In Greece, drug treatment centres, low-threshold services and public health laboratories/reference centres report annually to the Greek national focal point individual or aggregated data on the results of testing drug users entering treatment for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Surveillance data on the prevalence and incidence of HIV/ acquired immune deficiency syndrome (AIDS) among people who inject drugs (PWID) are derived from the Hellenic Centre for Diseases Control and Prevention (HCDCP-KEELPNO) of the Ministry of Health.
Until 2010, the proportion of new HIV cases linked to injecting drug use remained low, at 2-3 %, and the number of newly reported cases of HIV infection ranged from 9 to 25 per year. However, in 2011, the number of reported cases increased more than ten-fold, reaching 311 by the end of the year, indicating that there was an HIV outbreak among PWID. These cases represented 33 % of all newly reported HIV infections (with a known transmission route) in 2011. In 2012, approximately half of all newly reported HIV infections were linked to injecting drug use, while in the following years the number and proportion fell and, in 2015, approximately 1 in 10 new HIV infections was associated with injecting drug use, indicating a reduction in HIV transmission among PWID compared with HIV outbreak period. However, in approximately one quarter of new HIV cases, a mode of transmission was not reported.
HIV prevalence among PWID also increased among those tested, from 0.7-0.8 % of those registered before 2011 to 6.0-10.7 % in 2013. In 2015, the national HIV prevalence rates were between 5.7 % and 9.4 %, depending on treatment setting. In general, the highest HIV prevalence rates are observed among PWID in the Attica region, which includes the capital city, Athens.
The most recently available information on the prevalence of HBV and HCV among PWID indicate that, in 2015, infection rates among PWID ranged between 10.4 % and 24.5 % for HBV (based on anti-HBc) and were higher among older drug injectors and those with a longer injecting history. With regard to HCV infection, national data indicate that between 54.8 % and 69.6 % of treatment clients were HCV positive, while HCV infection was more common among PWID in Athens and, in particular, among those receiving opioid substitution treatment (OST).
HCV prevalence rates were significantly higher among PWID with an injecting history of more than two years than in recent initiates and among those aged under 25 years than among older drug users. It is estimated that up to 40 % of those with chronic HCV infection have a history of drug injection.
Newly diagnosed HIV cases attributed to injecting drug use
NBNB: Year of data 2015, or latest available year.
Prevalence of HIV and HCV antibodies among people who inject drugs in Greece
NBYear of data 2015.
In summary, the available data suggest that transmission of HCV and HIV is still ongoing among PWID in Greece, in Athens in particular, but, in the case of HIV, at lower rates than in 2011-13.
There is no systematic data collection for drug-related emergencies in Greece, but some data are available from various sources, such as the Poison Information Centre or drug treatment services.
In 2015, the Poison Information Centre reported 137 drug- related emergency cases, one third of which involved the use of heroin. The medical services for the drug treatment agencies in Athens and Thessaloniki reported 667 drug- related emergency cases, most of which involved the use of opioids.
Characteristics of and trends in drug-induced deaths in Greece
NBYear of data 2015.
Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).
Following a period of decline in drug-induced deaths since 2005, in 2015, the Hellenic Police reported an increase. Fewer than half of these deaths were toxicologically confirmed by 31 October 2016 and, because of reporting delays, the final statistical data will be available only in 2017. The majority of the confirmed deaths were of males who were older than 30 years and involved opiates.
In 2015, the mortality rate for all ages was of 8.7 deaths per million, below the European average of 14.3 deaths per million.
Drug-induced mortality rates among adults (15-64 years)
NBYear of data 2015, or latest available year.
Data are for all ages