COVID impact on drug market and user behaviour_GE
The aim of the study was to examine potential impact of COVID-19 containment measures on illicit drug supply and drug use behaviour among people who use drugs (PWUD) regularly in Tbilisi, Georgia. A prospective cohort of 50 Georgian PWUD participated in a bi-weekly online survey in April – September, 2020. They also took part in qualitative interviews at 3- and 6-month follow-up time points. In addition, cohort of 4 key informants were interviewed every month to assess their perceptions of changes in illicit drug supply and drug use behaviours. Availability of drugs was reduced during the lockdown and many PWUD switched to use alternative substances when preferable drugs were not available. The variety of substances used by study participants at the end of the study was smaller compared to the baseline use. Findings regarding changes in price and quality of drugs were mixed. When stable contacts with dealers were affected PWUD searched for new contacts and supply options. When access to sterile injection equipment was limited, PWUD exercised risk-containing injection behaviours. Despite some interruptions in service delivery during the first weeks of lockdown, providers of treatment and harm reduction services showed remarkable flexibility and were able to implement effective strategies to deliver services.