia 2014)

5.4

3.8

4.6

8

7.57.8

3.5

9.6

11

3.5

2.52.9 2.8

54.8

5.3

4.6

0.30.5

0

1.5

0

1.8

0

1.7

0.20 0 0 0

0.4 0.4 0.5

0

2.5

1.9 2

4.5

2.9

4.4

2.2

5.6

4.8

1.5

0.4

1.2 1.1

2.4 2.32.6

0.9

0

2

4

6

8

10

12

2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015

თბილისი ბათუმი ზუგდიდი თელავი გორი ქუთაისი რუსთავი

%

49.30%

56.80%

50% 48.10%51.20%

54%51.10% 53%

46.90%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2006 2007 2008 2009 2010 2011 2012 2013 2014

HCV ტესტების რაოდენობა პოზიტიური შემთხვევები

პოზიტიური შემთხვევების %


dabali. sagangaSo situaciaa baTumsa da zugdidSi. baTumi 2009 wlidan inarCunebs maRal maCvenebls, xolo zugdidSi sayuradReboa aiv prevalentobis zrda 2009 wlidan. orive qalaqSi narkotikebis momxmareblebs Soris aiv infeqciis gavrceleba zogad populaciaSi infeqciis gavrcelebis realur saSiSroebas qmnis. quTaissa da gorSi maCvenebeli erTsa da imave donezea, Tumca sayuradReboa am ukanasknelSi maCveneblis zrda 2009 wlidan. rusTavSi, sadac kvleva pirvelad 2015 wels Catarda, sxva qalaqebTan SedarebiT aiv infeqciis gavrceleba yvelaze dabalia.

6.2.3. narkotikebTan dakavSirebuli sxva infeqciebi

virusuli hepatitebi

arsebuli monacemebiT, saqarTvelo maRali HCV prevalentobis qveynebs ekuTvnis. amaze gavlena iqonia faqtorebis mTelma rigma: 1990-ianebSi jandacvis sistemis kolafsma, xarisxis standartebis simwirem samkurnalo dawesebulebebSi, ramac usafrTxo ineqciis praqtikas xeli ver Seuwyo, infeqciebis kontrolisa da sisxlis usafrTxoebis dacvis ukmarobam jandacvis sistemaSi, narkotikebis ineqciur momxmarebelTa Soris saineqcio xelsawyoebis gaziarebis praqtikam da a.S. (gamyreliZe et al. 2014).

ukanaskneli ramdenime wlis ganmavlobaSi qveynis mTavrobam mniSvnelovani nabijebi gadadga C hepatitTan sabrZolvelad, magaliTad: HIV/HCV ko-infeqciis mqone pacientebisTvis C hepatitis ufaso mkurnalobis erovnuli programis inicireba (dafinansebulia globaluri fondis aiv-programis farglebSi 2011 wlidan), penitenciur dawesebulebebSi patimarTaTvis C hepatitis ufaso mkurnalobis dawyeba, zogadi populaciisTvis 60%-iani fasdaklebis daweseba ribaverinisa da pegilirebuli interferonis kombinaciaze.

2014 wlis TebervalSi jandacvis saministrom amerikis SeerTebuli Statebis daavadebaTa kontrolis centrTan erTad daiwyo muSaoba C hepatitis daZlevis erovnul strategiasa da samoqmedo gegmis Seqmnaze. gadaudebeli strategia ukve amoqmedda, grZlevadian strategiaze muSaoba (2015-2020 wlebisTvis) amJamad mimdinareobs. paralelurad, saqarTvelos mTavrobam daiwyo molaparakeba farmakologiur kompania Gilead-Tan, romelic erT-erTi globaluri lideria pirdapiri da Zliermoqmedi antivirusuli preparatebis warmoebaSi, sofosbuvirisa da ledipasvir/sofosbuviris fiqsirebuli doziT komibinaciis CaTvliT, moawera xeli masTan urTierTgagebis memorandums 2015 wlis 21 aprils, rac farmkologiuri preparatebiT mkurnalobis saWiroebis mqone pirebis uzrunvelyofis aucilebeli pirobaa. qveviT mocemul cxrilSi asaxulia C hepatitis mkurnalobisaTvis gamoyenebuli farmakologiuri preparatebis cvlilebis dinamika saqarTveloSi (ix. cxrili 8).


cxrili 8: HCV sawinaaRmdego antivirusuli mkuralobis ganxorcielebis dro saqarTveloSi (daavadebaTa kontrolisa da sazogadoebrivi

janmrTelobis erovnuli centri 2015a)

mkurnaloba ganxorcielebis weli

Interferon alpha monotherapy 1996

Interferon alpha + ribavirin 1998

Pegilatedinterferon alpha 2001

Pegilatedinterferon alpha + ribavirin 2002

Pegilatedinterferon alpha + ribavirin + telaprevir or Boceprevir 2011

Sofosbuvir + pegilatedinterferon alpha + ribavirin 2014

Sofosbuvir + ribavirin 2014

Sofosbuvir + ledipasvir 2015

Sofosbuvir + daclatasvir 2015

Ombitasvir + paritaprevir + ritonavir + dasabuvir 2015

narkotikebis ineqciur momxmarebelTa Soris hepatitis gavrcelebaze qveyanaSi mwiri monacemebi moipoveba. rac Seexeba virusis gavrcelebas zogad populaciaSi, daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centris mier 2015 wlis mais-agvistoSi Catarda zogad populaciaSi HCV seroprevalentobis kvleva, romlis safuZvelzec SegviZlia vimsjeloT C hepatitis gavrcelebis masStabze ara marto zogad populaciaSi, aramed narkotikebis ineqciuri gziT momxmareblebs Sorisac. winaswari monacemebiT, gamokvleuli populaciis 7.1% iyo anti-HCV pozitiuri, xolo 5.16% iyo HCV RNA pozitiuri. kvlevis saboloo Sedegebi HCV da HBV prevalentobasa da incidentobaze asaxuli iqneba narkoviTarebis momdevno angariSSi.

zianis Semcirebis saqarTvelos qselis monacemebiT, romelic qveyanaSi narkotikebis ineqciuri momxmareblebisaTvis dabalzRurblovani servisebis uzrunvelmyofi ZiriTadi instituciaa, 2014 wels programis mosargebleTa Soris Catarda 14,411 HCV testi (swrafi, martivi testireba), aqedan 6,751(46.9%) aRmoCnda HCV dadebiTi (ix. diagrama 10):


diagrama 10: C hepatiti narkotikebis ineqciuri gziT momxmareblebs Soris - Catarebuli testirebisa da pozitiuri SemTxvevebis raodenoba (gogia 2014)

2014 wels zianis Semcirebis saqarTvelos qselis mier mosargebleTa Soris Catarda agreTve 8,122 testi B hepatitze (HBsAG), romelTagan 716 SemTxveva (8.8%) HBV dadebiTi aRmoCnda (ix. diagrama 11).

diagrama 11: B hepatiti narkotikebis ineqciuri gziT momxmarebelTa Soris - testebisa da gamovlenili dadebiTi pasuxebis raodenoba (gogia 2014)

saerTaSoriso fond kuraciosa da sazogadoebrivi gaerTianeba bemonis mier Catarebuli qcevis zedamxedvelobis ukanasknel gamokvlevaSi (ix. qveTavi 6.2.2) kvlevaSi CarTul Svidive qalaqSi maRali HCV prevalentobis maCvenebeli gamovlinda (Svidive qalaqisTvis 66.2%). calkeuli qalaqebis WrilSi maRali maCveneblebi saerTaSoriso fond kuraciosa da sazogadoebrivi gaerTianeba bemonis mier Catarebuli qcevis zedamxedvelobis ukanasknel gamokvlevaSi (ix. qveTavi 6.2.2) kvlevaSi CarTul Svidive qalaqSi maRali HCV prevalentobis maCvenebeli gamovlinda (Svidive qalaqisTvis 66.2%). calkeuli qalaqebis WrilSi maRali

6

diagrama 11: B hepatiti narkotikebis ineqciuri gziT momxmarebelTa Soris -

testebisa da gamovlenili dadebiTi pasuxebis raodenoba(gogia 2014)

diagrama 12: HCV prevalentoba narotikebis ineqciuri gziTmomxmareblebSi(saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba

bemoni, 2015)

7.30%

5.70%

7.30%

9.70%

5.30% 5.40%

7.40%

10%8.80%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2006 2007 2008 2009 2010 2011 2012 2013 2014

B ჰეპატიტზე ჩატარებული ტესტირების რაოდენობა

პოზიტიური შემთხვევები


49

57.5

65.7

79.5 80.7 81.885.6

34.3

40.5

49.6

66.1 66 66.3

74.2

41.6

50

57.1

73.3 73.7 74.679.8

0

10

20

30

40

50

60

70

80

90

თელავი რუსთავი გორი ზუგდიდი თბილისი ქუთაისი ბათუმი

%

5

diagrama 9: aiv-is prevalentoba%-Si narkotikebis ineqciur momxmareblebs Soris,

2009-2015 wlebSi, qalaqebis mixedviT(saerTaSoriso fondi kuracio da


diagrama 10: C hepatiti narkotikebis ineqciuri gziT momxmareblebs Soris -

Catarebuli testirebisa da pozitiuri SemTxvevebis raodenoba (gogia 2014)

5.4

3.8

4.6

8

7.57.8

3.5

9.6

11

3.5

2.52.9 2.8

54.8

5.3

4.6

0.30.5

0

1.5

0

1.8

0

1.7

0.20 0 0 0

0.4 0.4 0.5

0

2.5

1.9 2

4.5

2.9

4.4

2.2

5.6

4.8

1.5

0.4

1.2 1.1

2.4 2.32.6

0.9

0

2

4

6

8

10

12

2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015 2009 2012 2015

თბილისი ბათუმი ზუგდიდი თელავი გორი ქუთაისი რუსთავი

%

49.30%

56.80%

50% 48.10%51.20%

54%51.10% 53%

46.90%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2006 2007 2008 2009 2010 2011 2012 2013 2014

HCV ტესტების რაოდენობა პოზიტიური შემთხვევები



maCveneblebi dafiqsirda TbilisSi, quTaisSi da zugdidSi. aseTive maRali prevalentoba vlindeboda gasuli wlebis kvlevebiT, rac SesaZloa imis maCvenebeli iyos, rom narkotikebis ineqciuri momxmareblebi narkokarieris dasawyisSi usafrTxo ineqciis praqtikas ar eweodnen. yvelaze maRali prevalentoba amJamad baTumSia, yvelaze dabali - TelavSi (ix. diagrama 12).

diagrama 12: HCV prevalentoba narotikebis ineqciuri gziT momxmareblebSi (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015)

sifilisi

2014 wels saqarTveloSi registrirebuli iyo sifilisis 1,431 axali SemTxveva. incidentoba yvela asakis 100,000 sul mosaxleze iyo 38.4, rac gazrdili maCenebelia gasul wlebTan SedarebiT (ix. diagrama 13).

diagrama 13: sifilisis incidentoba 100,000 mosaxleze 2012-2014 wlebSi (gamyreliZe et al. 2014)

monacemebi imis Taobaze, Tu identificirebul inficirebulebs Soris ramdeni ineqciuri momxmarebeli iyo, ar moipoveba. arc qceviTi zedamxedvelobis 2014 wels Catarebul kvlevaSi iyo CarTuli sifilisze testireba. amitom problemaze msjeloba SegviZlia mxolod zianis Semcirebis saqarTvelos qselis monacemebze dayrdnobiT (gogia 2014), romelic 2010 wlidan regularulad (yovelwliurad)

6

diagrama 11: B hepatiti narkotikebis ineqciuri gziT momxmarebelTa Soris -

testebisa da gamovlenili dadebiTi pasuxebis raodenoba(gogia 2014)

diagrama 12: HCV prevalentoba narotikebis ineqciuri gziTmomxmareblebSi(saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba

bemoni, 2015)

7.30%

5.70%

7.30%

9.70%

5.30% 5.40%

7.40%

10%8.80%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2006 2007 2008 2009 2010 2011 2012 2013 2014

B ჰეპატიტზე ჩატარებული ტესტირების რაოდენობა

პოზიტიური შემთხვევები


49

57.5

65.7

79.5 80.7 81.885.6

34.3

40.5

49.6

66.1 66 66.3

74.2

41.6

50

57.1

73.3 73.7 74.679.8

0

10

20

30

40

50

60

70

80

90

თელავი რუსთავი გორი ზუგდიდი თბილისი ქუთაისი ბათუმი

%

7

diagrama 13: sifilisis incidentoba 100,000 mosaxleze 2012-2014 wlebSi(gamyreliZe et

al. 2014)

diagrama 14: gavrcelebuli nemsebisa da Spricebis raodenoba wlebis mixedviT(gogia

2014)

13.9

24.6

38.4

2012 2013 2014

1 2 3 4 5 6 7 8 9

წლები 2006 2007 2008 2009 2010 2011 2012 2013 2014

დარიგებული ნემსებისა და

შპრიცების რაოდენობა350,340 376,480 462,883 474,785 1,064,37 775,222 1,021,872,038,7403,573,405


შპრიცების რაოდენობა ერთ ნიმ-ზე8.75 9.4 11.57 11.86 26.6 19.38 22.7 45.3 79.4

8.75 9.4 11.57 11.86

26.6

19.3822.7

45.3

79.4

0102030405060708090

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000


awarmoebs RPR (Rapid Plasma Reagin) testirebas Tavisi programebis mosargebleTa Soris. 2014 wels Catarda 10,149 RPR testireba, romelTaganac 490 (4.8%) aRmoCnda RPR pozitiuri (ix. cxrili 9):

cxrili 9: sifilisi narkotikebis ineqciuri gziT momxmarebelTa Soris – testirebulTa da pozitiuri SemTxvevebis raodenoba wlebis mixedviT

(gogia 2014)

2010 2011 2012 2013 2014sifilisis Catarebuli testirebis (RPR) raodenoba 523 344 1,622 4,759 10,149

RPR prevalentoba % 0 0 3% 4% 4.8%

tuberkulozi

zianis Semcirebis saqarTvelos qselis monacemebiT, 2014 wels tberkulozis 4,075 teqsti Catarda maTi programebis mosargeble narkotikebis ineqciuri gziT momxmarebel pirebs Soris, aqedan pozitiuri pasuxi hqonda 396 pirs, ris safuZelzec isini gadamisamarTebuli iyvnen specializebul samkurnalo dawesebulebebSi, xolo maTgan 33 piri CerTo mkurnalobis saxelmwifo programaSi.

6.3. narkotikebTan dakavSirebuli sxva avadoba

6.3.1. araletaluri zedozireba

saqarTveloSi narkotikebis moxmarebiT gamowveuli araletaluri zedozirebebis SemTxvevebis Sesaxeb informaciis aRricxva ICD-is kodebis Sesabamisad (F10-F19) saxelmwifos mxridan iwyeba 2015 wlidan, daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centris mier, am mizniT 2013 wels specialurad SemuSavebuli statistikuri formis (forma IV-11) safuZvelze (daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centri 2015b).

narkoviTarebis 2013 wlis angariSSi SegiZliaT ixiloT informacia zianis Semcirebis saqarTvelos qselis mier ganxorcielebuli ori kvlevis farglebSi gamovlenili araletaluri zedozirebis SemTxvevebze, Sesabamisi codnisa da unar-Cvevebis arsebobaze da am mimarTulebiT Catarebul prevenciul saqmianobaze (gogia 2013).

Sinagan saqmeTa saministrodan miRebuli informaciis Tanaxmad, 2014 wels, administraciul samarTaldarRvevaTa kodeqsis 116-e muxlis mexuTe nawiliT (romelic gulisxmobs satransporto saSualebis marTvas narkotikuli an fsiqotropuli simTvralis mdgomareobaSi) saxdeldadebulia 5 piri. amave muxlis meSvide nawiliT ki (satransporto saSualebis, tvirTis, gzis, sagzao Tu sxvanagebobis,


agreTve sxva qonebis an adamianis sxeulis msubuqi dazianeba zemoqmedebis qveS satransporto saSualebis marTvis Sedegad) – 1611 piri (saqarTvelos Sinagan saqmeTa saministro 2014).

6.4. narkotikebTan dakavSirebuli sikvdili da sikvdiloba

saqarTveloSi narkotikebTan dakavSirebuli sikvdilis SemTxvevebis statistikis Segroveba Sewyda gasuli saukunis 90-ian wlebSi da ganaxlda 2007 wlidan, erovnuli sasamarTlo eqspertizis mier13.

cxrili 10: registrirebuli letaluri zedozirebis maCveneblebi (levan samxaraulis saxelobis sasamarTlo eqspertizis erovnuli biuro 2015)

weli registrirebuli zedozireba

2010 16

2011 16

2012 39

2013 28

2014 7

gamovlenili SemTxvevebis raodenoba mcirea da ar Seesabameba zianis Semcirebis servisebidan miRebul araformalur informacias da zianis Semcirebis saqarTvelos qselis mier ganxorcielebuli kvlevebis Sedegad miRebul monacemebs (ix. zianis Semcirebis saqarTvelos qselis 2015 wlis wliuri angariSi da winamdebare dokumentis seqcia 7). savaraudoa, rom am mimarTulebiT realuri aRricxvianobis bariers warmoadgenda arxelsayreli sakanonmdeblo garemo: Sromis, janmrTelobisa da socialuri dacvis ministris #239/n specialuri brZaneba (2000 w.), romelic zedozirebis Semswre (daxmarebis gamwev) eqimebs SemTxvevis policiisaTvis Setyobinebas avaldebulebda, monacemebis Segrovebas abrkolebda. 2014 wels moxda am kanonis modifikacia da eqimis mxridan policiisTvis Setyobinebis valdebuleba moixsna (garda im SemTxvevevebisa, sadac saxezea sxva danaSulis niSnebic), rac 2015 wlidan sinamdvilesTan ufro miaxloebuli aRricxvis pirobebs qmnis.

13 winamdebare angariSisTvis dazustda zedozirebis Sedegad gardacvlili adamianebis ricxvi; amis Sedegad, monacemebi gansxvavdeba 2013 wlis angariSSi moyvanili monacemebisgan.


7.1. Sesavali

saqarTveloSi zianis Semcirebis RonisZiebebi wamaldamokidebulebis problemaze reagirebis erT-erTi yvelaze ganviTarebuli mimarTulebaa. gasuli saukunis oTxmociani wlebidan qveyanaSi daiwyo zrunva aiv-Sidsis epidemiis SeCerebaze. am mizniT, SidsTan, malariasTan da tuberkulozTan brZolis globaluri fondisa da sxva saerTaSoriso donorebis mxardaWeriT, ganviTarda zianis Semcirebaze orientirebuli sapasuxo RonisZebebi da Sesabamisi infraqtruqtura. zianis Semcirebis saqarTvelos qseli, romlis wevri organizaciebi moqmedeben rogorc dedaqalaqSi, aseve saqarTvelos regionebSi, am infrastruqturis mniSvnelovani rgolia da muSaobs rogorc narkotikebis moxmarebasTan dakavSirebuli sikvdilis, aseve sisxliT gziT gadamdebi infeqciebis prevenciaze. 2014 wlidan qveyanaSi daiwyo agreTve C hepatitis daZlevis instituciuri meqanizmebis SemuSaveba, C hepatitTan dakavSirebuli gadaudebeli samoqmedo gegma ukve xorcieldeba, grZelvadiani (2015-2020 wlebis) samoqmedo gegma ki mocemuli angariSis daweris momentisaTvis SemuSavebis procesSia (ix. qveTavi 6.2.3).

7.2. narkotikebTan dakavSirebuli gadaudebeli situaciebisa da sikvdilis prevencia

narkotikebTan dakavSirebuli gadaudebeli situaciebisa da sikvdilis problemis masStabi dReisaTvis qveyanaSi arasakmarisad aris gacnobierebuli, ramdenadac oficialuri statistika am sakiTxze mwiria (ix. qveTavebi 6.3.1 da 6.4). amave dros, zianis Semcirebis saqarTvelos qselis mier mopovebuli informacia aCvenebs, rom problema seriozulia. kerZod, 2014 wels qselis mier aRiwera narkotikis moxmarebiT gamowveuli zedozirebis 528 SemTxveva. maRali maCveneblebi dafiqsirda baTumSi (28%), rusTavSi (21%), soxumsa (12%) da TbilisSi (11%), sxva qalaqebis maCveneblebi ar aRemateba 2-8%-s. mocemuli informacia Segrovda zianis Semcirebis saqarTvelos qselis mier proeqtis „waiRe saxlSi naloqsoni“ farglebSi, romelic 2009 wlidan xorcieldeba globaluri fondis finansuri mxardaWeriT aiv-infeqciis prevenciis programis beneficiarebisTvis. proeqtis mizania narkotikebis ineqciurad momxmarebelTa Soris zedozirebiT gamowveuli sikvdilis prevencia, adamianTa sicocxlis gadarCena. proeqtis farglebSi tardeba treningi, romelic xelsuwyobs narkotikebis ineqciuri gziT momxmarebelTa TemSi informirebulobis donisa da adekvaturi reagirebis unar-Cvevebis gazrdas. proeqtis mniSvnelovani komponentia mosargebleTa Soris naloqsonis

7. reagireba janmrTelobis korelatebsa da Sedegebze


ampulebis darigeba. gamoyenebuli naloqsonis ampulebis Sesaxeb Segrovebuli monacemebis Tanaxmad, programiT darigebuli naloqsonis ineqciis Sedegad, 2014 wels, zedozirebis 528 SemTxvevidan gadarCenilia 489 (93%) sicocxle, 39 SemTxvevaSi (7%) ki dafiqsirda letaluri Sedegi. monacemebi zedozirebis gamomwvevi nivTierebebis Sesaxeb ar moipoveba. cxrili 11 asaxavs programis farglebSi naloqsonis ampulebis darigebis dinamikas wlebis mixdeviT:

cxrili 11: naloqsonis ampulebis darigebis dinamika narkotikebis ineqciur momxmarebelTa Soris (gogia 2014)

wlebi 2009 2010 2011 2012 2013 2014

ampulebis raodenoba 2,400 1,848 288 1,396 1,628 9,881

7.3. narkotikebTan dakavSirebuli infeqciuri daavadebebis prevencia da mkurnaloba

narkotikebis moxmarebasTan dakavSirebuli infeqciuri daavadebebis prevencia da mkurnaloba xorcieldeba rogorc saxelmwifos, aseve samoqalaqo seqtoris organizaciebis mxrirdan, saerTaSoriso organizaciebis mniSvnelovani meTodologiuri da finansuri mxardaWeriT. aiv-Sidsisa da C hepatitis problemebs saxelmwifo pasuxobs Sesabamisi saxelmwifo programebiT, romelTac axorcieleben rogorc sajaro, aseve arasamTavrobo da kerZo organizaciebi.

aiv-Sidsis saxelmwifo programis mizania aiv/Sidsis gavrcelebis Semcireba aiv/Sidsis axali SemTxvevebis adreuli gamovlenisa da pacientebisTvis mkurnalobis uzrunvelyofis gziT. programis farglebSi uzrunvelyofilia antiretrovirusuli mkurnalobis universaluri xelmisawvdomoba. 2013 wlidan, aiv-infeqciis mkurnalobis axali gzamkvlevis (gaidlainebis) Sesabamisad, antiretrovirusuli mkurnaloba rekomendebulia daiwyos, Tu CD4 ujredebis raodenoba gautoldeba an CamorCeba 500-s; gzamkvlevis Tanaxmad, adreuli aRmoCena da mkurnalobaSi CarTva warmoadgens infeqciis gavrcelebis prevenciis erT-erT mniSnelovan gzas.

saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros C hepatitis eliminaciis programis pirveli etapis mizania saqarTveloSi C hepatitiT gamowveuli avadobis, sikvdilobisa da infeqciis gavrcelebis Semcireba daavadebis prevenciaze, diagnostikasa da mkurnalobaze mosaxleobis xelmisawvdomobis etapobrivi uzrunvelyofis gziT. programiT gaTaliswinebuli momsaxurebis moculoba moicavs: C hepatitiT daavadebul pirTa diagnostikas mkurnalobaSi CarTvamde da mkurnalobis procesis monitoringisTvis aucilebeli kvlevebis Catarebas; C hepatitiT daavadebul pirTa mkurnalobas C hepatitis samkurnalo medikamentebiT (sofosbuviri, pegilirebuli interferoni da ribavirini). mkurnalobis programaSi CarTva SeuZlia saqarTvelos moqalaqes, aqti


uri HCV infeqciiT, romelsac ar aqvs C hepatitis samkurnalo medikamentebze ukuCveneba, visac arasdros Cautarebia mkurnaloba an Cautarebia da warumatebeli aRmoCnda. es saxelmwifo programa iTvaliswinebs diagnostikis komponentSi pacientTa mxridan 70%-ian Tanagadaxdas, socialurad daucveli statusis mqone pirisgan ki 30%-ian Tanagadaxdas, xolo mkurnalobis komponentSi, mosargebleTaTvis medikamentebiT uzrunvelyofa usasyidloa. mocemuli angariSis momzadebis momentSi, 2015 wlisTvis, programaSi CarTulia 6,000 mosargeble.

infeqciuri paTologiis, Sidsis da klinikuri imunologiis samecniero/praqtikuli centris monacemebiT 2014 wlis bolos antiretrovirusul (arv) mkurnalobaze imyofeboda 2,541 aiv/SidsiT avadmyofi, maTgan 1,094 dainficirda narkotikebis ineqciuri moxmarebiT. 12-Tviani gadarCenis maCveneblebma mTlian populaciaSi Seadgina 87%, xolo narkotikebis momxareblebSi - 83% (CxartiSvili da CokoSvili 2015).

aiv/Sidsze konsultaciisa da testirebis momsaxureba, globaluri fondis mxardaWeriT, xelmisawvdomia sasjelaRsrulebis yvela dawesebulebaSi. 2014 wels aiv-sa da C hepatitze testirebuli patimrebis raodenoba iyo 8,000. maTgan C hepatiti daudginda 3,800-s (48%), xolo aiv infeqcia/Sidsi - 34 braldebuls/msjavrdebuls (<1%). sasjelaRsrulebis or - #2 da #8 - dawesebulebaSi xorcieldeba, agreTve, meTadoniT detoqsikaciis programa, romelsac axorcielebs fsiqikuri janmrTelobisa da narkomaniis prevenciis centri, aseve globaluri fondis mxardaWeriT. 2014 wels am programis farglebSi meTadoniT detoqsikaciis kursi gaiara 474 patimarma (maT Soris 4-ma qalma). stacionaruli mkurnalobis kursi gaiara oTxma patimarma. sasjelaRsrulebis dawesebulebebSi wamaldamokidebul pirebs emsaxurebian eqimi-narkologi, fsiqiatri, nevrologi da fsiqologi.

narkotikebis moxmarebasTan dakavSirebuli infeqciebis gavrcelebis prevenciaSi gansakuTrebul rols TamaSobs dabalzRurblovani servisebi, romelTac zianis Semcirebis saqarTvelos qseli axorcielebs. qseli aerTianebs 26 organizacias da koordinirebas uwevs qveynis masStabiT 11 qalaqSi dabalzRurblovani 14 servis-centris moqmedebas. dabalzRurblovani centrebi, sxva aqtivobebis Catarebis paralelurad, narkotikebis ineqciur momxmarebelTa TemSi avrceleben sterilur saineqcio saSualebebs, kondomebsa da sainformacio masalebs. diagrama 14-ze asaxulia saineqcio xelsawyoebis gavrcelebis dinamika wlebis mixedviT:


diagrama 14: gavrcelebuli nemsebisa da Spricebis raodenoba wlebis mixedviT (gogia 2014)

zianis Semcirebis saqarTvelos qseli aqtiurad cdilobs, gazardos prevenciuli programebiT mocvis geografiuli areali da masStabi, risTvisac 2010 wlidan iyenebs Tanawori-Tanaswors principze dafuZnebul (TTpd) intervencias, xolo 2015 wlidan gegmavs mobiluri ambulatoriebis servisis danergvas. TTpd intervencia iZleva axali beneficiarebis moZiebis da programaSi CarTvis SesaZleblobas da uzrunvelyofs momxmarebelTa TemSi mizanmimarTuli informaciis efeqtian da swraf gavrcelebas.

zianis Semcirebis serviscentrebSi 2014 wlidan dainerga tuberkulozis skriningi da skriningis safuZvelze tuberkulozis saxelmwifo programis ganmaxorcielebel dawesebulebebSi Semdgomi referirebis sistema. 2014 wels skriningi Cautarda 4,075 nim-s, saidanac 396 pirs Cautarda damatebiTi kvlevebi saxelmwifo programis farglebSi, ris safuZvelzec 33maTgani CaerTo mkurnalobaSi.

7.4. reagireba narkotikebis momxmarebelTa janmrTelobis sxva korelatebze

saqarTveloSi dResdReobiT ar aRiricxeba informacia narkotikebis moxmarebasTan dakavSirebul janmrTelobis sxva problemebsa da maTze reagirebis Taobaze. erTaderT xelmisawvdom sainformacio wyaros, sadac garkveuli monacemebi am sakiTxze moipoveba, warmoadgens zianis Semcirebis saqarTvelos qselis wevri organizaciebi. magaliTad, arasamTavrobo organizacia Tanadgoma wamaldamokidebul pirebsa da narkotikebis momxmareblebs, nebayoflobiTi konsultireba/testirebis farglebSi, fsiqikuri janmrTelobis problemebiT Tanaavadobis SemTxvevaSi, uwevs konsultirebas fsiqikuri janmrTelobis sakiTxebze (gogia 2014). aseve, eqimebi sazRvrebis gareSe (safrangeTi) organizaciis mxardaWeriT arasamTavrobo organizacia axali veqtori garkveuli tipis ufaso samedicino daxmarebiT uzrunvelyofs Tavis beneficiar narkotikebis ineqciuri gziT momxmareblebs. magaliTad, 2014 wels axalma veqtorma gauwia stomatologiuri momsaxureba 814 nim-s, xolo RviZlis fibroskanireba – C hepatitis mqone 910 nim-s (labartyava 2015).

7

diagrama 13: sifilisis incidentoba 100,000 mosaxleze 2012-2014 wlebSi(gamyreliZe et

al. 2014)

diagrama 14: gavrcelebuli nemsebisa da Spricebis raodenoba wlebis mixedviT(gogia

2014)

13.9

24.6

38.4

2012 2013 2014

1 2 3 4 5 6 7 8 9

წლები 2006 2007 2008 2009 2010 2011 2012 2013 2014


შპრიცების რაოდენობა350,340 376,480 462,883 474,785 1,064,37 775,222 1,021,872,038,7403,573,405


შპრიცების რაოდენობა ერთ ნიმ-ზე8.75 9.4 11.57 11.86 26.6 19.38 22.7 45.3 79.4

8.75 9.4 11.57 11.86

26.6

19.3822.7

45.3

79.4

0102030405060708090

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000


8.1. Sesavali

saqarTveloSi wamaldamokidebulTaTvis fsiqo-socialuri sareabilitacio momsaxurebis danergvis pirveli mcdeloba 2012 wels iyo wamowyebuli, Tumca uSedegod (javaxiSvili, oTiaSvili, tabataZe 2013). ukanaskneli wlebis manZilze es sakiTxi jandacvis saministros politikis da saxelmwifo programebis ganxilvis dRis wesrigidan moixsna.

wamaldamokidebul pirTa fsiqologiuri daxmarebis, maTi reabilitaciisa da socialuri reintegraciis mizniT ganxorcielebuli aqtivobebi saqarTveloSi sakmaod mwiria.

2014 wels, gasuli wlebis msgavsad, momxmarebelTa reabilitaciisaTvis saxelmwifo danaxarjebi simboluria. saqarTvelos mTavrobis dadgenileba #650 (2014 wlis 2 dekemberi) amtkicebs 2014 wlis janmrTelobis dacvis saxelmwifo programebs. am dadgenilebis Sesabamisad, biujetidan 1 pacientis samedicino momsaxurebisaTvis gamoyofilia 1600 lari. programa aseve iTvaliswinebs saxelmwifos mxardaWeras pacientTa reabilitaciisaTvis 2 punqtis mixedviT, romelic Semdegnairad aris gansazRvruli mTavrobis dadgenilebaSi:

1. opioidebis, fsiqoaqtiuri nivTierebebis da sxva stimulatorebis moxmarebiT gamowveuli fsiqikuri da qceviTi aSlilobebi: pirveladi fsiqo-fizikuri reabilitacia - 400 lari;

2. opioidebis, fsiqoaqtiuri nivTierebebis da sxva stimulatorebis moxmarebiT gamowveuli fsiqikuri da qceviTi aSlilobebi: damokidebulebis sindromi (kontrolirebadi) - intensiuri samedicino reabilitacia - 400 lari.

saxelmwifo programis farglebSi aRniSnuli punqtis Sesabamisad, wamaldamokidebulebis moklevadiani mkurnalobis kursis gavlis Semdeg pacients SesaZlebloba aqvs, miiRos eqim-narkologis an fsiqologis daxmareba ambulatoriul pirobebSi 2 kviris manZilze.

iusticiis saministros informaciiT, 2012 wlis noembris Tvidan, iusticiis saministros danaSaulis prevenciis centrma daiwyo yofili patimrebis reabilitaciis da resocializaciis programebi, romlis analogi qveyanaSi manamde ar arsebobda (saqarTvelos iusticiis saministro 2015). Tumca ucnobia, mosargebleTa Soris ra wili uWiravs patimrebs, romlebic fsiqoaqtiur nivTierebebTan dakavSirebiT ixdidnen sasjels. bolo wlebis manZilze moqmedeba daiwyo ram

8. socialuri korelatebi da socialuri reintegracia


denime programam, romlebic xels uwyobs narkotikebis momxmarebelTa an yofil momxmarebelTa reintegracias sazogadoebaSi. am programebis farglebSi ganxorcielebuli aqtivobebis mokle aRweriloba mocemulia qvemoT.

8.2. socialuri gariyva da narkotikebis moxmareba

saqarTveloSi monacemebi narkotikebis ineqciur momxmarebelTa socialuri gariyvis Taobaze mwiria. winamdebare TavSi warmodgenilia narkotikebis momxmarebelTa jgufis socialuri maxasiaTeblebi, romelic efuZneba 2014 wels narkotikebis problemur momxmarebelTa Soris Catarebul qcevaze zedamxedvelobis kvlevis mier mowodebul statistikur monacemebs (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2015a).

2014 wels saqarTvelos 7 qalaqSi sul gamoikiTxa 2,037 narkotikebis momxmarebeli da maTi udidesi umravlesoba aris kaci (98%). gamokiTxulTa 95.5% eTnikurad qarTvelia, rac saqarTveloSi arsebuli saerTo mosaxleobis eTnikur Semadgenlobas Seesabameba. saqarTveloSi dReisaTvis ar moipoveba monacemebi eTnikur umciresobebSi narkotikebis moxmarebis Sesaxeb, vinaidan eTnikur umciresobaTa Soris specifikuri kvleva saqarTveloSi ar Catarebula. gamokiTxulTa 4.5%-ma aRniSna, rom iZulebiT gadaadgilebuli piria.

ojaxuri mdgomareoba: kvlevis respondentebis TiTqmis naxevarma (45.3%) aRniSna, rom daqorwinebulia, xolo mesamedze odnav naklebi (32.2%) aRniSnavs, rom arasodes yofila qorwinebaSi. respondentebis TiTqmis erTma mexuTedma (21.2%) aRniSna, rom an ganqorwinebuli, an daSorebuli gaxldaT. qalaqebis mixedviT gansxvaveba umniSnveloa: daqorwinebulTa yvelaze didi wili baTumSi da quTaisSi dafiqsirda (56.5% da 55.6%, Sesabamisad). ganqorwinebis yvelaze dabali maCvenebeli zugdidSi gamovlinda (9.5%). respondentTa 12.5% aRniSnavs, rom marto cxovrobs. marto mcxovrebTa yvelaze didi procentuli maCvenebeli aRmoCnda TbilisSi (16.6%), xolo yvelaze naklebi – zugdidSi (7.2%).

respondentebis Zalian mcire raodenoba (1.4%) aRniSnavs, rom cxovrobs partniorTan, romelTanac qorwinebaSi ar imyofeba. partniorTan cxovreba SedarebiT xSiria baTumsa da TbilisSi (4% da 3%, Sesabamisad); danarCen qalaqebSi aseTTa wili 2%-ze dabalia.

ganaTleba: respondentebis umetesobas (59.9%) miRebuli aqvs saSualo an profesiuli ganaTleba. kvlevaSi monawile Svidive qalaqSi mesamedze odnav metma (35.5%) aRniSna, rom miRebuli aqvs umaRlesi ganaTleba. unda aRiniSnos, rom umaRlesi ganaTlebis mqone momxmarebelTa yvelaze maRali wili dedaqalaqSi dafiqsirda (59.5%), xolo yvelaze dabali maCvenebeli – zugdidSi (27.6%).

narkotikebis ineqciur momxmarebelTa Zalian mcire raodenobam aRniSna, rom saerTod ar hqonda miRebuli rame formaluri ganaTleba (TiTo-TiTo respondenti baTumsa da zugdidSi), an mxolod dawyebiTi ganaTleba hqonda (erTi respondenti rusTavSi).


dasaqmeba: 2,037 respondentisgan 2/3-ze meti kvlevis Catarebis momentisaTvis umuSevari iyo. umuSevarTa wili Svidive qalaqSi jamurad 69%-s Seadgenda da es maCvenebeli qalaqebis mixedviT meryeobda 51.3%-dan (gori) 73.2%-mde (quTaisi). studentebis wili 1%-ze mcire iyo. dasaqmebulTa didi nawili aRniSnavs, rom aqvs droebiTi samuSao. mudmivi, anazRaurebadi samsaxuri gamokiTxulTa mxolod 8.9%-s aqvs. mudmivi samuSaos qonis TvalsazrisiT yvelaze saimedo maCvenebeli TelavSi aRmoCnda – 18.7%, da yvelaze mZime maCvenebeli iyo zugdidSi, sadac respondentTa mxolod 5.6%-ma aRniSna, rom aqvs mudmivi samuSao. unda aRiniSnos, rom 2012 wlis kvlevaSi (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni 2012a), mudmivi samuSaos qonis TvalsazrisiT yvelaze maRali maCvenebeli zugdidSi gamovlinda (13.6%) da 2 wlis manZilze es maCvenebeli mkveTrad gauaresda.

Semosavlis done: kvlevaSi monawile Svidive qalaqSi, saSualod, narkotikebis yoveli mesame ineqciuri momxmareblis yovelTviuri Semosavali 100-dan 300 laramde meryeobs; erTi mexuTedis Semosavali 100 larze naklebia; respondentebis mxolod 16% aRniSnavs, rom maTi yovelTviuri Semosavali 500-1000 lars Seadgenda; respondentTa mxolod 3.5%-s aqvs TveSi 1,000 larze meti (ix. diagrama 15):

diagrama 15: narkotikebis ineqciur momxmarebelTa yovelTviuri Semosava-li larebSi, procentebSi (saerTaSoriso fondi kuracio da sazogadoebrivi

gaerTianeba bemoni, 2012)

mocemuli informacia adasturebs, rom narkotikebis ineqciuri momxmareblebi saqarTveloSi finansurad uaRresad mowyvlad jgufs warmoadgenen: umuSevrobis maCvenebeli narkotikebis momxmarebelTa Soris 7-jer aRemateba zogad mosaxleobaSi umuSevrobis maCvenebels. saqarTvelos statistikis erovnuli samsaxuris informaciiT, 2014 wels ekonomikurad aqtiur mosaxleobaSi umuSevrobis done ar aRemateba 12.4%-s14, xolo kvlevaSi monawile narkotikebis ineqciur momxmarebelTa 2/3-ze meti (69%) aRniSnavs, rom ar aris dasaqmebuli.

14 http://www.geostat.ge/?action=page&p_id=145&lang=geo

8

diagrama 15: narkotikebis ineqciur momxmarebelTa yovelTviuri SemosavalilarebSi, procentebSi(saerTaSoriso fondi kuracio da sazogadoebrivi


diagrama 16: saqarTvelos sisxlis samarTlis kodeqsis 260-e da 273-e muxlebiT

msjavrdebuli pirebis raodenobis dinamika wlebis mixedviT, 2007-2014

ww(“saqarTvelos uzenaesi sasamarTlo” 2015)

21.3%

35.4%

23.0%

10.0%

6.6%

3.5%

100 ლარზე ნაკლები

100-დან 300 ლარამდე




>1000

2007 2008 2009 2010 2011 2012 2013 2014

მსჯავრდებული 260-ე

მუხლით1,919 2,095 2,193 2,376 1,849 1,100 2,336 2,354

მათ შორის პატიმრობა (260) 1,552 1,467 1,649 1,855 1,135 598 1,193 1,515


მუხლით2,681 4,423 3,663 2,517 1,523 861 3,553 4,003

მათ შორის პატიმრობა (273) 775 1,605 1,340 874 403 220 435 972

0500

1,0001,5002,0002,5003,0003,5004,0004,5005,000


dasaqmebul momxmarebelTa yovelTviuri Semosavali uaRresad mwiria saqarTvelos saSualo maCveneblebTan SedarebiT: qveynis oficialuri statistikis mixedviT, daqiravebiT dasaqmebulTa saSualo Tviuri nominaluri xelfasi 2014 wels 818 lariT ganisazRvra.15 kvlevaSi monawile respondentebis 90%-ze mets nominalur xelfasze naklebi Semosavali aqvs. ufro metic, gamokiTxulTa meoTxedi 2014 wels erTi zrdasruli mamakacisTvis saWiro saarsebo minimumze (154.5 lari)16 nakleb Semosavals iRebda.

usaxlkaro momxmarebelTa Sesaxeb saqarTveloSi monacemebi ar moipoveba – qveyanaSi arasodes Catarebula kvleva, romelic Seiswavlida warsulSi Tu awmyoSi nivTierebaTa avadmoxmarebis istorias usaxlkaro individebSi. 2013 wlis dekemberSi daiwyo funqcionireba pirvelma TavSesafarma. jandacvis saministros monacemebiYT, e.w. „karvebis qalaqSi“ 170-190 adamiani binadrobs. TavSesafarSi mosaxvedrad sakmarisia piradi mimarTva an policielis mier referireba17. mediiT gavrcelda informacia TavSesafris mobinadreebs Soris alkoholiT intoqsikaciis ramdenime SemTxvevis Sesaxeb18. profesiul sazogadoebaSi ar miiCneva, rom sacxovrisis problema mwvave problemaa fsiqoaqtiuri nivTierebebis momxmarebelTa Soris, Tumca, alkoholisa Tu narkotikebis moxmarebis Sesaxeb kvleva usaxlkaro individebSi ar Catarebula.

8.3. socialuri reintegracia

narkotikebis momxmarebelTa socialuri reintegraciis programebis ZiriTadi nawili saerTaSoriso donori organizaciebis mier aris dafinansebuli. 2012 wlidan iusticiis saministros danaSaulis prevenciis centri aseve axorcielebs yofili patimrebis reabilitaciisa da resocializaciis programas. Tumca, monacemebi imis Sesaxeb, Tu rogoria programiT mosargebleTa gadanawileba Cadenili danaSaulis mixedviT, ar arsebobs.

saerTaSoriso donori organizaciebis mxardaWeriT ganxorcielebuli aqtivobebi da programuli monacemebi mosargebleTa Sesaxeb aRwerilia qvemoT.

migraciis saerTaSoriso organizaciis socialuri sawarmoebis programa:

2014 wlis 1 ivnisidan, migraciis saerTaSoriso organizaciis saqarTvelos misia, migraciis saerTaSoriso organizaciis bernis ofisTan da Sveicarul fond „kontaqt neTzTan“ mWidro TanamSromlobiT axorcielebs socialuri sawarmoebis programas saxelwodebiT: „socialur-ekonomikuri integracia socialuri sawarmoebis ganviTarebis mizniT saqarTvelos moqalaqe, dabrunebul da potenciur migrantebs Soris narkomoxmarebis problemis Sesamcireblad“. programas mxars uWers Sveicariis saxelmwifo samdivno migraciis sakiTxebSi. programa xels uwyobs migraciis istoriis, an saqarTvelodan emigrirebis ganzraxvis mqone, remisiaSi myof narkotikebis momxmarebelTa reabilitaciasa da integra

15 http://www.geostat.ge/?action=page&p_id=148&lang=geo16 http://www.geostat.ge/?action=page&p_id=178&lang=geo17 http://humanrightshouse.org/Articles/20431.html,wvdoma: 14 marti, 201518 mindia afciauri: usaxlkaro cxovreba Tbilisis TavSesafarSi. 13 ianvari, 2014. http://www.georgianjournal.ge/soci-

ety/25971-living-a-homeless-life-in-tbilisi-shelter.html


cias. am programis mizania saqarTvelos erovnuli antinarkotikuli sistemis potencialis ganviTareba narkotikebis arasamedicino mizniT moxmarebis problemis mdgradi gadaWris moZiebaSi. Sveicariul fonds kontaqT neTzs programaSi wvlili Seaqvs am sferoSi arsebuli gamocdilebis gaziarebiT. kontaqt neTzs narkotikebis momxmarebelTa reabilitaciis mizniT socialuri mewarmeobis gamoyenebis eqspertuli unarebi da mdidari gamocdileba aqvs, romelsac konsultirebis gziT uziarebs qarTvel partniorebs. migraciis saerTaSoriso organizaciis mier programis sawyis etapze dafuZnda proeqtis mxardamWeri komiteti, romlis SemadgenlobaSic yvela Sesabamisi samTavrobo struqturisa da saerTaSoriso organizaciis warmomadgeneli Sevida, ganxorcielda gamWvirvale da inkluziuri sagranto konkursi, romlis Sedegadac SerCeuli xuTi partniori organizaciis mier amoqmedda Semdegi eqvsi socialuri sawarmo, sadac dasaqmebuli arian samizne jgufis warmomadgenlebi:

• dekoratiuli yvavilebis, xisa da buCqebis sanerge, biologiurad sufTa produqtisa (bostneuli, burRuleuli) da mecxoveleobis, mefrinveleobisa da meTevzeobis ferma gorSi, romelTac amuSavebs goris municipalitetis goris sanerge meurneoba;

• suvenirebis, saTamaSoebis, avejisa da sxva inventaris mwarmoebeli xis saamqro, romelsac amuSavebs erovnuli probaciis saagentos Sps perspeqtiva;

• kafeteria da avtosamrecxao, romelsac amuSavebs iusticiis saministros ssip danaSaulis prevenciis centris subsidirebuli arakomerciuli organizacia Secvale scenari;

• artkafe, romelsac amuSavebs arasamTavrobo organizacia kamara.

• sxvadasxva saxis sareklamo inventarisa da masalebis mwarmoebeli sareklamo studia, romelsac amuSavebs sainformacio samedicino-fsiqologiuri centri Tanadgoma.

2015-2016 wlebSi socialuri sawarmoebi samizne kontingents SromiTi Terapiis sareabilitacio programas SesTavazeben. jamSi, programis farglebSi dagegmilia 120-mde remisiaSi myofi narkotikebis momxmarebeli piris grZelvadiani reabilitacia. programis monawileTa Semdgomi integraciis xelSesawyobad, dagegmilia sazogadoebrivi sainformacio kampaniis Catareba programis efeqtianobasa da kursdamTavrebulTa potencialis Sesaxeb informaciis gasavrceleblad, rac wvlils Seitans mosaxleobaSi arsebuli stigmis daZlevasa da potenciur damsaqmebelTa stimulirebaSi.

SidsTan, tuberkulozTan da malariasTan brZolis globaluri fondis pro-eqtis farglebSi 2014 wels ramdenime arasamTavrobo organizacia axorcielebda aqtivobebs narkotikis momxmarebelTa fsiqo-socialuri mxardaWeris mizniT.

sruliad saqarTvelos sapatriarqosTan arsebuli antinarkotikuli centri, globaluri fondis dafinansebiT, 2007 wlidan axorcielebs narkotikebis momxmareblebisa da maTi ojaxis wevrebis fsiqo-socialur sareabilitacio samuSaos, romlis farglebSic 2014 wels individualuri da jgufuri fsiqoTerapiis kur


si gaiara 152-ma mosargeblem. maT Soris 91-ma centrs saeklesio-sareabilitacio kerebis saSualebiT momarTa. mosargebleTa da maTi Tanadgomis qselisaTvis gankuTvnili ,,cxeli xazis” saSualebiT, narkotikebis 941-ma momxmarebelma an remisiaSi myofma pirma miiRo satelefono konsultacia. 172 momxmarebeli momzadda, rogorc Tanaswori ganmanaTlebeli. centris mier specialurad momzadebulma moZRvarma meTadonis programaSi CarTul beneficiarebTan 50 jgufuri sesia ganaxorciela. globaluri fondis proeqtis farglebSi centri aseve atarebs treningebs saeklesio-sareabilitacio kerebis sasuliero pirebisaTvis. sruliad saqarTvelos sapatriarqosTan arsebuli antinarkotikuli centri aRniSnavs, rom narkotikebis momxmarebelTaTvis gankuTvnili fsiqo-socialuri servisebiT sargebloben rogorc marTlmadidebeli, aseve aramarTlmadidebeli mosaxleobis warmomadgenlebi. mosargebleTa udidesi umravlesoba kacia (beqauri 2015).

fsiqo-socialuri reabilitaciis centri kamara adgilobrivi arasamTavrobo organizaciaa, romelic 2010 wlidan moqmedebs da daxmarebas uwevs specifikurad remisiaSi myof narkotikebis momxmareblebsa da maTi mikrosocialuri wris warmomadgenlebs. kamara sxvadasxva momsaxurebas uwevs nivTierebaze damokidebul pirebs detoqsikaciis gavlis Semdeg da sTavazobs Semdegi saxis momsaxurebas: fsiqodiagnostika, kognitur-bihevioruli Terapia, ioga, jgufuri fsiqoTerapia, artTerapia, miTodrama da musikaluri Terapia. kamaras aqtivobebi nawilobriv dafinansebulia globaluri fondisa da fondi Ria sazogadoeba saqarTvelos mier (Coxeli 2015). maTi saqmianobis ZiriTadi wili kerZo Semowirulobebis saSualebiT xorcieldeba. kamaras centrSi remisiaSi myof momxmarebelTaTvis iqmneba araformaluri da „ojaxuri“ atmosfero, romelic uzrunvelyofs mosargebleTa xangrZlivad darCenas programaSi (saSualod 6-Tviani samkurnalo periodi TiToeuli pacientisTvis). kamara yovelwliurad minimum 60-mde yofil momxmarebels emsaxureba. 2014 wels misi servisiT isargebla 85-ma pirma. maT Soris mxolod 2 qali iyo.

kamaras sareabilitacio centrSi, artTerapiis komponentis farglebSi beneficiarebs SesaZlebloba aqvT, Seqmnan xelovnebis nawarmi, naxatebi da sxva nakeTobebi, romelTa gamofena-gayidva yovelwliurad xorcieldeba. es amaRlebs beneficiarebis TviTSefasebas da xels uwyobs maT socialur reintegracias. garda amisa, msgavsi sajaro RonisZiebebi miznad isaxavs, Seamciros narkomomxmareblebis mimarT arsebuli stigma da uaryofiTi winaswarganwyobebi (fanjikiZe 2015).

fsiqikuri janmrTelobis da narkomaniis prevenciis centris fsiqo-socialuri reabilitaciisa da nebayoflobiTi konsultireba-testirebis (nkt) ganyofileba, globaluri fondis proeqtis farglebSi, agreTve axorcielebs narkotikebis momxmarebelTa fsiqo-socialur reabilitacias. ganyofilebis bazaze reabilitaciis kurss gadian pacientebi, romlebic CarTuli arian CanacvlebiTi Terapiis programebSi, da pirebi, romlebmac Caitares stacionaruli an ambulatoriuli detoqsikacia. aq mosargebleebs sTavazoben iseT fsiqologiur momsaxurebas, rogoricaa: fsiqodiagnostika, individualuri, jgufuri da ojaxuri fsiqoTerapia, fsiqologiuri konsultireba, artTerapia, ergoTerapia, konfliqtebis marTva-mogvareba da TviTdaxmarebis jgufebi. centris bazaze or


ganizebulia aseve e.w. „sulieri daxmareba“ romlis farglebSic mosargebleebs, survilis SemTxvevaSi, SeuZliaT Sexvdenen eklesiis msaxurT, romlebic exmarebian sxvadasxva problemis mogvarebaSi da eklesiuri cxovrebis dawyebaSi. centrSi funqcionirebs Tanamedrove inventariT aRWurvili sportuli darbazi, sadac tardeba fizikur-gamajansaRebeli procedurebi, romlebic, garda fizikuri gajansaRebisa, xels uwyobs pacientebis mier brazis marTvas, SfoTvis da depresiis donis regulirebas. centrSi pacientebs agreTve eZlevaT SesaZlebloba, Seiswavlon muSaoba kompiuterze, isargeblon internetiTa da sxvadasxva kompiuteruli programiT. 2014 wels fsiqikuri janmrTelobisa da narkomaniis prevenciis centri moemsaxura 52 pirs. 3-6 Tviani sareabilitacio programa daasrula 21-ma pirma (TodaZe, mosia 2015).

evrokavSiris dafinansebiT mimdinare proeqts „socialuri reintegraciis popularizacia: socialuri biuroebis Seqmna yofili patimrebisa da pro-bacionerebisTvis, aseve gaTavisuflebamdeli programebis gaumjobeseba sasjelaRsrulebis dawesebulebebSi“ axorcielebs adgilobrivi arasamTavrobo organizacia sainformacio-sakonsultacio centri Tanadgoma saerTaSoriso arasamTavrobo organizaciebTan – meinlain fondTan da Sidsis aRmosavleT-dasavleT fondTan partniorobiT (kasreliSvili 2015). proeqtis farglebSi socialurad daucveli mosaxleobisTvis tardeba konsultaciebi aiv-ze, B da C hepatitze, aseve fsiqologiuri da samedicino konsultaciebi, midis muSaoba zedozirebis prevenciasa da fsiqologiur reabilitaciaze 12 nabijis midgomaze dayrdnobiT, agreTve tardeba komunikaciis unaris gasaviTarebeli treningi samuSaos maZiebeli mosargebleebisTvis. 2014 wels baTumSi, quTaissa da zugdidSi socialuri biuroebis servisiT isargebla 631-ma adamianma, maTgan 293 yofili patimaria, 249 – probacioneri da 82 – patimari. gasul wels proeqtma SeZlo ramdenime mosargebles problemis mogvareba: quTaisSi yofili patimari, romelic ojaxma ar miiRo da gariya, darCa usaxlkarod. socialur biuroSi aRmoCenili daxmarebis Sedegad man miiRo socialurad daucveli martoxela piris statusi da droebiT moTavsda TavSesafarSi. zugdidSi socialuri biuroebis rekomendaciebiT yofili patimrebi dasaqmdnen sastumroSi mimtanad da Txilis qarxanaSi muSad. Tumca, aRwerili erTeuli SemTxvevebi umniSvneloa qveyanaSi arsebuli problemis masStabis gaTvaliswinebiT.

dReisaTvis qveyanaSi ar arsebobs narkotikebis momxmarebel qalTa saWiroebebze morgebuli fsiqo-socialuri reabilitaciis momsaxureba, arc raime igegmeba am mimarTulebiT, maSin, rodesac narkomomxmarebeli qalebi ormagi socialuri stigmis zewolas ganicdian – sqesisa da narkotikebis moxmarebis gamo. moxmarebasTan dakavSirebuli problemebis paralelurad, qali narkomomxmareblebi xSirad ojaxuri an genderuli Zaladobis obieqtebi xdebian.

qveyanaSi arsebuli saWiroebebis gaTvaliswinebiT, narkomomxmareblebisa da remisiaSi myofi pirebisaTvis fsiqo-socialuri reabilitaciis servisebis xelmisawvdomoba, maT Soris, geografiuli xelmisawvdomoba, araadekvaturia. amasTan, momxmarebelTa grZelvadian reabilitaciasa da socialur reintegraciaze orientirebuli servisebis moqmedeba srulad aris damokidebuli saerTaSoriso donori organizaciebis dafinansebaze, rac safrTxes uqmnis am servisebis mdgradobas.


9.1. Sesavali

winamdebare angariSisTvis narkotikebTan dakavSirebuli danaSaulis statistikuri monacemebi movipoveT ramdenime saxelmwifo uwyebidan – saqarTvelos Sinagan saqmeTa saministrodan, saqarTvelos mTavari prokuraturidan, da saqarTvelos uzenaesi sasamarTlodan. monacemebis ZiriTadi nawili gamoTxovilia Sesabamis uwyebaSi werilobiTi mimarTvis gziT. garda amisa, gamoviyeneT Sinagan saqmeTa saministros internetgverdze ganTavsebuli informacia.

vinaidan saqarTveloSi ar xdeba meoradi narkodanaSaulis saTanado aRricxva, angariSSi warmodgenilia pirveladi narkodanaSaulis monacemebi. pirvelad narkodanaSaulSi vgulisxmobT narkotikebTan dakavSirebuli sisxlis samarTlis kodeqsis da administraciuli kodeqsis muxlebis darRvevas. meoradi narkodanaSaulis qveS vgulisxmobT danaSauls, romelic Cadenilia narkotikuli saSualebis zemoqmedebis qveS, an narkotikis SesaZeni Tanxis mosapoveblad, anda ukanono narkobazris monawileebis mier (magaliTad, Zaladobrivi danaSauli bazris gadanawilebis mizniT).

9.2. narkotikebTan dakavSirebuli danaSauli

9.2.1. sisxlis samarTlis sasjelebi narkodanaSaulisTvis

saqarTvelos uzenaesi sasamarTlos mier mowodebuli informaciis mixedviT, 2014 wels saqarTvelos pirveli instanciis sasamarTloebma ganixiles saqarTvelos sisxlis samarTlis kodeqsis (ssk) 33-e TaviT gaTvaliswinebuli danaSaulisaTvis msjavrdebuli 6,666 piris mimarT warmoebuli 6,452 saqme. ganxilul saqmeTa udidesi nawili (95%-ze meti) exeboda ssk-is 260-e da 273-e muxlebiT gaTvaliswinebul danaSauls – ganxiluli saqmeebis saerTo raodenobis 33.4%-s da 62%-s Sesabamisad. 260-e muxli iTvaliswinebs patimrobas (6 Tvidan uvado patimrobamde) Semdegi qmedebisaTvis: narkotikuli saSualebis, misi analogis an prekursoris an axali fsiqoaqtiuri nivTierebis ukanono damzadeba, warmoeba, SeZena, Senaxva, gadazidva, gadagzavna an gasaReba. 273-e muxli iTvaliswinebs sanqciebs (jarima an Tavisuflebis aRkveTa 1 wlamde) Semdegi qmedebisaTvis: piradi moxmarebisTvis narkotikuli saSualebis, misi analogis an prekursoris mcire odenobiT ukanono damzadeba, SeZena, Senaxva, anda eqimis daniSnulebis gareSe ukanono moxmareba, Cadenili ganmeorebiT erTi wlis ganmavlobaSi. Tavisuflebis aRkveTa miesaja

9. narkotikebTan dakavSirebuli danaSauli, narkotikebTan dakavSirebuli danaSaulis

prevencia da cixe


260-e muxliT msjavrdebul pirTa 2/3-s da 273-e muxliT msjavrdebul pirTa 1/4-s. jarima ZiriTad an damatebiT sasjelad miesaja yvela muxliT msjavrdebulTa 45%-s da saproceso SeTanxmeba gaformda 71%-Tan (ix. cxrili 12).

cxrili 12: pirveli instanciis sasamarTloebSi 2014 wels narkotikul danaSaulTan dakavSirebuli ganxiluli saqmeebis da pirebis raodenoba

(saqarTvelos uzenaesi sasamarTlo, 2015)

sssk-s muxlebi

ganxilulia ganaCenis gamotaniT

maT Soris miesajaT sasjeliganxilu-lia sap-roceso

SeTanxme-biT

Tavisuflebis aRkveTa

pirobiTi

msjavri

jarima (ZiriTadi sasjeli)

jarima (damatebiTi sasje

li)

sazogadoebisTvis sasargeblo

Sroma

saqme piri piri piri piri piri piri saqme

260 2156 2354 1515 802 37 1215 144 1858

261 57 59 9 12 38 16 53

262 130 132 78 10 44 36 92

263 2 2 __ __ 2 2

264 1 1 __ 1 __ 1

265 113 114 53 60 1 63 98

271 __ 1 __ 1 1 1

273 3993 4003 972 2082 805 741 2618

sul 6452 6666 2627 2968 927 2072 144 4723

wina welTan SedarebiT mniSvnelovnad ar Secvlila 260-e muxliT msjavrdebulTa saerTo raodenoba, Tumca sagrZnoblad gaizarda 273-e muxliT msjavrdebulebis ricxvi. aRsaniSnavia, rom orive am ZiriTad muxlTan mimarTebaSi, Tavisuflebis aRkveTa, rogorc sasjeli, 2013 welTan SedarebiT gacilebiT ufro xSirad aris gamoyenebuli 2014 wels: 64%-is mimarT 2014 wels, 2013 wlis 45%-is nacvlad 260-e muxlTan mimarTebaSi, da 24%-is mimarT 2014 wels, 2013 wlis 12%-is nacvlad 273-e muxlTan mimarTebaSi (ix. diagrama 16).


diagrama 16: saqarTvelos sisxlis samarTlis kodeqsis 260-e da 273-e muxlebiT msjavrdebuli pirebis raodenobis dinamika wlebis mixedviT,

2007-2014 ww (saqarTvelos uzenaesi sasamarTlo, 2015)

9.2.2. administraciuli samarTaldarRvevebi

saqarTvelos Sinagan saqmeTa saministros informaciiT, 2014 wels narkologiuri Semowmeba Cautarda 50,865 pirs (ix. cxrili 13). Semowmebis Sedegad narkotikuli saSualebis moxmarebis faqti daudginda 14,005 pirs, yvelaze ufro xSirad gamovlinda marixuanas (61.7%), opiumis (22%), meTadonisa (12%) da buprenorfinis (9.3%) moxmareba. aRsaniSnavia, rom narkologiuri Semowmebisas erTsa da imave pirs xSir SemTxvevaSi gamokvleva utardeba ramdenime nivTierebis moxmarebis faqtis dasadgenad. Sesabamisad, cxrilSi mocemuli sxvadasxva nivTierebebis dadebiTi pasuxebis jami aRemateba im pirTa raodenobas, romelTac daudgindaT moxmareba.

cxrili 13: im pirTa raodenoba, romelTac 2014 wels CautardaT narkologiuri Semowmeba Sss-is saeqsperto-kriminalistikur mTavar

sammarTveloSi (saqarTvelos Sinagan saqmeTa saministro 2015)

2014

saer

To

rao

de-

noba

dad

ebiT

i

uar

yof

iTi

opi

umi

bupr

eno

rf

ini

mar

ixu

ana

meT

ado

ni

met

amf

etam

ini,

am

fet

amin

i

koka

ini

tr

amad

ol

i

eqst

azi

sinT

etu

ri

mar

ixu

ana

ianv. 6,482 2,139 4326 976 125 956 199 174 8 15 15 43

Teb. 5,761 1,802 3,959 961 128 592 201 131 7 14 10 32

mart. 4,526 901 3,625 182 154 338 176 142 5 25 8 31

apr. 3,060 518 2,542 127 92 187 135 48 0 12 6 11

8

diagrama 15: narkotikebis ineqciur momxmarebelTa yovelTviuri SemosavalilarebSi, procentebSi(saerTaSoriso fondi kuracio da sazogadoebrivi


diagrama 16: saqarTvelos sisxlis samarTlis kodeqsis 260-e da 273-e muxlebiT

msjavrdebuli pirebis raodenobis dinamika wlebis mixedviT, 2007-2014

ww(“saqarTvelos uzenaesi sasamarTlo” 2015)

21.3%

35.4%

23.0%

10.0%

6.6%

3.5%

100 ლარზე ნაკლები





>1000

2007 2008 2009 2010 2011 2012 2013 2014


მუხლით1,919 2,095 2,193 2,376 1,849 1,100 2,336 2,354

მათ შორის პატიმრობა (260) 1,552 1,467 1,649 1,855 1,135 598 1,193 1,515


მუხლით2,681 4,423 3,663 2,517 1,523 861 3,553 4,003

მათ შორის პატიმრობა (273) 775 1,605 1,340 874 403 220 435 972

0500

1,0001,5002,0002,5003,0003,5004,0004,5005,000


mai. 2,950 495 2,468 80 106 175 151 30 6 15 4 13

ivn. 2,971 583 2,392 122 73 262 133 14 5 8 4 29

ivl. 3,498 767 2,722 115 107 500 107 9 0 16 0 7

agv. 3,957 1,099 2,858 109 121 825 113 8 5 8 8 8

seqt. 4,918 1,504 3,414 98 132 1,239 123 19 3 5 3 2

oqt. 4,388 1,619 2,777 105 96 1,407 118 12 3 9 1 2

noemb. 4,061 1,365 2,696 100 77 1,169 96 23 2 0 0 ---

dek. 4,293 1,213 3,081 92 93 996 111 21 4 5 3 1

sul 50,865 14,005 36,860 3,067 1,304 8,646 1,663 631 48 132 62 179

narkologiur Semowmebaze wardgenilTa mxolod 1% iyo qali (ix. cxrili 14).

cxrili 14: im pirTa raodenoba, sqesis mixedviT, romelTac 2014 wels CautardaT narkologiuri Semowmeba Sss-is saeqsperto-kriminalistikur

mTavar sammarTveloSi (saqarTvelos Sinagan saqmeTa saministro, 2015)

sqesi qali mamakaci sul

saerTo 485 50,380 50,865

dadebiTi 112 13,893 14,005

pozitiuri pasuxi % 23 27.6 27.5

Sinagan saqmeTa saministros saeqsperto-kriminalistikuri mTavari sammarTvelos mier Catarebuli narkologiuri Semowmebebis Sedegad dgindeba mTeli rigi narkotikuli saSualebebis moxmarebis faqtebi. 2013-2014 wlebSi yvelaze xSirad marixuanasa da opiumis jgufis nivTierebebis moxmarebis faqti dadginda. am kuTxiT aRsaniSnavia 2014 wels 2013-Tan SedarebiT marixuanas moxmarebis gamovlenis mniSvnelovani zrda da opiumis jgufis moxmarebis gamovlenis mniSvnelovani kleba (ix. diagrama 17). agreTve, TvalSisacemia marixuanas moxmarebis gamovlenis mkveTri da mdgradi mateba.


diagrama 17: narkologiuri Semowmebis Sedegad gamovlenili narkotikuli saSualebebis moxmarebis maCveneblebi 2007-2013-2014 wlebSi (%)(naCvenebia

monacemebi xuT yvelaze xSirad dafiqsirebul narkotikul saSualebasTan dakavSirebiT) (saqarTvelos Sinagan saqmeTa saministro, 2008, 2014, 2015)

2014 wels wina welTan SedarebiT narkologiur Semowmebaze wardgenis maCvenebelma iklo daaxloebiT 10,000 piriT (ix. diagrama 18). iklo, agreTve, dadebiTi pasuxebis wilobrivma maCvenebelma - 2014 wels dadebiTi pasuxebis wili 27.5% iyo, xolo 2013-Si – 37.7%.

diagrama 18: narkotikebze Semowmebuli adamianebisa da dadebiTi Sedegebis raodenoba, 2006-2014 ww (saqarTvelos Sinagan saqmeTa saministro, 2007-2015)

uzenaesi sasamarTlos mier mowodebuli informaciis Tanaxmad, 2014 wels saqarTvelos administraciuli kodeqsis 45-e muxlis safuZvelze gamotanilia 9,161 dadgenileba, maT Soris 8,694 (95%) fuladi jarimis Taobaze. samwuxarod, ukve ramdenime welia, ver xerxdeba uzenaesi sasamarTlodan informaciis mopoveba

9

diagrama 17: narkologiuri Semowmebis Sedegad gamovlenili narkotikuli

saSualebebis moxmarebis maCveneblebi 2007-2013-2014 wlebSi (%)(naCvenebia monacemebixuT yvelaze xSirad dafiqsirebul narkotikul saSualebasTan dakavSirebiT)

(saqarTvelos Sinagan saqmeTa saministro, 2008, 2014, 2015)

diagrama 18: narkotikebze Semowmebuli adamianebisa da dadebiTi Sedegebis

raodenoba, 2006-2014 ww(saqarTvelos Sinagan saqmeTa saministro, 2007-2015)


ოპიუმიბუპრენორფინი

მეთადონი

მეტ/ამფეტამინი0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

2007 2013 2014

2006 2007 2008 2009 2010 2011 2012 2013 2014

დადებითი 4,014 17,745 19,302 11,794 11,348 8,138 7,627 22,711 14,005

უარყოფითი 1,286 39,255 23,727 21,498 22,244 19,040 12,373 37,485 36,860

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

9

diagrama 17: narkologiuri Semowmebis Sedegad gamovlenili narkotikuli

saSualebebis moxmarebis maCveneblebi 2007-2013-2014 wlebSi (%)(naCvenebia monacemebixuT yvelaze xSirad dafiqsirebul narkotikul saSualebasTan dakavSirebiT)

(saqarTvelos Sinagan saqmeTa saministro, 2008, 2014, 2015)

diagrama 18: narkotikebze Semowmebuli adamianebisa da dadebiTi Sedegebis

raodenoba, 2006-2014 ww(saqarTvelos Sinagan saqmeTa saministro, 2007-2015)


ოპიუმიბუპრენორფინი

მეთადონი

მეტ/ამფეტამინი0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

2007 2013 2014

2006 2007 2008 2009 2010 2011 2012 2013 2014

დადებითი 4,014 17,745 19,302 11,794 11,348 8,138 7,627 22,711 14,005

უარყოფითი 1,286 39,255 23,727 21,498 22,244 19,040 12,373 37,485 36,860

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000


gadaxdili jarimebis odenobasTan dakavSirebiT. Sesabamis moTxovnaze uwyeba gvpasuxobs, rom narkotikebTan dakavSirebuli muxlebis safuZvelze gadaxdili fuladi Tanxebis daTvlas ver awarmoebs. aRsaniSnavia, rom 2011 wlamde am informaciis mopoveba uzenaesi sasamarTlodan SesaZlebeli iyo.

cxrili 15: 2014 wels pirveli instanciis sasamarTloebSi saqarTvelos administraciul samarTaldarRvevaTa kodeqsis 45-e muxlis safuZvelze

gamotanili dadgenilebebi (saqarTvelos uzenaesi sasamarTlo, 2015)

sasamarTlo gadawyvetilebebi pirebis raodenoba

administraciuli patimroba 115

fuladi jarima 8,694

gaTavisuflda administraciuli pasuxismgeblobisgan 261

saqme prokuraturas gadaegzavna Semdgomi gamoZiebisTvis 91

sul 9,161

9.3. narkotikebTan dakavSirebuli danaSaulis prevencia

saqarTveloSi calke aRebuli narkotikebTan dakavSirebuli danaSaulis prevenciis strategia ar arsebobs. miuxedavad amisa, SeiZleba vigulisxmoT, rom am mimarTulebiT muSaoba mimdinareobs danaSaulis prevenciis zogadi RonisZiebebis gatarebis dros, magaliTad, iusticiis saministrosTan moqmedi ssip danaSaulis prevenciis centris muSaobis farglebSi. centri xels uwyobs gaTavisuflebuli patimrebis reabilitacias da sazogadoebaSi reintegracias. agreTve, SeiZleba CavTvaloT, rom narkotikebis moxmarebis prevenciuli RonisZiebebi Seicavs danaSaulis prevenciis komponentebs. ufro detalurad gaecaniT me3 TavSi.

9.4. narkotikebis moxmareba da problemuri moxmareba sasjelaRsrulebis dawesebulebebSi

2014 wlis dekembrisTvis saqarTvelos sasjelaRsrulebis 15 dawesebulebaSi 10,372 (281 qali) braldebuli da msjavrdebuli ixdida sasjels(saqarTvelos sasjelaRsrulebisa da probaciis saministro 2015a). informacia imis Taobaze, Tu maT Soris ramdeni ixdida sasjels narkotikebTan dakavSirebuli danaSaulis gamo da zogadad sapatimroebSi narkotikebis moxmarebis Taobaze xelmisawvdomi ar aris. saministros mesveurebi aRiareben sapatimroebSi fsiqotropuli


nivTierebebis moxmarebis problemas, Tumca zusti ricxobrivi monacemebi am sakiTxze ar moipoveba. rac Seexeba aralegaluri narkotikebis moxmarebas, iseve, rogorc wina wlebSi, miCneulia, rom qarTuli cixeebi narkotikebisgan Tavisufali sivrcea, anu, narkotikebi iq ar Seedineba da Sesabamisad, arc moixmareba. es sakiTxi detalurad aris aRwerili narkoviTarebis 2013 wlis angariSSi.

9.5. narkotikebTan dakavSirebul janmrTelobis sakiTxebze reagireba cixeebSi

saqarTvelos sasjelaRsrulebisa da probaciis saministros 2014 wlis angariSis mixedviT: „2014 wels warmatebiT dasrulda penitenciuri jandacvis reforma (e.w. „18-Tviani reforma“), romelic 2013-2014 wlebSi sistemis srul gardaqmnas isaxavda miznad“ (saqarTvelos sasjelaRsrulebisa da probaciis saministro 2015b). reforma gulisxmobda sistemur cvlilebebs, romlebic moicavda rogorc samedicino infrastruqturis gaumjobesebas, aseve profesiuli kadrebis kvalifikaciis amaRlebas. sasjelaRsrulebis sistemaSi bolo wlebis manZilze ganxorcielebuli cvlilebebis Taobaze ufro detaluri informacia asaxuli iyo narkoviTarebis 2013 wlis angariSSi.

9.5.1. wamaldamokidebulebis mkurnaloba sasjelaRsrulebis dawesebulebebSi

sasjelaRsrulebisa da probaciis saministros 2014 wlis angariSis mixedviT, penitenciur sistemaSi gafarTovda narkologiuri servisebis miwodeba da dafarva, kerZod, gaixsna axali narkologiuri ganyofileba, daiwyo sainformacio kampania fsiqotropul medikamentebze damokidebulebis winaaRmdeg, gaformda xelSekrulebebi samoqalaqo seqtoris narkologiur centrebTan da daiwyo patimrebis mkurnaloba/reabilitacia, gafarTovda meTadoniT detoqsikaciis programa da gadawyda CanacvlebiTi SemanarCunebeli Terapiis dawyeba (saqarTvelos sasjelaRsrulebisa da probaciis saministro, 2015b).

wamaldamokidebulebis specializebuli mkurnalobis miReba SesaZlebelia sasjelaRsrulebis sistemis sam sapatimro dawesebulebaSi. Tbilisisa da quTaisis winaswari dakavebis dawesebulebebSi moqmedebs meTadonis detoqsikaciis programebi. damatebiT, sasjelaRsrulebis centralur saavadmyofoSi stacionaruli detoqsikaciis ganyofileba abstinenciaze orientirebul mkurnalobas sTavazobs saWiroebis mqone patimrebs. 2014 wels meTadoniT detoqsikaciuri mkurnaloba gaiara 474-ma braldebulma da msjavrdebulma, maT Soris 4-ma qalma.stacionaruli detoqsikaciis kursi gaiara 4-ma patimarma.

9.5.2. zianis Semcirebis RonisZiebebi

narkotikebis moxmarebiT gamowveuli zianis Semcirebis programebi saqarTvelos cixeebSi ar xorcieldeba. wina wlebis msgavsad, iTvleba, rom aralegalu


ri narkotikebi sapatimroebSi ar Sedis da Sesabamisad, patimrebi narkotikebs ar moixmaren. zianis Semcirebis erTaderTi komponenti, romelic aiv/Sidsis prevenciis egidiT xorcieldeba sapatimro dawesebulebebSi, aris nebayoflobiTi konsultireba da testireba (nkt). nkt kabinetebi moqmedebs sasjelaRsrulebis yvela dawesebulebaSi, garda orisa. es momsaxureba dafinansebulia SidsTan, tuberkulozTan da malariasTan brZolis globaluri fondis grantis farglebSi.

9.5.3. jandacvis momsaxurebebze wvdoma da maTi miwodeba narkotikebis momxmareblebisTvis sasjelaRsrulebis dawesebulebebSi

sasjelaRsrulebis saministros monacemebiT, 2014 wels sasjelaRsrulebis dawesebulebebSi myof 8,000 pirs Cautarda testireba aiv-is da C hepatitis virusze. maT Soris dadebiTi pasuxi gamovlinda aiv-ze 34 SemTxvevaSi da C hepatitze 3,800 SemTxvevaSi (saqarTvelos sasjelaRsrulebisa da probaciis saministro 2015a). C hepatitis eliminaciis saxelmwifo programis farglebSi sapatimroebSi myofi adamianebisaTvis uzrunvelyofilia specifikuri mkurnalobis universaluri xelmisawvdomoba, rac imas niSnavs, rom yvelas, visac C hepatitis mkurnaloba esaWiroeba, aqvs SesaZlebloba, miiRos igi. aiv/Sidsis antiretrovirusuli mkurnaloba patimrebisaTvis agreTve universalurad xelmisawvdomia. 2014 wlis dekemberSi antiretrovirusul mkurnalobas 75 patimari iRebda (saqarTvelos sasjelaRsrulebisa da probaciis saministro 2015c).

9.6. narkotikebis momxmareblebis reintegracia cixidan gaTavisuflebis Semdeg

dReisaTvis sapatimroebSi ar moqmedebs raime specifiuri programa, romelic narkotikebis moxmarebasTan dakavSirebuli problemebis mqone patimrebis gaTavisuflebis Semdeg reintegraciis xelSewyobaze iqneboda orientirebuli.fsiqo-socialuri reabilitaciis programebi ZiriTadad finansdeba evrokaSirisa da arasamTavrobo organizaciebis mier.

rac Seexeba gaTavisuflebis Semdgomi fsiqo-socialuri reabilitaciis programebs, 2012 wlidan moqmedebs evrokavSiris mier dafinansebuli proeqti „socialuri biuroebis Seqmna yofili patimrebisa da probacionerebisTvis, aseve gaTavisuflebamdeli programebis gaumjobeseba sasjelaRsrulebis dawesebulebebSi“. proeqts uZRveba arasamTavrobo organizacia sainformacio-sakonsultacio centri Tanadgoma saerTaSoriso arasamTavrobo organizaciebTan – meinlain fondTan da Sidsis aRmosavleT-dasavleT fondTan partniorobiT. yofil patimrebs proeqti sTavazobs aiv/Sidsze, B da C hepatitze testirebas, zedozirebis prevenciasa da fsiqo-socialur reabilitacias 12 nabijis programis modeliT; aseve komunikaciis unarebis trenings maTTvis, vinc samsaxurs eZebs. detaluri informaciisTvis ixileT socialuri reintegraciis Tavi 8.


10.1. Sesavali

narkoviTarebis monitoringis gamarTuli sistemis ararsebobis gamo narkotikebis ukanono brunvasTan da narkobazris maxasiaTeblebTan dakavSirebiT srulyofili informaciis Segroveba saqarTveloSi ver xerxdeba. monacemebis ZiriTadi wyaro Sinagan saqmeTa saministroa, saidanac Sesabamisi informacia winamdebare angariSis avtorebma gamoviTxoveT werilobiTi moTxovnebis safuZvelze da aseve, moviZeT saministros veb-gverdze arsebul resursebSi. agreTve, gamoviyeneT narkotikebis momxmareblebis servisis mimwodeblebis mier gaziarebuli informacia, romelic asaxavs am jgufSi sxvadasxva narkotikuli saSualebebis mimdinare (bolo 1 Tve) moxmarebis tendenciebs. garda amisa, angariSSi asaxulia epidzedamxedvelobis kvlevis is Sedegebi, romelic sxvadasxva narkotikuli saSualebebis moxmarebis gavrcelebas exeba.

10.2. narkotikebis xelmisawvdomoba

saqarTveloSi ar aRiniSneba narkotikuli saSualebebis organizebuli masiuri warmoeba, romelic Sida da/an gare bazars moamaragebda romelime narkotikiT. amis sapirispirod, qveyanaSi farTod aris gavrcelebuli saineqcio narkotikebis (stimulatorebis da opioidebis) kustaruli damzadeba. am SemTxvevaSi, narkotikebis momxmarebelTa mcirericxovani jgufi (rogorc wesi, 3-5 adamiani) saxlis pirobebSi amzadebs da Semdgom moixmars narkotiks. am tipis damzadeba xdeba mxolod sakuTari moxmarebis mizniT da CvenTvis ucnobia kustarulad damzadebuli narkotikuli saSualebis gasaReba/gayidvis faqtebi.

ama Tu im saxis narkotikuli saSualebis xelmisawvdomobis srulfasovani Sefaseba ver xerxdeba verc ukanono brunvidan amoRebuli narkotikebis odenobebis safuZvelze da verc narkotikebis momxmarebelTa mier drois ama Tu im periodSi sxvdasxva narkotikis ufro xSiri (Tu iSviaTi) moxmarebis tendenciebis safuZvelze. bunebrivia, arc Zalovani struqturebis mier Catarebuli narkologiuri Semowmebis Sedegebi (yvelaze meti dadebiTi Sedegi iyo marixuanas, opiumis, buprenorfinis, meTadonisa da met/amfetaminisTvis – ix. diagrama 17) SeiZleba CaiTvalos ama Tu im saxis narkotikis xelmisawvdomobis maCveneblad. aseve, 2014 wels heroinis rekorduli amoReba (591 kg – ix. cxrili 17) ver migvaniSnebs imas, rom amis Sedegad heroini miuwvdomeli unda gamxdariyo qarTul narkobazarze. analogiurad, zianis Semcirebis saqarTvelos qselis da epidzedamxedvelobis kvlevis Sedegebi, romelic gviCvenebs, rom 2014 wels narkotikebis momxmare

10. narkobazari


blebSi gaizarda heroinisa da buprenorfinis moxmareba (ix. diagrama 4), pirdapir ver migvaniSnebs am narkotikebis gazrdil xelmisawvdomobaze. savsebiT SesaZlebelia, rom momxmarebelTa arCevanze gavlenas, garda xelmisawvdomobisa, sxva faqtorebic axdens.

10.2.1. axali fsiqoaqtiuri nivTierebebi

axali fsiqoaqtiuri nivTierebebis xelmisawvdomobasTan dakavSirebuli informacia asaxulia Sinagan saqmeTa saministros 2014 wlis narkoviTarebis angariSSi (Sss-s kompetenciis farglebSi) da pirvel yovelwliur angariSSi saqarTveloSi axal fsiqoaqtiur nivTierebebTan dakavSirebiT arsebul viTarebaze (saqarTvelos Sinagan saqmeTa saministro, 2014, saqarTvelos Sinagan saqmeTa saministro, 2015). aRniSnuli angariSebis mixedviT, 2014 wlis 1 maisis Semdgom (axali fsiqoaqtiuri nivTierebebis Sesaxeb kanonis ZalaSi Sesvlis TariRi) erTi wlis manZilze dafiqsirda axali fsiqoaqtiuri nivTierebebis moxmarebis gamovlenis 90%-iT kleba (2013 w maisi-2014w ivnisi – 687 SemTxveva, 2014 w. maisi-2015 w. ivnisi – 53 SemTxveva). imave periodSi moxda axali fsiqoaqtiuri nivTierebebis saqarTvelos sazRvarze Semotanis gamovlenili SemTxvevebis mniSvnelovani Semcireba – 53 SemTxveva 5-is sapirispirod. aRniSnuli angariSebis avtorebi miiCneven, rom moyvanili monacemebi metyvelebs qveyanaSi axali fsiqoaqtiuri nivTierebebis moxmarebis 90%-iT Semcirebaze. epidemiologiasa da narkoviTarebis monitoringis sferoSi arsebuli standartebis Tanaxmad, amdagvari daskvnis gasakeTeblad ar aris sakmarisi mxolod moxmarebis gamovlenis da sazRvarze identificirebuli nivTierebebis raodenobis maCveneblebi.

10.3. amoReba

2014 weli gamorCeuli iyo narkotikuli saSualebebis ukanono brunvidan amoRebis rekorduli maCveneblebiT. gansakuTrebiT es exeba heroinisa da kanafis amoRebas. es SesaZloa aixsnas rogorc mocemuli nivTerebebis Semodinebis gazrdiT, aseve amoRebis mimarTulebiT policiis muSaobis efeqtianobis amaRlebiT, da aseve policiis aqtivobis Sesabamisi prioritetebis dasaxviT. cxrili 16 aCvenebs 2006-2014 wlebSi amoRebuli narkotikuli saSualebebis odenobas.


cxrili 16: 2006-2014 wlebSi ukanono brunvidan amoRebuli narkotikuli saSualebebis (sufTa nivTierebebis) raodenobebi (saqarTvelos Sinagan saqmeTa saministro 2007-2015)19

2006 2007 2008 2009 2010 2011 2012 2013 2014

heroini (kg) 8.59 16.15 12.11 5.05 1.71 0.47 0.29 117.62 591.89

opiumi (kg) 0.22 0.14 0.05 0.12 0.09 0.09 0.01 0.05 0.21

marixuana (kg) 26.24 23.64 28.29 43.70 27.06 48.47 30.08 71.60 57.39

tramadoli (kg) 0.07 0.1 0.73 0.13 0.21 0.02 0.01 0.14 0.730

kanafi (mcenare) (kg) 123.03 64.85 41.56 100.25 26.88 88.91 21.07 217.77 5,420.8

meTadoni (kg) 0.02 0.21 0.32 0.29 0.03 0.003 0.04 0.009 0.14

subuteqsi (abi) 10,852 16,232 13,757 7,022 2,815 3,031 777 1,678 -----

amfetamini (gr) 0.0063 0.68 0.87 0.29 0.19 0.26 57.52

metamfetamini (kg) 0.002 0.0004 0.002 0.003 0.008 0.002 0.001 0.003 0.06

morfini (kg) 0.003 0.004 0.03 0.006 0.007 0.005 0.004 0.002 11.76

kodeini (kg) 0.03 0.01 0.03 2.29

fentanili (kg) 0.0004 0.0008

dezomorfini (kg) 0.001 0.01 0.0006

kokaini (kg) 0.0005 0.001 0.13 0.008 0.002 0.50

efedrini (gr) 1.19 1.02 3.68 7.59 1.86 1.01 0.79 0.00015

eqstazi (mdma) 0.000002 0.01 0.077 0.071

fsevdoefedrini 0.07

tramadoli (kg) 0.07 0.1 0.73 0.13 0.21 0.02 0.01 0.14 0.73

lizerginis mJava (LSD) (gr) 0.0014 0.0019 0.0015

pregabalini (kg) 0.59 15,4

yayaCo (kg) 2.02 0.28 13.93 8.22

buprenorfini (kg) 0.25

10.4. fasi/siwminde

qveyanaSi moxmarebuli narkotikebis fasisa da siwmindis Taobaze sando da srulyofili informacia xelmisawvdomi ar aris.

19 (cxrilSi moyvanili monacemebi SesaZloa gansxvavdebodes narkoviTarebis wina angariSebSi moyvanili monacemebisagan. mimdinare angariSSi gamoyenebulia bolo monacemebi, romelic mowodebulia Sss-s mier 2015 wlis 12 dekembris N2747853 werilSi. miuxedavad imisa, rom yvela wina wliur angariSSi agreTve gamoyenebulia Sss-s mier im periodSi mowodebuli informacia, zog SemTxvevaSi monacemebi gansxvavdeba).


adiqtologiuri, 30, 32

aiv, 6, 16, 17, 18, 20, 21, 24, 26, 28, 34, 36, 38, 39, 40, 41, 42, 48, 49, 50, 58, 66

alkoholi, 15,16,17,19, 20, 27, 30, 55

ambulatoriuli, 6,14, 33, 34, 37, 57

amoReba, 67, 68

amfetamini, 10, 35, 61, 67, 69

arasamTavrobo, 12, 20, 23, 32, 49, 51, 56, 57, 58, 66

arasrulwlovani, 21

bavSvebi, 18, 19, 20, 21

bionarkotiki, 21, 27

buprenorfini, 17, 27, 28, 35, 61, 67, 68, 69

gadazidva, 59

ganaTlebisa da mecnierebis saministro, 8, 19, 20, 21

dabalzRurblovani, 43, 50

danaSauli, 10, 11, 52, 55, 56, 59, 64

dafinanseba, 14, 32, 33, 34, 58

detoqsikacia, 32, 33, 36, 57

evrokavSiri, 58, 66

evropis narkotikebisa da narkomaniis monitoringis centri, 5, 15

erovnuli samoqmedo gegma,12,

efedrini, 11, 69

efeqturoba, 14

eqstazi, 61, 69

zedozireba, 13, 26, 28, 46, 47

zianis Semcireba, 6, 12, 14, 32, 48

zogadi mosaxleobis gamokiTxva, 15

Tambaqo, 15, 19, 20, 22

intoqsikacia, 31, 55

indeqsi

incidentoba, 38, 39, 43, 45

iusticiis saministro, 8, 9, 12, 52, 55, 56, 64

kanafi, 17, 27, 35, 68, 69

kanoni, 5, 10, 11, 12, 13, 19, 31, 35, 47, 68

kvleva, 6, 12, 15, 16, 17, 23, 24, 26, 27, 31, 40, 41, 42, 43, 44, 45, 53, 54, 55, 61

kodeini, 10,14, 69

kokaini, 35, 69

kondomi, 28

konsultireba, 40, 51, 57, 66

koordinacia, 12

marixuana, 5, 11, 27, 61, 62, 67, 69

mediaproduqti, 22

meTadoni, 26, 29, 34, 35, 36, 50, 57, 61, 65, 67, 69

metamfetamini, 10, 35, 61, 69

mTavroba, 32, 33, 35, 42

mizanmimarTuli prevencia, 21

mkurnaloba, 6, 14, 28, 30, 31, 32, 33, 34, 36, 37, 40, 43, 49, 50, 51, 65, 66

msjavrdebuli, 21, 50, 59, 60, 61, 64, 65

narkobazari, 67

narkotikebTan dakavSirebuli danaSauli, 59, 64

narkotikebTan dakavSirebuli sikvdili, 47

nemsebisa da Spricebis gacvlis programa, 29, 51

opioidebi, 6, 32, 34, 35, 36, 52, 67

parlamenti, 5, 12, 19

polinarkomania, 30, 35

policia, 10, 13, 38, 47, 55, 68


prevalentoba, 6, 16, 17, 23, 24, 25, 26, 40, 41, 42, 43, 44, 45, 46

prevencia, 6, 8, 12, 18, 19, 20, 21, 22, 24, 26, 28, 29, 32, 37, 46, 48, 49, 50, 51, 55, 56, 57, 58, 59, 64, 66

problemuri moxmareba, 23, 64

riskjgufi, 34

saineqcio instrumenti, 26 ,28

saineqcio xelsawyoebi, 42 ,50

sakoordinacio sabWo,

saministro, 8, 9, 11, 13, 14, 18, 19, 20, 21, 22, 31, 33, 36, 42, 46, 47, 49, 52, 55, 56, 59, 61, 62, 63, 64, 65, 66, 67, 68, 69

samoqmedo gegma, 9, 12, 48

sasamarTlo, 5, 7, 8, 11, 12, 47, 59, 60, 61, 63, 64

saskolo, 19, 21

sasjelaRsrulebisa da probaciis saministro, 64, 65, 66

sikvdiloba, 13, 47

sinTeturi, 61

siwminde, 69

skola, 15, 19, 20

socialuri gariyva, 53

socialuri reintegracia, 37, 52, 55

stacionaruli, 6, 14, 32, 33, 34, 50, 57, 65

suboqsoni, 35, 36

subuteqsi, 6, 16, 17, 25, 69

fasi, 69

floba, 9

fsevdoefedrini, 11, 69

fsiqosocialuri reabilitacia, 32, 37, 57, 58, 66

fsiqotropuli, 9, 10, 11, 46, 64, 65

Sefaseba, 12, 17, 20, 67

Sidsi, 18, 20, 21, 24, 28, 34, 38, 39, 40, 48, 49, 50, 58, 66

Sinagan saqmeTa saministro, 8, 11, 13, 21, 22, 31, 46, 47, 59, 61, 62, 63, 67, 68, 69

Sromis, janmrTelobisa da socialuri dacvis saministro, 8, 9, 11, 13, 21, 31, 33, 35, 47, 49

CanacvlebiTi Terapia, 6, 32, 35

cixe, 59, 65

xarji, 14, 36

hepatiti, 16, 42, 43, 44, 48, 49, 50, 51, 66

heroini, 6, 16, 17, 25, 26, 27, 28, 35, 67, 68, 69

hospitalizacia, 36


aiv/Sidsi – adamianis imunodeficitis virusi/SeZenili imunodeficitis sindromi

arv – antiretrovirusuli mkurnaloba

nkt – nebayoflobiTi testireba-konsultireba

Sss – Sinagan saqmeTa saministro

BSS – Bio Behavioral Surveillance Survey – qcevaze zedamxedvelobis kvleva

EMCDDA – European Monitoring Centre for Drugs and Drug Addiction – narkotikebisa da narkomaniis monitoringis evropuli centri

EUDAP – European Drug Prevention Program – evropis narkotikebis avadmoxmarebis prevenciis programa

GARP – Global AIDS Report – globaluri angariSi Sidsis Sesaxeb

GHPP – Georgian HIV Prevention Program – saqarTelos aiv-prevenciis programa

GHRN – Georgian Harm Reduction Network – zSsq – zianis Semcirebis saqarTvelos qseli

HIV/AIDS – Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome - adamianis imunodeficitis virusi / SeZenili imunodeficitis sindromi

HRDU – High Risk Drug Use – maRali riskis narkotikebis moxmareba

MIA – Ministry of Internal Affairs – Sinagan saqmeTa saministro

MSY – Ministry of Sports and Youth Affairs – sportisa da axalgazrdobis saqmeTa saministro

NCDC – National Centre for Disease Control – daavadebaTa kontrolis erovnuli centri

PDI – Peer Driven Intervention – Tanaswori Tanaswors principze agebuli intervencia

RPR – Rapid Plasma Reagin – swrafi testi

abreviaturebi


UNAIDS – United Nations AIDS Fund – gaerTianebuli erebis organizaciis Sidsis fondi

UNICEF – United Nations Children’s Fund – gaerTianebuli erebis organizaciis bavSvTa fondi

UNODC – United Nations Office on Drugs and Crime – gaeros narkotikebisa da danaSaulis ofisi

UNGASS – United Nations General Assembly Special Session – gaeros generaluri asambleis specialuri sesia

USAID – United States Agency for International Development – amerikis SeerTebuli Statebis saerTaSoriso ganviTarebis saagento


cxrili 1: narkotikebTan dakavSirebuli jandacvis danaxarjebi 2012-2014 wlebSi (saqarTvelos janmrTelobisa da socialuri dacvis saministro 2015) ................................................................................................................... 14

cxrili 2: bolo 12 Tvis manZlze alkoholisa da aralegaluri narkotikebis moxmareba seqsmuSak qalebSi, 2014 wels (saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri Tanadgoma 2014) ......... 17

cxrili 3: alkoholisa da aralegaluri narkotikebis moxmarebis prevalentoba msm-ebs Soris (saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri Tanadgoma 2012) .............................................. 17

cxrili 4: samkurnalo dawesebulebebis legaluri statusi da dafinansebis wyaroebi ........................................................................................................ 32

cxrili 5: 2014 wels namkurnalev pirTa asakobrivi da sqesis mixedviT ganawileba (gamyreliZe et al. 2014) ................................................................................... 34

cxrili 6: abstinenciaze orientirebuli samkurnalo programebis pacientebis mier upiratesad moxmarebuli narkotikuli saSualebebi 2014 wels, procentebSi (gamyreliZe et al. 2014) .......................................................... 36

cxrili 7: aiv prevalentoba asakobrivi jgufebis mixedviT (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015) ........................................................................................................................................... 41

cxrili 8: HCV sawinaaRmdego antivirusuli mkuralobis ganxorcielebis dro saqarTveloSi (daavadebaTa kontrolisa da sazogadoebrivi janmrTelobis erovnuli centri 2015a) ..................................... 43

cxrili 9: sifilisi narkotikebis ineqciuri gziT momxmarebelTa Soris – testirebulTa da pozitiuri SemTxvevebis raodenoba wlebis mixedviT (gogia 2014) ........................................................................................................... 46

cxrili 10: registrirebuli letaluri zedozirebis maCveneblebi (levan samxaraulis saxelobis sasamarTlo eqspertizis erovnuli biuro, 2015) ............................................................................................................................. 47

cxrili 11: naloqsonis ampulebis darigebis dinamika narkotikebis ineqciur momxmarebelTa Soris (gogia 2014) .............................................................. 49

cxrilebi


cxrili 12: pirveli instanciis sasamarTloebSi 2014 wels narkotikul danaSaulTan dakavSirebuli ganxiluli saqmeebis da pirebis raodenoba (saqarTvelos uzenaesi sasamarTlo, 2015) ........................................... 60

cxrili 13: im pirTa raodenoba, romelTac 2014 wels CautardaT narkologiuri Semowmeba Sss-is saeqsperto-kriminalistikur mTavar sammarTveloSi (saqarTvelos Sinagan saqmeTa saministro, 2015) ....................... 61

cxrili 14: im pirTa raodenoba, sqesis mixedviT, romelTac 2014 wels CautardaT narkologiuri Semowmeba Sss-is saeqsperto-kriminalistikur mTavar sammarTveloSi (saqarTvelos Sinagan saqmeTa saministro, 2015) .................................................................................................................. 62

cxrili 15: 2014 wels pirveli instanciis sasamarTloebSi saqarTvelos administraciul samarTaldarRvevaTa kodeqsis 45-e muxlis safuZvelze gamotanili dadgenilebebi (saqarTvelos uzenaesi sasamarTlo, 2015) ................................................................................................................. 64

cxrili 16: 2006-2014 wlebSi ukanono brunvidan amoRebuli narkotikuli saSualebebis (sufTa nivTierebebis) raodenobebi (saqarTvelos Sinagan saqmeTa saministro. 2007-2015) ............................................. 69


diagrama 1: bolo 30 dReSi moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebis prevalentoba (gogia 2014; gogia 2015) ................... 25

diagrama 2: qalebis mier bolo 30 dRis manZilze moxmarebuli fsiqoaqtiuri da narkotikuli saSualebebi, 2014 weli (gogia 2015) ................. 25

diagrama 3: bolo 30 dReSi moxmarebuli narkotikuli da fsiqoaqtiuri saSualebebis prevalentoba asakobrivi jgufebis mixedviT (gogia 2015) ........................................................................................................... 26

diagrama 4: ineqciuri narkotikebis moxmarebis tendenciebi 2009, 2012 da 2015 wlebSi (saerTaSoriso fondi kuracio da samedicino-fsiqologiuri centri Tanadgoma, 2015) ..................................................................... 28

diagrama 5: 2003-2014 wlebSi abstinenciaze orientirebuli da oCT namkurnalevi pacientebi (gamyreliZe et al. 2014)....................................................... 37

diagrama 6: aiv/Sidsis incidentoba (axladgamovlenili SemTxvevebi) 2005-2014 wlebSi, 100,000 sul mosaxleze zogad populaciaSi (CxartiSvili, CokoSvili 2015) ........................................................................................ 39

diagrama 7: aiv-is gadacemis gzebi, 2012-2014 ww, procentebSi (gamyreliZe et al. 2014) ......................................................................................................... 39

diagrama 8: aiv prevalentoba narkotikebis ineqciurad momxmareblebSi, 2014 (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015) .................................................................. 40

diagrama 9: aiv-is prevalentoba %-Si narkotikebis ineqciur momxmareblebs Soris, 2009-2015 wlebSi, qalaqebis mixedviT (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015) ............................................................................................................................ 41

diagrama 10: C hepatiti narkotikebis ineqciuri gziT momxmareblebs Soris - Catarebuli testirebisa da pozitiuri SemTxvevebis raodenoba (gogia 2014) ....................................................................................................... 44

diagrama 11: B hepatiti narkotikebis ineqciuri gziT momxmarebelTa Soris - testebisa da gamovlenili dadebiTi pasuxebis raodenoba (gogia 2014) ................................................................................... 44

diagramebi


diagrama 12: HCV prevalentoba narotikebis ineqciuri gziT momxmareblebSi (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2015) ................................................................................................... 45

diagrama 13: sifilisis incidentoba 100,000 mosaxleze 2012-2014 wlebSi (gamyreliZe et al. 2014) ........................................................................................... 45

diagrama 14: gavrcelebuli nemsebisa da Spricebis raodenoba wlebis mixedviT (gogia 2014) ............................................................................................ 51

diagrama 15: narkotikebis ineqciur momxmarebelTa yovelTviuri Semosavali larebSi, procentebSi (saerTaSoriso fondi kuracio da sazogadoebrivi gaerTianeba bemoni, 2012) .................................................................. 54

diagrama 16: saqarTvelos sisxlis samarTlis kodeqsis 260-e da 273-e muxlebiT msjavrdebuli pirebis raodenobis dinamika wlebis mixedviT, 2007-2014 ww (saqarTvelos uzenaesi sasamarTlo, 2015) ...................... 61

diagrama 17: narkologiuri Semowmebis Sedegad gamovlenili narkotikuli saSualebebis moxmarebis maCveneblebi 2007-2013-2014 wlebSi (%) (naCvenebia monacemebi xuT yvelaze xSirad dafiqsirebul narkotikul saSualebasTan dakavSirebiT) (saqarTvelos Sinagan saqmeTa saministro, 2008, 2014, 2015) .............................................................................. 63

diagrama 18: narkotikebze Semowmebuli adamianebisa da dadebiTi Sedegebis raodenoba, 2006-2014 ww (saqarTvelos Sinagan saqmeTa saministro, 2007-2015) ......................................................................................................... 63


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wlam

de


dan

arT

i 2:

inf

or

mac

iasa

mku

rna

lo

daw

eseb

ul

ebeb

isS

esax

eb

samk

ur

nal

o

daw

eseb

ul

eba

misa

mar

Ti

da

sako

ntaq

to

pi

ri

moms

axu

reb

amo

cu

lo

ba

moms

axu

re

per

sona

li

gamt

aru

nar

iano

ba (w

eliw

adSi

sa

Sual

od

ram

den

i in

div

idis

mo

msax

ur

eba

Seu

Zlia

daw

ese

bul

ebas

)

mku

rna

lo

bis

fas

i

fsi

qiku

ri

jan

mrT

elo

bisa

d

a na

rko

mani

is

prev

enc

iis

cen

tr

i

saj

aro

sa

mar

Tl

is

iur

idiu

li

pir

i

qavT

araZ

is q

. 21

a, T

bil

isi;

mana

na b

eru

CaS

vil

i

1. o

CT (s

axel

mwif

o, 1

4 c

ent

ri,

6 T

bil

isSi

, 8

reg

ione

bSi;

2. s

tac

iona

ru

li

de

to

qsik

acia

da

pir

ve

lad

i r

eabi

lit

acia

(s

axel

mwif

o d

a ke

rZo

).

40 s

awo

l

i42

eqi

mi-n

arko

lo

gi;

68-m

edd

a;

11- s

oc

ial

ur

i mu

Saki

;

15 -

fsi

qol

ogi

;

oCT

gai

ara

2300

kl

ient

ma;

stac

iona

ru

li

det

oqs

ikac

ia d

a pi

rve

lad

i r

eabi

lit

acia

– 3

63

klie

nti

- 132

sax

elmw

ifo

da

231

ker

Zo s

eqt

or

Si.

oCT

-215

lar

i (1

05 s

axel

mwif

o, 1

10

Tan

agad

axd

a); s

iRar

ibis

zR

var

s qv

emo

T

myo

fi

da

aiv/

Sid

si d

adeb

iTi

ind

ivid

ebi

sTvi

s mo

msax

ur

eba

uf

aso

a;

stac

iona

ru

li

det

oqs

ikac

ia d

a pi

r

vel

adi

rea

bil

itac

ia k

erZo

seq

to

rSi

22

00- 2

500

lar

i, s

axel

mwif

o p

ro

gram

a -

2250

lar

i.

same

dic

ino

c

ent

ri

„ur

ant

i“

ker

Zo k

lin

ika

S. n

uc

ubi

Zis

V p

lat

o, 2

a ko

rpu

si

zu

rab

six

ar

ul

iZe

stac

inar

ul

i d

a am

bul

at

or

iul

i d

eto

qsik

acia

; pi

rve

lad

i r

eabi

l

itac

ia; C

anac

vleb

iTi

Ter

apii

s 4

cen

tr

i; 2

pr

ogr

ama

fin

ansd

eba

glo

bal

ur

i f

ond

is

mxar

daW

eriT

, 4 -

saxe

l

mwif

o p

ro

gram

iT (1

10

lar

i T

veSi

)

10 s

awo

l

i,

800

kv/m

20 e

qimi

-nar

kol

ogi

;

25 m

edd

a;

6 f

siqo

lo

gi;

4 so

cia

lu

ri

muSa

ki;

10 -

admi

nist

rac

iul

i pe

rso

nal

i;

1000

kl

ient

i Ca

nac

vleb

iT

Ter

apia

Si;

stac

iona

ru

li

moms

axu

reb

a - 1

5 kl

ient

i T

veSi

;

stac

iona

ru

li

det

oqs

ikac

ia d

a pi

r

vel

adi

rea

bil

itac

ia k

erZo

seq

to

rSi

22

00- 2

500

lar

i, s

axel

mwif

o p

ro

gram

a -

2250

lar

i.

same

dic

ino

c

ent

ri

„bem

oni

“

ker

Zo k

lin

ika

p. q

avT

araZ

is

q. 1

6, s

amku

r

nal

o k

omb

ina

tis

Sen

oba

, me

-7 s

arT

ul

i

zaz

a Ci

qova

ni

stac

iona

ru

li

da

ambu

l

ato

riu

li

det

oqs

ika

cia

; pir

vel

adi

rea

bil

it

acia

;

1 sa

xel

mwif

o p

ro

gram

a;

5 sa

wol

i,

453

kv/m

5 - e

qimi

-nar

kol

ogi

;

9 - m

edd

a;

3 - f

siqo

lo

gi;

2 - r

eabi

lit

acii

s sp

ecia

lis

ti;

3 - a

dmi

nist

rac

iul

i pe

rso

nal

i;

stac

iona

ru

li

moms

axu

reb

a:

121

3 kl

ient

i T

veSi

det

oqs

ikac

iisa

da

pir

vel

adi

rea

bil

it

acii

s ma

qsim

alu

ri

fas

i 55

00 l

ari

Tve

Si;

saxe

lmw

ifo

pr

ogr

ama:

200

0 l

ari;


jo

ni W

ant

ur

ias

saxe

lo

bis

same

d

icin

o c

ent

ri

ker

Zo k

lin

ika

T. e

ris

Tav

is

quCa

3

mzia

mu

jir

iZe

stac

inar

ul

i d

eto

qsik

ac

ia; p

irve

lad

i r

eabi

l

itac

ia;

5 sa

wol

i;1

- fsi

qol

ogi

;

6 - e

qimi

-nar

kol

ogi

;

2013

wel

s 47

-ma

klie

ntma

gai

ara

det

oqs

ikac

iis

kur

si (a

qed

an 2

- sa

xel

mwif

o p

ro

gram

iT)

2250

lar

i sa

xel

mwif

o p

ro

gram

a;

2300

-250

0 l

ari

- ker

Zo;

nar

kol

ogi

ur

i c

ent

ri

baT

umS

i

saj

aro

sam

arT

l

is i

ur

idiu

li

pir

i

n. j

ayel

is

quCa

44,

ba

Tu

mi.

lia

jin

War

aZe

stac

inar

ul

i d

eto

qsik

ac

ia; p

irve

lad

i r

eabi

l

itac

ia;

5 sa

wol

i;5

- eqi

mi n

arko

lo

gi;

10 -

med

da;

1 - f

siqo

lo

gi;

2 - s

oc

ial

ur

i mu

Saki

;

2013

wl

is m

anZl

ze

cen

tr

i mo

em

saxu

ra

45 k

lie

nts

(31

klie

nti

saxe

lmw

ifo

pr

ogr

amaS

i, 1

4 -

ker

Zo s

eqt

or

Si).

klin

ika

„neo

geni

“

ker

Zo k

lin

ika

dav

iT v

ad

aWko

ria

;st

acio

nar

ul

i d

a am

bu

lat

or

iul

i mk

ur

nal

o

ba, d

eto

qsik

acia

, pir

ve

lad

i r

eabi

lit

acia

14 s

awo

l

i;

680q

m

6 -

eqim

i;

6 - m

edd

a;

1- f

siqo

lo

gi;

saxe

lmw

ifo

pr

ogr

ama

(225

0 l

ari)

da

Sid

a st

and

art

i ;

wliuri angarisi 2014 - altgeorgia.gealtgeorgia.ge/2012/myfiles/drug report geo 2014.pdf · 1....

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