Greece Country Drug Report 2019

Harm reduction

Following the 2011 human immunodeficiency virus (HIV) outbreak among people who inject drugs (PWID) in Athens, harm reduction service provision in Greece, in particular opioid substitution treatment and syringe programmes, was scaled up in 2012 and 2013. Low-threshold facilities and outreach programmes are provided by two drug treatment agencies (KETHEA and OKANA) and several smaller non-governmental organisations; they focus on the prevention of infectious diseases and of overdose deaths, as well as on the management of health problems among drug users. Drug users attending a drug treatment programme have the right to free medication if they are HIV or hepatitis C virus (HCV) positive or have other serious health problems (Law No 4348/16 Joint Ministerial Decree Oik 25132/4/4/16). PWID are also an important target group in the HCV action plan, adopted in 2017.

Harm reduction interventions

In Greece, harm reduction interventions include the provision of clean needles and syringes, condoms, printed health education and information materials, and training in safe use and first aid for drug users. The services offered by low-threshold programmes include testing for infectious diseases (in Athens). Vaccination against hepatitis A and B viruses is available free of charge. Access to HIV treatment has increased in recent years, with around 1 000 people who use drugs receiving antiretroviral therapy in 2017. Results from a large study in Athens suggest that access to treatment for chronic HCV infection is low. Integrated service offers by harm reduction providers and health and social services in the city of Athens aim to increase diagnosis of infections and treatment access of PWID.

Needle and syringe programmes (NSPs) operate in the region of Athens and in Thessaloniki; harm reduction service coverage in the rest of the country remains low. In 2017, around 278 000 sets of sterile injecting equipment were provided at six fixed locations in Athens and Thessaloniki, while seven additional sites in Athens were regularly serviced by outreach teams. The number of syringes distributed through NSPs has decreased over the past 5 years, and, although the estimated number of active injectors has decreased, syringe coverage remains below recommended benchmarks.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No Yes No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czechia Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.