Injecting drug user size estimation studies carried out in 2009, 2012 and 2015 
revealed growing trends of drug abuse in Georgia:estimated number of people who 
inject drugs (PWID) have been increased from 40000 and 45000 to 50000. Since 
Soviet period the most popular injective narcotics have been opioids: home-made 
opium, heroine, buprenorphine and home-made desomorphine ("Krokodile") replacing 
each other on the black market. Self-made desomorphine typically contains big 
amounts of different toxic substances and causes significant somatic disorders, 
especially skin, bone, blood infections, liver and kidney failure; is highly 
addictive, associates with frequent injections that enhance injecting-related 
harm, including the risk of HIV transmission, in comparison with typical 
opioids. The aim of the study was to determine the effectiveness of opioid 
substitution treatment (OST) on depression and anxiety in opioid dependent 
clients with history of different opioid substance use. 104 opioid drug users 
undergoing OST with intensive psychological counseling have been divided in 5 
groups according to the principal opioid drug that was abused during past 6 
months before starting treatment: heroine, desomorphine, illicit methadone 
injectors, illicit buprenorphine injectors, and multiple drug abusers consuming 
opioids as primary drugs. Level of depression (Beck Depression Inventory), 
anxiety (Spielberger Anxiety Inventory) as well as clinical symptoms, risky 
behavior, quality of life (WHO), and other data were measured before starting 
and after 3, 9, 15, 21 months of treatment. The illegal use of 
psychotropic-narcotics was checked through random urine-testing 1-2 times per 
patient per month. In all five groups remarkable decrease of depression and 
anxiety was observed in comparison with the starting data. Before inclusion 
desomorphine and poly-drug users had the highest scores of depression and 
anxiety while buprenorphine users manifested the lowest rate. Improvement of 
figures was observed in all groups in three month period that have been 
continuing during 21 month of treatment process. Study revealed normalization of 
scores forbothstatesin groups of heroine, desomorphine, methadone and 
buprenorphine users. The highest scores of depression and anxiety were observed 
in the group of poly-drug abusers andwhile depression rate hesitated in the 
range of clear "no-depression", anxiety index still remained close to the 
clinical important threshold after 21 month of treatment. Urine-testingon 
psychotropic-narcotic substances indicated remarkable decrease of illegal drug 
abuse in all studied groups in three month and although abuse of benzodiazepine 
drugs was highest in desomorphine and poly-drug abusers, the difference between 
groups was not statistically significant. Although some disparities have been 
observed in dynamics of subjects with different spectrum of initial opioid 
substance use, including homemade desomorphine, there is no significant 
difference between groups and OST effectively supports to improve depression and 
anxiety indices, and dramatically decreases use of illegal psychotropic-narcotic 
drugs during treatment. However poly-drug users seems to be the most resistant 
to achieve stabilization and require more treatment time and targeted 
interventions.