International - Greece

Basic Data

(Lifetime Prevalence of Drug Use) "Preliminary data provided by the University Mental Health Research Institute (UMHRI) regarding the most recent survey (2004) show that 8.6% of the Greek population aged 12-64 reported lifetime use of illicit drugs, mainly cannabis. The lifetime drug use ratio between men and women is 3 to 1. The highest prevalence is met in the age group 18-35 and in the Greater Athens area as compared with the second largest city (Thessaloniki), the other urban, and the semi-urban and rural areas."

(Prevalence of Illicit Drug Use Among Youth) "Only 15-year-old students were asked about cannabis, ecstasy, and “other illicit drugs” use, as well as about the use of inhalants or nonmedical use of prescription-type tranquilizers or sedatives. The findings for lifetime use indicate that:
"• cannabis use is reported by 7.2% of the 15-year-olds
"• ecstasy use is reported by 1.2%, and
"• use of “other illicit drugs” is reported by 3.1% (Figure 2.1).
"With regard to lifetime use of legally-marketed substances in 2010:
"• 8% reported use of inhalants
"• 3% reported non-medical use of prescription-type tranquillizers or sedatives
"• 4.1% reported use of other medicines, with or without prescription."

(Prevalence of Cannabis Use Among Youth) "Among the 15-year-old students who reported cannabis use (7.2%) (Figure 2.2):
"• most of them (6,3%) reported recent use (use in the last 12 months);
"• more than half (4.1%) reported current use (use in the last 30 days);
"• more than half (4.2%) reported having used the drug at least 3 times, and 3% reported having tried it only 1-2 times.
"A significantly higher number of boys than girls reported drug use. For cannabis in particular, three times as many boys (10.6%) as girls (3.7%) reported lifetime use of the drug. Cannabis use only 1-2 times was reported by 4.3% of the boys and 1.6% of the girls, whilst cannabis use 3 or more times was reported by 6.1% of the boys and 2.1% of the girls (Figure 2.2)."

(Trends in Prevalence of Cannabis Use Among Youth) "Over time, with the exception of cannabis, there is no significant variation in the lifetime prevalence of any substance use. For cannabis in particular, following the decline recorded from 2002 to 2006, prevalence rates increased between 2006 and 2010 (Figure 2.3), with the increase being significant only among boys.
"It is to be noted that the increase in cannabis use prevalence from 2006 to 2010 reflects all, lifetime use (3.7% and 7.2%, respectively), last year use (3.1% and 6.3%, respectively) and last month use (2.2% and 4.1%, respectively). The increase in cannabis prevalence also applies to trying the substance 1 or 2 times (1.6% and 3%, respectively) and to using the substance more than 3 times (2.1% and 4.2%, respectively)."

(Prevalence of Illicit Drug Use Among Youth Compared With Other EU Nations) "According to preliminary data from the 2010 HBSC survey published in the EMCDDA annual report (EMCDDA, 2011), in recent years (2006-2010) there has been an overall stable or decreasing trend in cannabis use in many countries. However, increases have been recorded not only in Greece, but also in the Czech Republic, Latvia, Lithuania, Romania and Slovenia.
"According to a Eurobarometer survey conducted in 27 European countries, including Greece, in spring 2011 on a sample of 504 young people aged 15-25 through a telephone interview, cannabis use is reported by 10% of the sample, with most of these young people (7%) reporting last year use. The European average was 26%, with some 14% reporting last year use. The lowest cannabis prevalence rates were recorded in Greece, Hungary, Malta and Cyprus (Figure 2.4)."

(Prevalence of Illicit Drug Use Among Greek Youth Compared with Other EU Nations) "Furthermore, according to the Eurobarometer survey findings, young people in Greece compared to the European / EU27 average:
"• Report lower prevalence rates of use of “legal highs” (a variety of new drugs in the form of powder, pills or herbal mixtures);
"• Report higher percentages of perceived “high risk” associated with the use of cannabis 1-2 times (38% vs. EU/27 average of 23%) and cocaine (72% vs. 66%), while fewer of them perceive of ecstasy use 1-2 times as being risky (54% vs. EU/27 average of 59%).
"• Twice as many as the EU/27 average think it is “impossible” for them to have access to heroin (47% vs. EU average of 24%), cocaine (42% vs. 19%), ecstasy (41% vs. 20%), cannabis (28% vs. 11%), while higher rates are also recorded for access to alcohol and tobacco. Among the countries that participated in the survey, only in Cyprus and Finland were the rates similar to the Greek ones.
"• Report in lower percentages that in order to get information about drugs they would use the “internet” (45% vs. EU average of 64%), the “media” (9% vs. 15%) or “a friend” (23% vs. 37%), while report in higher percentages “parents or other relatives” (35% vs. 28%) and, especially, “prevention centers” (38% vs. 20%) as likely sources of information.
"• Report in lower percentages that they would support tough measures (penalties/sanctions) against drug users as the response to the drug problem (17% vs. EU/27 average of 33%)."

(Charges Brought for Drug-Related Offenses) "Every year the Greek REITOX Focal Point collects from the Central Anti-drug Coordination Unit – National Intelligence Unit (SODN-EMP) data on charges brought for drug-related offences. In 2010, the Greek DPAs21 brought 14,803 charges against 13,581 individuals for drug use, production / cultivation, dealing / trafficking and other drug-related offences (see ST11). As shown in Figure 9.1, the decline in both the number of individuals charged with drug-related offences and the number of drug-related cases observed in the three-year period 2005-2007 reappeared in the years 2009-2010. More specifically, the number of individuals returned to the levels of 2006-2007 and the number of cases to the levels of 2005."

(Convictions for Drug-Related Crimes) "The Hellenic Statistical Authority (ELSTAT) is responsible for collecting data from the judicial services on the number of individuals convicted for drug-related offences and reports them to the Greek REITOX Focal Point on a yearly basis. The latest available data are for the year 2008 (Figure 9.2). Of a total of 46,128 convicts, 1,831 (4.0%) were convicted for drug-related crimes. The overwhelming majority (95.8%, Ν=1,755) are men. 1,212 individuals (66.2%) were convicted for drug use, possession or cultivation of a small quantity for personal use, 539 individuals were convicted for drug use, dealing and trafficking (29.4%), 55 individuals for drug dealing and trafficking (3.0%), and 25 individuals for drug cultivation / production (1.4%). Figure 9.3 shows the distribution of convicts by gender and drug-related offence in the four-year period 2005-2008. In the period under consideration there has been no significant variation in the distribution of convicts by gender and drug-related offence."

(Sentences for Drug Convictions) "The maximum sentences imposed for drug use, possession or cultivation of a small quantity for personal use are prison sentences of one year. Of the sentences imposed for drug trafficking / dealing, 98.2% are prison sentences for a term or for life. Similarly, the sentences imposed for drug cultivation / production are non-commutable prison sentences exceeding five years. The sentences imposed for drug use, dealing and trafficking are prison sentences exceeding one year, and 98.9% of them are prison sentences for a term or for life.
"98.6% of the sentences imposed for drug use, possession or cultivation of a small quantity for personal use were suspendable and commutable. On the other hand, non-commutable sentences were imposed in the vast majority of the trafficking / dealing cases (92.7%).
"Agewise, 79.0% of the individuals convicted for drug-related offences were between 22 and 44 years old. This figure is similar to the ones reported in 2005 (80.0%), 2006 (77.0%) and 2007 (77.0%)."

(Prevalence of Problem Drug Use) "The number of problem drug users (PDU) in Greece is estimated each year by the internationally recommended capture-recapture method, applied to the annual data of the TDI. By fitting a suitable statistical model to the records of users from three sources (KETHEA, 18 ANO and the rest of the network of data providers), an estimate can be obtained of the size of the “hidden population” of users who did not attend any therapeutic service during the year. In keeping with this procedure, a PDU is defined as someone who will at some point seek treatment for heroin use.
"The estimated total number of users aged 15-64 years whose primary drug is heroin is 22,515 for the year 2010, with 95% confidence interval 20,202 – 25,171. Table 4.1 presents the breakdown of this total by gender, age and place of residence. Although the estimated total appears to represent a decrease from the previous year’s estimate of 24,097 (95% c.i. 21,362 – 27,272), the difference is not statistically significant. In fact, a comparison of the estimates for every year since the first application of this method in 2002 (Figure 4.1) shows an increasing trend, of the order of 628 additional problem drug users every year.
"Table 4.2 presents estimates of the number of problem drug users who injected in the last month. The estimated total of 9,439 (95% c.i. 8,110 – 11,060) is similar to previous years. There is no discernible long-term trend in the numbers of injecting drug users (Figure 4.1)."

(HIV Prevalence and IDU) "According to HCDCP [Hellenic Centre for Disease Control and Prevention] data, from the beginning of 2010 until 31-12-2010, 604 new HIV-positive cases were reported in Greece (including AIDS cases). Of those (including cases of undetermined transmission group, approximately 35%), 15 cases (2.5%) were IDU, most of them males (unpublished HCDCP data; Malliori et al., 2011). In line with the FP [Focal Point] data on IDU entering treatment, HCDCP data for the period 2000 to 2010, show that the annual number of cases of HIV infection attributed to intravenous drug use remained consistently at low levels, never exceeding 19 cases per year. However, the number of reported cases of HIV/AIDS attributed to intravenous drug use was sharply increased during 2011, so as by the end of July, 113 cases had been reported in the HCDCP surveillance system (Figure 6.3).
"According to both the FP and the HCDCP, the sharp increase in the number of reported cases of HIV/AIDS in IDU in the first seven months of 2011 is not attributed to any changes in the testing policy of the treatment centres or the laboratories."

(Hepatitis C Prevalence and IDU) "Based on DRID [Drug-Related Infectious Diseases] data from IDU tested upon entering treatment for HCV (anti-HCV/EIA) in 2010 (Figure 6.4):
"— Depending on the Source of data, infection rates in 2010 ranged between 44.4% and 69.3%, significantly higher figures than those reported for the general population, which are not in excess of 3% (chronic infection) (Iatriko Vima 2006, Lionis et al. 1997, Gogos et al. 2003) despite that in Greece, after 1970, the share of injecting drug use as a source of infection has grown so much as to become, from 1980 on, the main cause of infection among the reported known causes (Raptopoulou et al 2011).
"— Compared to 2009, in 2010 infection rates appear to have increased in all three data sources and, notwithstanding the variations in the data of Data source 3, it appears that after 2008 there are signs of an upsurge in the infection rates.
"— Different profiles of IDU correspond to different prevalence rates. As shown in Figure 6.4, IDU admitted to “drug-free” treatment in ΚΕTHΕΑ (Data source 2) and in 18ΑΝO (Data source 3) tend to be younger in age and with a less severe abuse history compared to IDU entering OST treatment or accessing low-threshold services. The former population reports also lower HCV infection rates (ranging from 44.4% to 48.7%, for 18ANO and KETHEA, respectively) compared to those of IDU tested at OST and low-threshold programmes (69.2%)."

(Treatment Service Capacity) "The data on treatment services presented in this section refer to the main treatment phase and are mostly derived from the analysis and processing of the questionnaires which were filled in by 61 of the 75 treatment programmes operating across the country. Six (6) programmes did not report data and were therefore excluded from the analysis, just like one (1) detoxification programme described separately in this Chapter, six (6) programmes in prison described in Chapter 11, and one (1) outpatient unit for adolescents which currently provides mostly counselling services and was therefore included in the analysis of the counselling centres in this Chapter.
"The 61 dependence treatment units that reported data on their treatment services in 2010 can be divided into the following types:
"• 22 OST [Opioid Substitution Treatment] units, of which six (6) chiefly methadone substitution units and sixteen (16) buprenorphine substitution units.
"• 39 drug-free treatment programmes, of which eleven (11) inpatient programmes for adults, fourteen (14) outpatient programmes for adults and fourteen (14) outpatient programmes for adolescents.
"In 2010, the aforementioned treatment programmes’ reported total capacity was 6,610. Finally, most of the treatment slots were offered in OST units (80.2%), and 19.8% were offered by drug-free treatment programmes."

(Treatment Utilization) "In the reporting year, the total clients who received main treatment were 8,067 (data for 60 of the 61 structures), of whom 5,106 were already in treatment at the beginning of the year (data for 59 of the 61 structures).
"Total admissions to the main phase of the treatment services came up to 2,961 (data for 60 of the 61 structures).
"The mean power of dependence treatment units in 2010 was 5,186 clients (data for 60 of 61 structures)."

(Opioid Substitution Treatment, Client Data) "In 2010, “all clients” in the OST programme came up to 6,264, of whom 46.2% in methadone –and 53.8% in buprenorphine OST units.
"Out of the total 2010 admissions (1,798 clients), 38.9% were admissions to methadone substitution units and 61.1% admissions to buprenorphine substitution units. As shown on Figure 5.5, the total capacity of OST units in 2010 was 5,300. The mean power of the programmes in 2010 was 4,552 clients.
"In 2010, most of the clients in methadone substitution units were prescribed with methadone (2,477) and a relatively small number of clients was prescribed with buprenorphine as a substitute (375). In buprenorphine substitution units, most of the clients (2,453) were prescribed with buprenorphine (methadone was not prescribed to any client in treatment). The combination of buprenorphine- naloxone was prescribed to quite a few clients of buprenorphine substitution units (1,484), and to a smaller number of clients of methadone substitution units (154).9 It should be noted that, in substitution units, clients often switch from one substitute to another, depending on the phase of treatment, therefore it is not possible to rule out double entries for pharmaceutical substances.¹⁰

(Growth in Treatment Capacity) "In the period 2002-2010, the capacity of treatment programmes steadily increased. Figure 5.2 illustrates this increase, which is a direct consequence of the increasing number of treatment structures over the years. Similarly, the number of “all clients” in treatment per year increased, as demonstrated by the sum of clients already in treatment and “admissions” (3,745 in 2002 versus 8,067 in 2010).
"More specifically, in 2010 treatment programme capacity increased by 10,8% compared to 2009. There is also an increase by 8.3% in total number of clients who received main treatment in the reporting year compared to 2009. Last year, the increase in capacity was commensurate with the increase in the number of clients (10.8% and 8.3% respectively). As for the mean power, there is an increase by 9.9% compared to 2009."

(Clients Entering Treatment, Primary Drug, and Outcomes) "Most of the clients (6,754) report opioids as their primary drug, followed at a great distance by cannabis (243) and cocaine (93) (data for 57 of the 61 structures). Injecting use prior to admission was reported by 4,192 clients in treatment in the reporting year (data for 55 of the 61 structures). Out of “all clients”, 2,400 (32.3%) are aged over 40 (data for 59 of the 61 structures).
"With regard to treatment outcome, 55 of the 61 structures reported the relevant data. More specifically, 4,039 clients (62.9%) continued in treatment until the end of 2010. As for the modes of exit from treatment programmes, 2,385 clients (37.1%) withdrew from the programmes while the prevailing modes are premature discharge (38.2%), dropout (28.9%), treatment completion (24.4%) and referral to another unit or service (5.3%)."

Laws and Policies

(National Drug Strategy) "The National Plan against Addictions for the period 2011-2012, which was prepared by the Committee, takes into consideration the constraints imposed by the economic crisis and consequent fiscal austerity and attempts to streamline expenditure.
"The Plan has two main axes: demand reduction and supply reduction.
"The goals in the field of Demand Reduction include:
"• Prevention: full geographical coverage at the prefecture level; needs assessment; enhanced provision; training activities for prevention professionals; extending the activities of the Prevention Centres to cover issues related to mental health promotion and dependence prevention (tobacco, alcohol, illicit drugs, internet)
"• Treatment and Reintegration: to increase treatment availability and access to all treatment modalities; to extend treatment to special populations of dependent users (army recruits, prisoners, immigrants); to shorten the waiting list for substitution treatment; to enhance treatment services and step up efforts for the occupational and social integration of former drug users and stabilised clients in substitution treatment.
"Research and Evaluation are highlighted as axes of the National Plan against Addictions. Most notably, enhancement of research and use of research data for policymaking, evaluation of activities and identification of the evidence-based practices in addiction management at the national level, as well as use of international best practice in evaluation, setting across-the-board criteria for the evaluation of agencies and, finally, evaluation of the National Plan against Addictions itself.
"Another important axis is Information and Public Awareness, i.e. promotion of the agencies’ activities, raising public awareness and changing perceptions of treatment clients, as well as providing information to specific population and professional groups in view of facilitating the activities of the agencies.
"The focus of Supply Reduction is on reinforcing suppression and international cooperation of law enforcement agencies, improving infrastructure at the national level, networking with demand reduction agencies, and training for the development of a balanced, complementary and multi-pronged policy in suppression and prevention."

(National Plan Against Addictions) "The National Plan against Addictions for the period 2011-2012, which was prepared by the Committee, takes into consideration the constraints imposed by the economic crisis and consequent fiscal austerity and attempts to streamline expenditure. The main goals of the National Plan in the field of demand reduction (with a special reference to treatment) are the following6:
"• to increase treatment availability and access to all treatment modalities;
"• to extend treatment to special populations of dependent users (army recruits, prisoners, immigrants);
"• to shorten the waiting list for OST;
"• to enhance treatment services
"Against the unfavourable backdrop of economic crisis and spending cuts, in 2010 the agencies embarked on the implementation of the National Plan against Addictions and expanded their activities and their units. In August 2011, the Minister for Health announced 40 new units of the OKANA OST Programme, most of which will be hosted in hospitals and staffed by the existing ΟΚΑΝΑ and/or hospital staff."

(Expansion, New Initiatives, and the Economic Crisis) "Hope in 2010 went hand in hand with the awareness that the economic crisis was deepening and fiscal austerity would spread. The increase in the number of units and the increase in the number of clients in treatment, doubled by the decrease in staff and pay cuts, indicated that the system was already overstretched and could take no more tension.
"Nonetheless, the initiatives taken and the work carried out in 2010 appeared to be bearing fruit.
"— The implementation of the National Action Plan against Addictions, prepared by the National Committee for the Coordination and Planning of Drugs Responses seems feasible and, in spite of the cuts in their grants, most of the agencies started to implement it in 2011.
"— The new bill of law on drugs, tabled by the Ministry of Justice, decriminalises drug use, releases dependent users from prison and institutes treatment in prison. The scientific and humanitarian importance of this decision aside, there will also be savings, since it is well-known that a user in prison costs 4 to 8 times more than a user in treatment.
"— The ministerial decision to allocate all revenues from fines, commutation of sentences and asset confiscation for drug-law violations to the Ministries of Health and Justice.
"— The new operating framework of the ΟΚΑΝΑ substitution programme meets the conditions for being a prelude to the drafting of national guidelines for substitution treatment.
"— The amendment to law 3459/2006 consolidates prevention by the Prevention Centres run by ΟΚΑΝΑ/local authorities and sets out a new institutional framework, through the creation of a single set of by-laws that will include accreditation and the evaluation of their work.
"— The substitution programme is expanding in order to do away with the waiting list with the creation of 40 new units in Athens and Thessaloniki.
"In the year of the strictest austerity in recent decades, in the field of drugs, as indicated by the above, we have implemented more actions and have taken more initiatives than in any other year. This is no oxymoron. It is the combination of a number of initiatives taken by the National Coordinator, the agencies’ “spite” to respond to the increased needs of the users, and the self-abnegation of their staff who work without being paid, often for long periods of time. The 2009 annual report stated that the demand reduction system in Greece has a very solid foundation. This year, this is being proven."

(Greek Drug Law Reform) "The most important developments in the drugs legislation were introduced in 2011.
"New bill of law on drugs
"Amending the drug code of laws 3459/2006. The bill has two axes, one being the non-criminal treatment of users, and two foreseeing a new coordinating scheme.
"The law expressly provides that the offender’s diagnosed drug dependence is grounds for lifting or reducing criminal liability and shall result in acquittal or reduced sanctions.
"With regard to the users’ criminal treatment, it provides as follows:
"• Full decriminalisation of possession and supply of drugs for personal use. Cannabis cultivation for personal use is defined as a minor offence.
"• More lenient criminal treatment of the supply of small quantities (misdemeanour), and the supply of drugs to close friends/relatives.
"• Increased penalties for offences committed by professionals (medical practitioners, pharmacists, civil servants) in certain settings (schools, army, prisons) or involving minors.
"• Express prohibition of more lenient sentencing for dependent suppliers of large quantities of drugs, for whom the strictest penalty is envisaged (life sentence) or a prison sentence between 10 and 20 years and a € 600,000 fine. The supply of large quantities is determined by the financial yield, with a threshold of € 50,000."