Accessing Treatment Across Contested Territorial Divides: The Specific Challenges of Drug Users Residing in Abkhazia on Methadone Treatment in Georgia

Abstract

Territorial contestation severely restricts access to care: Drug users living in Abkhazia face daily, risky cross-Administrative Boundary Line journeys to access methadone treatment in Georgian-controlled territory.

Limited advocacy capacity and visibility: The efforts of patients on methadone treatment to challenge restrictive regulations remain largely invisible, and they struggle to reach decision-makers at local, national, and international levels.

Limited donor support and the relocation of methadone services further from the Enguri crossing point in Natsuluku have worsened accessibility of substitution treatment for patients residing in Abkhazia.

Urgent need to expand harm-reduction approaches: Improving access to methadone and other harm-reduction programmes, including drug use prevention, is essential, as these options are safer and more effective than abstinence-only models, compulsory treatment, or no treatment at all.