Topics
1. National context
The Organisation Against Drugs (OKANA) performs the legal function of national coordinator on drug demand reduction which reports to the Ministry of Health and Social Solidarity. Furthermore, OKANA is one of the biggest public providers of treatment and reintegration programmes in Greece. It is also the only organisation which has legal permission to establish, operate and monitor substitution treatment programmes.
In 2009, the total number of officially-recognised drug treatment programmes in Greece was 77, run under the auspices of governmental and non-governmental organisations. The aforementioned programmes are divided into the following categories: 11 drug free inpatient programmes, 31 drug-free outpatient programmes and 22 substitution treatment units, out of which seven are methadone substitution units and 15 are buprenorphine substitution units. Furthermore, around 28 counseling centers operate in the country and is usually an access point for drug treatment for increased proportion of drug users. In addition, two specialised detoxification structures are in operation, IANOS, within the Rehabilitation Department for Dependent Individuals with scheduled programme duration of 21 days, and ATRAPOS unit for adolescents with scheduled programme duration of 120 days. A number of specific treatment interventions exist for adolescent drug users, which are targeted towards adolescent cannabis users, and there are also three specialised units for female problem drug users. Government funds are the sole source of funding for the majority of programmes, except one programme which is funded by local authorities. The main theoretical models applied in drug treatment programmes are therapeutic communities, systemic approaches and psychodynamic theory.
Substitution treatment has seen a systematic expansion and decentralisation since late 2002. Pharmaceutical substances used in substitution treatment are methadone which was introduced in 1993 and buprenorphine which was introduced in 2002. According to the Greek Ministerial Decree 19546/2003, substitution treatment can only be provided by officially recognised treatment centres.
According to the latest available estimates (2009), a total of 2 544 patients were on methadone and 2 222 on buprenorphine out of a reported total of 5 360 patients in opioid substitution treatment.
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.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 4786 | 4682 | 5501 |
| % of which for opioid use | 86.4 | 85.3 | 84.0 |
| % of which for cocaine use | 3.8 | 4.0 | 4.5 |
| % of which for cannabis use | 8.2 | 8.7 | 9.6 |
| % of which for stimulants use (other than cocaine) | 0.1 | 0.0 | 0.0 |
| Number of new clients entering treatment | 2246 | 2224 | 2603 |
| % of which for opioid use | 80.9 | 80.0 | 79.3 |
| % of which for cocaine use | 5.2 | 5.1 | 4.5 |
| % of which for cannabis use | 12.2 | 13.0 | 14.7 |
| % of which for stimulants use (other than cocaine) | 0.1 | 0.1 | 0.0 |
| 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 2009 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2005, 2007 (Tables TDI 4 and 5) and 2011 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | Full |
| Psychosocial in-patient interventions | Full |
| Detoxification | Limited |
| Substitution/maintenance treatment | Limited |
| Notes: For an explanation of terms used, see the definitions of terms. Based on question 3.1 " Please assess the current availability of the treatment interventions below in relation to the user needs, judging the degree to which treatment capacity matches the demand" of Structured Questionnaire SQ27P1 on 'Treatment programmes'. Rating Scale (level of availability):
Reitox national reports 2008, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| Opioid substitution treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of clients in opioid substitution treatment | 3950 | 5053 | 5360 |
| of which with methadone | 2524 | 2838 | 2544 |
| of which with buprenorphine | 1426 | 2215 | 2222 |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2011. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |||
| 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 Table HSR-1 in the EMCDDA Statistical Bulletin 2010. ‘N. App.’ stands for ‘Not applicable’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| 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 Table HSR-2 in the EMCDDA Statistical Bulletin 2011. 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: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | ||
Treatment availablity in Europe
The graphic below presents an overview of treatment provision by different types of service (psychosocial outpatient, substitution, psychosocial inpatient and detoxification) in different European countries and can be used for comparative purposes. Click on the thumbnail to view it.
Figure 1: Treatment availability in Europe, 2007
5. References and links
Related EMCDDA resources
- Health and social responses statistics
- Treatment demand statistics
- Annual report on the state of the drugs problem
- National reports for Greece
- Country overview for Greece
- Drug treatment responses page
- Best practice portal
- Treatment demand key indicator page
For a comprehensive overview on drug treatment systems, availability and utilisation in Europe, please consult the 2008 online report on ‘Quality of treatment services in Europe — drug treatment — situation and exchange of good practice’ published by the Directorate General for Health and Consumers.
External links
Please note that the EMCDDA is not responsible for the content of external sites.
- University Mental Health Research Institute (UMHRI) (EL, EN)
- Organisation Against Drugs - Okana (EL, EN)
- Therapy Centre for Dependent Individuals (KETHEA) (EL, EN)
- PLEFSI Early Intervention Network (EL)
- NOSTOS Therapeutic Programme (EL)
Treatment inventories
Treatment research centres
- Greek REITOX Focal Point (EL, EN) - University Mental Health Research Institute
- Organisation Against Drugs (ΟΚΑΝΑ) (EL, EN)
- KETHEA (Therapy Center for Dependent Individuals) (EL, EN)
