Country overview: Greece
- 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 | Greece | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2008 | 11 213 785 | 497 455 033 | Eurostat | |
| Population by age classes | 15–24 | 2008 | 11.2 % | 12.6 % 1 | Eurostat |
| 25–49 | 37.6 % | 36.3 % 1 | |||
| 50–64 | 18.3 % | 18.4 % 1 | |||
| GDP per capita in PPS (Purchasing Power Standards) 2 | 2007 | 94.9 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 3 | 2006 | 24.2 % | 26.9 % p | Eurostat | |
| Unemployment rate 4 | 2008 | 8.3 % 1 | 7 % | Eurostat | |
| Unemployment rate of population agends under 25 years | 2008 | 22.9 % 1 | 15.5 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 5 | 2006 | 90.9 | Council of Europe, SPACE 2006.1 | ||
| At risk of poverty rate 6 | 2006 | 21 % | 16 % 7 | SILC, 2007 | |
p Eurostat provisional value.
1 2007 figures.
2 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.
3 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.
4 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.
5 Situation of penal institutions on 1 September, 2006.
6 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold in the current year and in at least two of the preceding three years.
7 EU-25 countries.
Drug use among the general population and young people
The last available data regarding drug use among the general population in Greece are from the household survey conducted by the University Mental Health Research Institute (UMHRI) in 2004. Overall, lifetime prevalence of illicit drug use showed a significant increase between 1984 and 2004, peaking in 1998 and followed by downward trend between 1998 and 2004. The most recent survey (2004) shows that 8.6 % of the Greek population aged 12–64 reported lifetime use of illicit drugs, mainly cannabis.
In 2006 a study was conducted in Athens, Thessaloniki and Heraklion among the population aged 15–64. Results showed that 19.4 % of respondents had tried any illicit drug at least once, and that lifetime prevalence was higher among males (24.8 %) then among females (14 %). Lifetime prevalence of cannabis was reported by 19.3 % of respondents. Respondents in Athens reported higher drug use than in the two other cities.
As regards the student population, the latest ESPAD study was conducted in 2007, and involved a nationwide sample of high school students aged 15–16 years. In 2007, similarly to 2003, 6 % had ever tried marijuana or hashish ( 9 % in 1999). In 2007, inhalants lifetime prevalence was reported by 9 % of the students (15 % in 2003 and 14 % in 1999). Lifetime prevalence of amphetamines was reported by 3 % of the sample, 2 % reported ecstasy use, 2 % reported LSD use as well. Results indicated 5 % for the last year prevalence of cannabis use (similar to the finding of ESPAD 2003), 3 % for the last month prevalence of cannabis (2 % in 2003).
Prevention
Drug prevention in Greece is mostly implemented by the 70 prevention centres established by ΟΚΑΝΑ, local authorities and by the Ministry of Education and Religious Affairs across the country.
Major emphasis is placed on prevention interventions in the school setting. Prevention in primary and secondary education encompasses programme-based interventions in the context of the health promotion programmes of the Ministry of Education and interventions designed and delivered by prevention agencies. The development of personal and social skills play an important role in these activities, both in primary and secondary education. Knowledge about drugs and changing attitudes towards drugs are also important components of programmes implemented in secondary education. In the school year 2005–06, there was an increase in drug prevention interventions implemented in primary and secondary schools. Furthermore, prevention agencies provide training seminars and supervision sessions to help teachers implement health promotion programmes. Families are also one of the core target groups of Greek prevention agencies: family prevention includes information events and training programmes (parents’ groups). In addition, prevention agencies appear to be responding to the challenge of organising prevention interventions outside the school setting for pre-adolescents and adolescents. These interventions include creative activities and experiential groups such as; drama groups, music groups and painting groups. In the view of providing information and raising public awareness about drugs and drug dependence, drug-specialised agencies utilise the internet, mobile units and organising prevention programmes in the workplace. Finally, prevention professionals target other members of the local community such as volunteers, the army, public security forces, health professionals and youth mediators.
Although drug prevention in Greece focuses more on universal interventions, it is clear that efforts are being made to develop and implement selective and indicated interventions reaching groups and individuals at risk. Icarus Prevention Unit (Κethea) designs and implements selective and indicated prevention interventions; targeting young offenders, immigrants, re-migrants, refugees, disabled children, children from dysfunctional environments and children living in care institutions.
Problem drug use
An estimation based on the capture–recapture method was conducted for the first time in 2001. Since 2002, it has included three data sources.
Analyses estimated that there were 2.7 problem drug users per 1 000 inhabitants between the ages of 15–64 years in 2007 (in total, between 18 224 and 23 181 users). The majority of these lived in Athens. The estimated numbers have been stable since 2002 taking into account their confidence intervals.
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.
Treatment demand
Treatment demand data in Greece are collected through a well-established network of treatment providers, excluding private practitioners and private hospitals. In 2007, 53 treatment centres submitted treatment demand data out of the 63 treatment centres comprising of outpatient centres, inpatient centres and low threshold agencies.
In 2007, a total of 4 786 individuals entered treatment out of which 2 246 were first time treatment clients. In 2007, the primary substance of abuse among all clients entering treatment were opioids, at 86.2 %, followed by cannabis at 8.2 % and cocaine at 3.8 %. Furthermore, among those entering treatment for the first time, the primary substance of abuse was opioids at 80.9 %, the second most frequent substance was cannabis at 12.2 %, followed by cocaine at 5.2 %.
In 2007, 26 % of all clients entering treatment were aged less than 25 years. A higher percentage in age distribution was reported among new treatment clients, with 32 % being under the age of 25 years. In 2007, the male-to-female ratio for all clients entering treatment was 85 % for male and 15 % for female. The same distribution was also reported among new treatment clients with 85 % for male and 15 % for female.
Drug-related infectious diseases
Since 2001, a national infectious diseases network has operated in Greece in order to collect data on infectious diseases among intravenous drug users. This network includes 33 reference points — that is centres such as treatment centres, low threshold services and public health laboratories/reference centres — which provide individual or aggregated data annually to the Greek focal point about the results of drug users tested for HBV, HCV and HIV.
The most recent available information on prevalence of the hepatitis C virus (HCV) and hepatitis B virus (HBV) among injecting drug users (IDUs) has been derived from those agencies which provided individual data for the years 2001 to 2006. In 2004–05, the data indicate that infection rates among IDU (ever-in-lifetime IDUs) have ranged between 15.3 % and 29.1 % for the HBV antigen and between 42.6 % and 66 % for HCV. Comparing the rates over the four years, the data show that the HBsAg prevalence among IDUs decreased between 2001 (4.3 %) and in 2006 (3.6 %). The data also show that there is a great variation in the prevalence of HCV infections among different regions in Greece, which may be partly attributed to the distribution of substitution and drug-free centres within and among the regions.
Surveillance data on the prevalence and incidence of HIV/AIDS among IDUs in Greece are derived from the Hellenic Centre for Infectious Diseases Control (HCIDC-KEEL) of the Ministry of Health and Welfare. The ratio of IDUs to the total number of HIV-positive cases registered in Greece up to end of October 2006 was reported at 3.1 % (234 cases out of 6 456). However, it should be noted that for 21.6 % of the cases, the mode of transmission was not specified. Among 485 new HIV cases (including AIDS cases) in 2004 (until the end of October 2006), 3.1 % were intravenous drug users (vis-à-vis 2.7 % in 2004).
Drug-related deaths
The Greek focal point collects data on drug-related deaths from the Public Security Directorate of the Hellenic police. These data are based on the results of forensic tests and toxicological laboratories, and the Forensic Services of the Ministry of Justice. Data on drug-related deaths are only available for deaths caused by an acute intoxication of drugs. This classification corresponds with the EMCDDA standard definition for special registries. In 2007, 175 drug-related deaths were reported (173 in 2006 and 314 in 2005), of which 175 were confirmed with the appropriate toxicological analyses. In 96 % of the confirmed drug-related deaths, the cause of death was heroine use, in 1 % cocaine use and in 3 % use of psychotropic substances other than cocaine.
Treatment responses
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 2006, the total number of officially-recognised drug treatment programmes in Greece was 54, run under the auspices of governmental and non-governmental organisations. The aforementioned programmes are divided into the following categories: nine inpatient drug-free programmes, 28 outpatient drug-free programmes and 17 substitution treatment units, out of which seven are methadone substitution units and 10 are buprenorphine substitution units. Furthermore, in 2006 a specialised detoxification unit was created, with a scheduled programme duration of 21 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. The main theoretical models applied in drug-free programmes are therapeutic communities, systemic approaches and psychodynamic theory.
Substitution treatment has seen a systematic expansion and decentralisation since late 2002. In 2004 and 2005 alone, six new units started operating within the remit of OKANA. 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.
Methadone is prescribed in the majority of cases, and according to the latest available estimates (2006) a total of 2 524 patients were on methadone and 1426 on buprenorphine out of a reported total of 3 950 patients in opioid substitution treatment.
Harm reduction responses
Addressing the health problems of dependent drug users has always been a concern for dependence treatment programmes in Greece. Low-threshold services in Greece implement a very broad range of interventions in the area of harm reduction and prevention and care for infectious diseases. Their number, however, continues to be limited: such services operate only in Attica and Thessaloniki, and there is no coverage for the rest of Greece. About 35 000 syringes were distributed through the four existing needle and syringe exchange programmes at fixed and mobile outlets in 2007. Low-threshold services also provide printed material and training to drug users in safe use and first aid.
A significant number of interventions are implemented by street work programmes, designed to prevent the spread of infectious disease and to reduce drug-related harm in high risk user populations. In 2006 a partnership was forged between the ΟΚΑΝΑ street work service and the Athena–Hygeia prevention centres street work programme of the city of Athens. The key objective of this partnership is for interventions to be extended in order to reach new groups of users (e.g. young cannabis users) and to identify new drug scenes. The joint actions, implemented regularly on a weekly basis, include: (i) distribution of printed information material produced by ΟΚΑΝΑ and the Athena–Hygeia prevention centres about the services available to drug users, about prevention of the spread of infectious diseases and about safer use practices: (ii) on-the-spot counselling and referral to low-threshold or other healthcare services urgently needed by users; and (iii) needle and condom distribution.
Drug markets and drug-related offences
In terms of drug trafficking, heroin originating from south-west Asia is smuggled into Greece through the ‘Balkan route’. Cannabis is imported mainly from Albania, and cocaine is shipped in from South America.
Recent figures in terms of seizures in Greece are reported by the Central Anti-drug Coordinating Unit. In 2007, there was an increase in the quantity of LSD and cocaine seizures when compared to 2005. In 2007, 2 884 units of seized LSD was reported and 255 kg of seized cocaine was reported. Alternatively in 2007, a decrease in the quantity of heroin and ecstasy seizures was reported when compared to 2006. In 2007, there were 259 kg of heroin seizures and 58 355 ecstasy tablets seizures. A major achievement of the Drug Prosecution Office was the seizure in August 2004 of one tonne of cocaine in Kalamata, the largest seizure ever in Greece.
Data on drug-law offences are collected by the Hellenic Police and other Prosecution Authorities. In 2007, a total of 15 247 drug law offences were reported, out of which 49.2 % were cannabis law offences, followed by 41.1 % of heroin law offences and 8.4 % of cocaine law offences.
National drug laws
The Greek drug law of 1987 and its amendments were codified in 2006. Under this law, drug offenders in Greece are assessed as either dependent or non-dependent. The law distinguishes between drug possession or acquisition for personal use or commercial use, and the punishment varies accordingly. In 2003, a new law stipulated that individuals obtaining or otherwise processing drugs for personal use only, in quantities to satisfy their own needs only, or using drugs or cultivating cannabis plants in numbers and areas justified for personal use only, are sentenced to no more than one year in prison. In accordance with this law, the offence is not recorded on the offender’s criminal records on condition that they do not commit a relevant offence for a five year period. Offenders may be admitted to a special treatment unit or a special prison department operating under the auspices of lawfully-recognised agencies upon the order of the investigating judge. Traffickers may be sentenced to between five and 20 years' imprisonment, with a life sentence possible.
National drug strategy
Greece’s national strategy on drugs 2006–12 was adopted in 2006 and should be complemented with several successive drug action plans. The first of these action plans was foreseen for the period 2006–08, yet it was finally not adopted and another action plan was first drafted in the second half of 2007. The Greek drug strategy is comprehensive and balanced, focusing on illicit drugs and alcohol and covering the same pillars as the EU drug strategy: coordination; demand reduction; supply reduction; international cooperation; training; research and evaluation. A main priority is the increase of access to treatment and the minimisation of waiting lists for Greece’s substitution programme. Emphasis is also placed on prevention and on combating organised crime.
Coordination mechanism in the field of drugs
The coordination, monitoring and evaluation of the overall policy implementation in demand reduction were assigned by the national action plan to the Greek Organisation Against Drugs (OKANA). In addition, an Inter-ministerial Coordination Committee created by law in 2001, assists OKANA in monitoring the implementation of the national action plan.
The Central Anti-drug Coordination Unit — National Intelligence Unit (SODN-EMP) is in charge of the coordination of information provided by all prosecution authorities.
Drug-related research
The national drug strategy foresees a scientific approach to the drugs problem through monitoring, evaluation and research. Several governmental sources provide funding mainly to university departments, including the national focal point, and a major treatment centre which is also active in the research field. The majority of the research conducted is epidemiological, but clinical research on treatment, amongst other types of research, is also carried out. Each year, the national focal point collects information on this topic through a structured questionnaire and makes it available through a dedicated website. Research findings are also available through scientific journals, websites and national drug conferences.