Needle drugs seldom make a city look pretty, but some cities are more disfigured by them than others. In 2006, when I first visited Tbilisi, Georgia, it had all the wrecked majesty of an ex-beauty queen with six years of track-marks down her arms. It was a great European capital in decay: crumbling bridges, refugees from war, and—most of all—cast-off syringes everywhere. Alleys, parks, and tunnels under the Soviet-style boulevards all had this spiky detritus, which badly spoiled Tbilisi’s old-world romance and instead put it into a permanent state of biohazard.

So when I returned this year, I packed thick-soled shoes. It turned out that, but for the frigid temperatures (and my own self-respect), I could have worn Tevas. The syringes, which once pumped opiates into the veins of as many as 250,000 addicts, are absent. The subway now feels safe, clean, and orderly, with no trash more revolting than a Snickers wrapper. The tunnels under Rustaveli Avenue still smell pissy, but so do most big cities’ tunnels. If the addicts are still there, they have been persuaded to shoot up with greater discretion. And if they are now gone, the Georgians have accomplished something remarkable, which is the rapid diminution of smackheads.

Charting Georgian drug abuse through time, you’d see a low baseline, starting when Georgia won its independence from the Soviet Union in 1991; a lack of free trade meant few drugs. Then, during the chaos of the ’90s, the line would jump a few times, with little epidemics of heroin—called shavi, or “black,” for its tarry appearance—club drugs, and marijuana. Georgia was spared widespread alcoholism, perhaps because it alone among ex-Soviet states is a wine-sipping land, instead of a vodka-slamming one.

But starting after 2000, you’d see the line jump dramatically, as if stuck in the ass with a syringe. What drove it up was an opiate called buprenorphine—brand name Subutex, street name “subu”—that effectively did not exist in the country before 2000. At its peak, one in 20 Georgians was on hard drugs, with Subutex driving the epidemic. “It was like a millennium gift for Georgians who wanted to use drugs,” says George Tsereteli, a physician who is a member of Georgian parliament.

And now it’s gone: from zero users to hundreds of thousands and back to zero again, in a decade or less. The journey has been torturous, a case study in grotesque consequences and appalling trade-offs—some former Subutex devotees have taken to injecting pills dissolved in gasoline instead—and it shows that, whatever you think the solution to drug abuse is, you’re probably mistaken.