Country overview: Cyprus
- Situation summary
- Data sheet
- Barometer
Contents
- Drug use among the general population and young people
- Prevention
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-related offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Drug-related research
| Year | Cyprus | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2010 | 803 147 | 501 105 661 p | Eurostat | |
| Population by age classes | 15–24 | 2010 | 14.9 % | 12.1 % p | Eurostat |
| 25–49 | 37.2 % | 35.8 % p | |||
| 50–64 | 18.0 % | 19.1 % p | |||
| GDP per capita in PPS (Purchasing Power Standards) 1 | 2009 | 98 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 2 | 2008 | 18.4 % | 26.4 % p | Eurostat | |
| Unemployment rate 3 | 2010 | 6.5 % | 9.6 % | Eurostat | |
| Unemployment rate of population aged under 25 years | 2010 | 17.8 % | 20.9 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 4 | 2009 | 110.8 | Council of Europe, SPACE I-2009 | ||
| At risk of poverty rate 5 | 2009 | 16.2 % | 16.3 % | SILC | |
p Eurostat provisional value.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2009.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
Drug use among the general population and young people
In 2009, a second general population survey compatible with the EMCDDA guidelines was carried out on licit and illicit substance use, and mental health issues. The sample comprised 3 385 respondents aged between 15 and 64 years who were Greek speakers residing in the government controlled areas. In 2009, the lifetime prevalence of cannabis was reported at 11.6 % , last year prevalence at 4.4 % and last month prevalence at 2.5 % compared to the respective prevalence rates at 6.6 % , 2.1 % and 1.4 % in 2006. Cannabis was followed by lifetime prevalence of cocaine, reported at 3.0 %, with last year prevalence at 1.2 % and last month prevalence of cocaine at 0.7 %. In a previous survey lifetime prevalence of cocaine was reported at 1.1 %, last year prevalence at 0.6 % and last month prevalence at 0.4 %. For both cannabis and cocaine, the data indicate an increase with regards to lifetime, recent and current use. In 2006, ecstasy was the second most prevalent drug reported, but in 2009 the substance was the third most prevalent drug used with lifetime prevalence reported at 2.0 %, with last year prevalence at 0.6 % % and last month prevalence of ecstasy at 0.3 %. A strong relation between gender and illicit drug use was reconfirmed in 2009, with men having higher prevalence rates for all drugs. The 2009 survey indicated further declines in the mean age of drug experimentation if compared to the 2006 survey results. Thus, ecstasy use seems to start earlier than other drugs at mean age of 19.8 years, followed by cannabis (20.5 years) and heroin (20.4 years). While in the 2006 survey, the mean age of experimentation with ecstasy was reported at 21.3 years, cannabis 20.1 years and heroin 23.6 years.
The ESPAD school survey was conducted regularly in Cyprus since 1995 among 15–16 year olds. The proportion of those who admitted use of cannabis at least once in their lives (lifetime prevalence) decreased from 5 % in 1995 to 2 % in 1999, and then increased to 5 % in 2007. Lifetime prevalence of cannabis use is higher among males then females. In addition, in 2007, last year prevalence of cannabis use was 4 % and last month prevalence, 3 %. In 2007, lifetime prevalence of inhalants was reported to be 16 % and was 18 % in 2004. Reported lifetime prevalence of cocaine, amphetamines and ecstasy were all similar and rated 3 %.
Prevention
Strategic main objectives for drug prevention in Cyprus are to enhance life skills of young people, improve functioning of the family, and to inform the public and authorities about substance use and related prevention strategies. The prevention strategy aims to standardise prevention programmes, particular attention is given to vulnerable groups or individuals and also to interventions in recreational settings.
The evaluation of the 2004–08 National Drug Strategy and Action Plan and the development of the National Drug Strategy for 2009–12 resulted in development of a mechanism for continuous monitoring of prevention programmes and the adoption in 2010 of the first prevention guidelines. The development of the first prevention guidelines as well as the establishment of the prevention programme submission licensing procedure aims to increase effectiveness of monitoring all prevention activities and programmes. The prevention guidelines manual unifies and standardise the prevention programs through definition of the main prevention approaches, discussing quality and effectiveness aspects of the prevention programs. It describes the philosophy of prevention in the drugs field as portrayed in the National Drug Strategy 2010–12, defines the main prevention approaches and includes a large section on programme quality and effectiveness.
Universal prevention is the most common mode of prevention activities implemented in school settings and target mainly lower and higher secondary school students; however some activities might involve family and are implemented also at the community level.
With regards to selective prevention, the programme ‘Fred goes net’ has been implemented between November 2008 to December 2009. It targeted adolescents who are first-time offenders, in connection with problem use of addictive substances (especially by the police, but also at school or at work), with early intervention measures in order to prevent progression to drug dependency.
According to the evaluation report the programme ‘Fred goes net’ was successful. It also was externally evaluated. The preliminary results of the evaluation suggested that the intervention did reach the target population and generated positive outcomes. In particular, among 91 individuals who were referred by the criminal justice system (the vast majority concerned police referrals) to the programme majority were males aged 14–24 with a mean age of 20.5. Only four females were enrolled into the programme. The vast majority of the participants reported cannabis use (98.9 %) as well as alcohol uses (96.7 %). Cocaine/crack was reported by 32.1 % of the participants and amphetamine or other stimulant use by 17.9 %.
The National Drug Strategy for 2009–12 focuses to reduction of harm from alcohol and drugs among young people in recreational settings. For example, the nightclub staff was trained to recognize drug related health problems and provide the first aid in such cases; the operation of some public bus routes are extended to the night time; trained workers inform the visitors of recreational places on drug prevention and treatment service availability and in some places taxi vouchers are provided to intoxicated clubbers.
Indicated prevention activities have not been implemented yet in Cyprus.
Problem drug use
Problem drug use was calculated in Cyprus for the first time in 2004. These results could be confounded by the newly-established status of a detoxification centre, where buprenorphine is used for managing withdrawal symptoms. As this was the first time such a centre had opened in Cyprus, the results might reflect a possibility that a large number of users repeatedly requested treatment at this particular centre.
In 2009, based on treatment demand data there were estimated to be between 868 – 1 286 opiate users (1.6–2.3 per 1 000 inhabitants aged 15–64) and the total number of problem drug users estimated at 1 182–1 688 (2.1–3.0 per 1 000 inhabitants aged 15–64). There is no clear trend in PDU population sizes over the years and the figures shall be treated with caution due to the methodological limitations. In 2007 and 2009, an increase of estimated PDU population was noted. In the first instance it was attributed to a significant increase of foreigners seeking treatment during a reporting year, but in 2009, to an increase of availability of OST in the country. However, in 2008, a decrease of estimated opiate PDU population was attributed to the lower treatment demand, a lack of prison data and a significant decline of foreigners recorded in treatment.
The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category. In Cyprus, due to insignificant numbers of drug users in treatment due to other drugs than opioids and cocaine, the definition includes only these two categories of users.
Treatment demand
In 2009, all treatment centres providing treatment reported data to the Cyprus national focal point: 16 outpatient treatment centres, 2 inpatient treatment centres, and a treatment centre in the prisons. In 2009, a total of 670 clients entered treatment, out of which 319 of all clients entered treatment for the first time. There is a clear upward trend in the number of all treated patients since 2004 which is mirrored also by the upward trend of new clients entering the treatment but in a less rapid rate. As regards the primary drug use of all those entering treatment in 2009, opioids continued to be the most commonly reported primary drug, at 57.4 %, followed by cannabis at 25.1 % and cocaine at 14.4 %. Among new treatment clients, the distribution is different with cannabis as the drug with most entries, 40.1 % followed by opioids with 38.9 % and cocaine with 16.9 %.
In 2009, 25 % of all clients entering treatment were aged less than 25 years. A higher percentage of young clients was observed among new treatments, with 32 % being under the age of 25. With regards to gender distribution among all clients entering treatment in 2008, 86 % were male and 14 % were female. This distribution was also similar among first-time treatment clients. The foreigners (both EU and non-EU nationals) constitute up to one third of all treatment demands, and it is one of the peculiarities of treatment demand data in Cyprus.
Drug-related infectious diseases
According to data provided by drug treatment centres and prisons in 2009, 0–1.3 % of 349 users reported being HIV positive. Since 2005, four HIV cases have been reported due to injecting drug use in Cyprus. In 2009, no new HIV cases among injecting drug users have been reported. Among 116 tested injecting drug users, 46.6 % were found positive for hepatitis C (29.2 % in 2008, 34.3 % in 2007). Among 115 tested injecting drug users in 2009, 0.9 % were found positive for hepatitis B. However, the above results should be treated with caution as the data coverage is low.
Drug-related deaths
Recording of drug-related deaths was implemented for the first time in 2004. No data is available for previous years. In 2008, 11 direct drug-related deaths were recorded (compared to 11 in 2008, 12 in 2007, 7 in 2006, 9 in 2005 and 14 in 2004). With regards to the distribution by age and sex, the majority were young men and the mean age was 30. All deaths were registered by the Cyprus police, who cooperate closely with the National Laboratory, which is tasked with confirming the deaths through toxicological examinations. In 2009, all recorded death cases were confirmed by toxicological results and opiates were involved in 66.7 %.
Treatment responses
The Cyprus Anti-Drugs Council (CAC) is the supreme national body responsible for the drafting, coordination and monitoring of the implementation of the National Drug Strategy. The Council is also responsible for the coordination of governmental as well as non-governmental drug care services. Drug treatment is mainly delivered by non-governmental organisations, which are independent but rely on the allowance of the CAC to operate.
According to the CAC, the treatment system consists of counselling, rehabilitation, detoxification and substitution centres. All counselling, outpatient and inpatient programmes state psychosocial interventions as their primary treatment tool. Counselling centres mainly focus on motivational enhancement and support whereas inpatient and outpatient rehabilitation programmes focus on individual and group counseling, therapy as well as psychotherapy. Most programmes provide services to drug users regardless of the substance being used. Only two programmes (one inpatient and one outpatient) target problem drug users.
- Detoxification: only two centres reported providing detoxification services; one is a governmental facility (‘Anosi’) and the other is a private clinic (‘Veresies Clinic’), which offers an outpatient and an inpatient programme.
- Substitution: three programmes offer substitution/maintenance services. One of them is the ‘Veresies Clinic’ and the other two are governmental programmes. (‘Gefyra’ and ‘Sosivio’), which offer services in Nicosia and Limassol, either on an outpatient or inpatient basis.
In 2009, there were 10 counselling centres, two of them targeting adolescents and young adults, 16 outpatient programmes, and a drug rehabilitation programme in the central prison. Although current additions to the treatment system have enriched it considerably, the lack of specialised (for drugs other than heroin) treatment services is observed.
In 2009, substitution treatment (HDBT) was offered to 286 clients in Cyprus.
Harm reduction responses
The development of strategies to reduce drug-related harm is coordinated by the Cyprus Anti-Drugs Council. Main actors responsible for organising and implementing harm reduction programmes include the various departments of the Ministry of Health, such as the National AIDS programme and the Mental Health Services. A reparative law was passed in 2010 which declassified provision and supply of syringes and needles by health professionals to injecting drug users as an offence.
Specifically, in Cyprus, four programmes are oriented towards a harm reduction approach which may contribute positively to prevention of drug-related deaths. The treatment and counselling programmes that include harm reduction measures are: (1) the programme ‘Stochos’ which is offering its services to intravenous drug users as a direct access centre, including needles and syringes provision, (2) the substitution programme provided by a private Clinic, (3) ‘Gefyra’ and (4) ‘Sosivio’, which are outpatient governmental substitution programmes. In addition, in all governmental and in some non-governmental treatment programmes, harm reduction measures have been adopted such as: (1) vaccinations and medical examinations for the prevention of infectious diseases, (2) psycho-education and (3) medical care whenever it is necessary.
It is worth mentioning that the National Strategy on Drugs 2009–12 aims to further implement actions in the area of harm reduction. In high-risk cases and more specifically in the context of recreational nightlife, the CAC held a number of coordinative meetings during 2009 for the implementation of the strategic plan for safer clubbing which is going to be actualised in 2010.
Drug markets and drug-related offences
According to the Drug Law Enforcement Unit (DLEU), Cyprus is the final destination of all drugs seized. This may be due to its geographic location at the crossroads of three continents, and its regular connections by air and sea with European, Middle-Eastern and African destinations, According to the seizures made by the police, illegal drugs, particularly cannabis (herb and resin), ecstasy and heroin enter the Republic of Cyprus from the Turkish-occupied area of the island. The countries of origin of other illicit substances are Greece, the United Kingdom, the Netherlands, Turkey and Bulgaria.
According to the DLEU, a total of 772 drug law offence cases were reported in 2009. About 565 of reported drug law offences involved cannabis, followed by 73 reports of cocaine and 50 of heroin.
In 2008 no data was provided regarding the number of seizures. However, in 2009, compared to 2007, an increase can be noted in the number of cannabis resin seizures (127 in 2009, 25 in 2007), cannabis plants (51 in 2009 and 25 in 2008). A decrease is recorded in the number of herbal cannabis seizures (503 in 2009 and 629 in 2007) and heroine seizures (54 in 2009 and 87 in 2007). In 2009, the number of cocaine seizures remained almost the same as in 2007 (77 in 2009 and 74 in 2007). Regarding the amounts of illegal drugs seized; after a two years drop, in 2008 a significant increase was reported for the quantity of ecstasy tablets seized compared to the previous years, with 9 881 tablets seized, the third largest amount ever since 1995. In 2009, however, only 17 ecstasy tablets were seized. In addition, a decrease was reported in the quantity of seized cannabis plants, heroin, herbal cannabis and cocaine when compared to 2008 levels.
National drug laws
In Cyprus, drugs are classed A, B or C according to their level of harm, with class A causing the most harm. Penalties for drug use in Cyprus are up to life imprisonment for all classes, but this is almost never implemented. Possession is regarded as a serious criminal offence, punishable by up to 12 years in prison for class A, 8 years for class B and 4 years for class C substances. Trafficking class A or B drugs may be punished by up to life in prison, while trafficking class C drugs carries a penalty of up to 8 years. In 2003, limits on quantities for personal use were introduced, whereby possession of a quantity of a substance above the assigned limit may lead to the presumption that the person intended sale of the substance. The limits include three or more cannabis plants, 30 or more grams of cannabis or its products and 10 or more grams of prepared cocaine or opium (or its derivatives).
While there has been a tendency towards increased sentencing in recent years, there is also an ongoing effort to promote the implementation of alternative measures to imprisonment in the criminal justice system.
National drug strategy
In 2009, implementation of the new National Drug Strategy 2009–12 was initiated. The new strategy has broadened its scope and besides covering drug supply and drug demand reduction, also takes a note to consolidate harm reduction activities. It aims to standardise drug prevention in schools, in work and in recreational settings, to promote alternative free time activities among young people, to improve police operational activities and access to treatment and rehabilitation, and also to promote harm reduction activities, including needle and syringe exchange and in recreational settings in the country.
The previous Cyprus’ national drug strategy 2004–08 was adopted in 2004 and has been implemented through two action plans 2004–08, respectively focusing on drug supply reduction and drug demand reduction.
Coordination mechanism in the field of drugs
The Cyprus Anti-Drugs Council is the authority responsible for the coordination and monitoring of all actions against drugs. The Council is presided over by the Minister of Health, and has the Chairperson of the Cyprus Youth Board as Vice-President. The other members are seven experts nominated by the Council of Ministers. The law L128(I)/2000 which steers the operation of the CAC was modified in 2009, such that the appointment of a Coordinator/President of the CAC will be done directly by the Office of the President of the Republic.
The Council’s major duties are to plan, coordinate and monitor the implementation of the national drug strategy, through the formation of networks, ad hoc committees and regular meetings of all stakeholders.
Horizontal inter-ministerial coordination is carried out by the National Drugs Committee, presided over by the President of the Republic and composed of six ministers: Health, Interior, Justice and Public Order, Education and Culture, Labour and Social insurance, and Defence.
Drug-related research
In Cyprus, the focal point is active in promoting and stimulating further research in the drugs field. Research topics considered as priority are related with the implementation and monitoring of the EMCDDA’s five key epidemiological indicators. The top research priorities are to estimate drug use in the general and school population and to obtain the most accurate estimations of problem drug use. Recent drug-related studies mentioned in the 2010 Cyprus National report cover a wide range of topics including prevalence surveys, estimates of problem drug use, protective factors and prison-based interventions.
