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Drug treatment overview for Greece

Map of Greece

1. National context

An increase in availability of and access to targeted treatment interventions and a strong focus on the effectiveness of these interventions are among the key priorities of the Greek National Drug Action Plan 2004–16. The treatment is provided by public entities or corporate bodies under private law, all of which are fully or partially funded by the Government (except one programme funded by local authorities).

By the end of 2013 there were 105 drug treatment units, and the capacity of the Greek drug treatment system has almost doubled since 2008 due to the expansion of availability of opioid substitution treatment (OST). The programmes are divided into the following categories: 11 drug-free inpatient programmes (residential drug treatment and therapeutic communities); 32 drug-free outpatient programmes (11 of which are for adolescents); 53 substitution treatment units (11 of which were launched in 2012); eight drug-free treatment programmes in prison settings (seven of which are outpatient clinics for released prisoners); and one specialised detoxification structure offering a 21-day treatment programme.

The main treatment modalities available in Greece are psychosocial interventions (drug-free programmes), OST and detoxification. The main theoretical models behind drug treatment programmes are medication-assisted treatment for opioid addicts, therapeutic communities, systemic approaches and psychodynamic theory.

There are around 39 counselling centres, which are access points for drug treatment for an increasing proportion of drug users, provided separately for adults and adolescents. With regard to special treatment programmes, one early intervention programme for cannabis users is integrated into a drug-free outpatient treatment unit for adolescents. OKANA is the only organisation to have legal permission to establish, operate and monitor OST programmes. In 2013 a new Operational Framework for the OST Programme was published by OKANA to help rationalise OST treatment across different programmes and support client mobility within the OKANA treatment system. Pharmaceutical substances used in OST are methadone, introduced in 1993, and buprenorphine, introduced in 2002.

In 2011–12 the availability of OST was significantly expanded following a call in the national plan against addiction, and it has become the most frequently offered treatment option and currently is available in most cities. In 2013, however, the number of OST clients remained at the level of 2012, indicating that the capacity of the system has been reached. According to the latest available estimates from 2013, a total of 9 973 patients received OST, with buprenorphine-based medication being the predominant medication prescribed for this treatment. No waiting time is normally expected for entering OST, except in the Attica region (Athens) where the estimated waiting time is 3.5 years.

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2. Treatment registries and monitoring systems

No national register for clients in treatment exists at present. Nonetheless, the Greek Focal Point implements the Treatment Demand Indicator (TDI), which collects individual and anonymous data about each person approaching specialised drug treatment centres (and low-threshold services) in Greece.

Moreover, the Greek Focal Point systematically collects detailed data on treatment programmes and the structural and functional features of organised treatment units. As far as medically-assisted treatment is concerned, monitoring is also performed by OKANA, the only agent who has the permission granted by law to establish and operate substitution treatment programmes.

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3. Treatment demand

Table 1: Number of clients entering treatment in Greece by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 5645 5834 5696 4891
Number of all clients entering treatment with known primary drug 5632 5820 5679 4862
% of which for opioid use 82.7 80.6 77 69.3
% of which for cocaine use 4.4 4.3 4 5.1
% of which for cannabis use 11.2 12.8 16 21.5
% of which for stimulants use (other than cocaine) 0.2 0.3 0 0.4
Number of new clients entering treatment 2441 2572 2406 2089
Number of new clients entering treatment with known primary drug 2436 2568 2397 2084
% of which for opioid use 75.5 73.4 69 54.9
% of which for cocaine use 4.9 4.2 4 5.9
% of which for cannabis use 18.1 20.2 25 35.4
% of which for stimulants use (other than cocaine) 0.1 0.3 0 0.6
Notes:
The variation across time, in particular with regard to the absolute numbers of clients in treatment, should be interpreted with caution as coverage data may have changed over time. For further information on coverage details please refer to the relevant EMCDDA Statistical Bulletin.
For an explanation of terms used, see the definitions of terms.
Sources:

Reitox national reports 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

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4. Treatment provision

Table 2: Opioid substitution treatment provision in Greece
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 6264 6783 9878 9973
of which with methadone 2477 1945 2485 2667
of which with buprenorphine 4466 6293 9979 7306
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Greece
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1993
Buprenorphine (HDBT) 2002
Heroin assisted treatment,including as trials N.App.
Slow-release morphine N.App.
Buprenorphine/naloxone combination 2006
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Greece
Legal framework of opioid substitution treatment Methadone Buprenorphine
Do office-based medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
Do specialised medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
For an explanation of terms used, see the definitions of terms.
'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.
Sources:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

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5. References and links

Related EMCDDA resources

 

External links

Please note that the EMCDDA is not responsible for the content of external sites.

 Treatment inventories

 Treatment research centres

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About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 22 May 2015