Palliative Care Development in Georgia.

Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine, and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home, but oral morphine is not available for patients in the hospital. Prescribing regulations have changed and all physicians are allowed to prescribe and the length of a prescription is now seven days rather than three days previously. Unfortunately, patients and families must still pick up their opioid medications at pharmacies in the police station. Opioids for cancer patients in inpatient units or at home are free. Palliative care education has been incorporated into both undergraduate and postgraduate medical and nursing education and a number of physicians have received specialist training abroad. Palliative Care Standards and Guidelines have been developed; and palliative care services, although insufficient to meet the need, are available for patients at home, as inpatients and a children's hospice opened in 2017.