Subsections:

1. Lifetime Prevalence of Drug Use

Basic Data

"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."

"2005 National Report to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: University Mental Health Research Institute, 2005), p. 14.
http://www.emcdda.europa.eu/a…

2. Lack of Current Data on Prevalence of Use Within General Population in Greece

"General population data based on probabilistic sampling have been available at almost regular intervals (every 5 years) already since the mid-1980s from the surveys conducted first by the Psychiatric Clinic of the Athens University Medical School and later by the UMHRI. Moreover, the methodology of the latest survey conducted by UMHRI in 2004 was fully harmonised with the EMCDDA standards for surveys (see www.emcdda.europa.eu/themes/k…), thereby permitting comparability between the situation in Greece and the situation in other European countries. It is noted, however, that since 2004 there has been no repeat survey of a representative general population sample."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 29.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

3. Prevalence of Illicit Drug Use Among Youth in Greece, 2011

"According to the most recent data (2011):
"Any illicit drug use1: almost one in every 6 students aged 15-19 (15.3%) have used an illicit drug at least once in their lifetime. Twice as many male (21.1%) than female students (9.4%) have used drugs in their lifetime. Drug use increases with age: lifetime prevalence increases from 7.4% at the age of 15, to 21.9% and 40.2% at the ages of 18 and 19, respectively. Drug use is significantly higher in the cities of Athens and Thessaloniki (19.3% and 19.4%, respectively) compared to the other areas (12.0%) (Table 2.1).
"Drugs: cannabis (13.4%) and inhalants (14.1%) are the drugs most commonly used by students. Lifetime prevalence of drugs other than cannabis and inhalants was below 3% in 2011. Irrespective of the drugs used, boys use drugs in significantly higher proportions compared to girls (Table 2.1).
"Recent and current use
"Data on recent (i.e., use in the last 12 months) -and current use (i.e., use in the last 30 days) is available only for cannabis. In 2011, one in every 10 students aged 15-19 (10.4%) reported recent - and one in every 16 (6.3%) current use of cannabis. The male to female ratio was 2 to 1 for current use (14.3% and 6.4%, respectively), and 3 to 1 for current use (9.1% and 3.3%, respectively). Recent and current use increases significantly by age. Finally, twice as many students in Athens and Thessaloniki than students in other areas report recent and current use (Table 2.2)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 30.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

4. Prevalence and Frequency of Cannabis Use Among Youth in Greece, by Gender

"More students have repeated cannabis use (3 times or more; 7.8%) than they have only used 1-2 times (5.6%). Boys repeated cannabis use in significantly higher proportions compared to girls (11.1% and 4.4%, respectively). Repeated cannabis use (as opposed to 1-2 times use) increases after the age of 16. Finally, students in Athens and Thessaloniki repeat cannabis use in significantly higher proportions compared to other areas (10.6%, 11.1%, and 5.4%, respectively) (Table 2.2)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 31.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

5. 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)."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), p. 20.
http://www.emcdda.europa.eu/a…

6. 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)."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), p. 21.
http://www.emcdda.europa.eu/a…

7. 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%)."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), pp. 21-22.
http://www.emcdda.europa.eu/a…

8. Charges Brought for Drug-Related Offenses in Greece, 2010

"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 DPAs23 brought 13,176 charges against 12,805 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 2009-2011. More specifically, the number of individuals returned to the levels of 2004 and the number of cases to the levels of 2006-2007."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 126.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

9. Convictions for Drug-Related Crimes in Greece, 2009

"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 2009 (Figure 9.2). Of a total of 45 127 convicts, 1 818 (4.0%) were convicted for drug-related crimes. The overwhelming majority (96.3%, ?=1 751) are men. 1 222 individuals (67.2%) were convicted for drug use, possession or cultivation of a small quantity for personal use, 520 individuals were convicted for drug use, dealing and trafficking (28.6%), 61 individuals for drug dealing and trafficking (3.4%), and 15 individuals for drug cultivation / production (0.8%). Figure 9.3 shows the distribution of convicts by gender and drug-related offence in the four-year period 2005-2009. In the period under consideration there has been no significant variation in the distribution of convicts by gender and drug-related offence.
"Most of the offences (32.4%) were committed in the region of Attica, 30.5% in the region of Central and West Macedonia, 8.1% in the Peloponnese, 7.9% on Crete, 6.4% in the region of East Macedonia and Thrace, 4.9% on the Aegean islands, and 9.8% in the rest of the country. It is pointed out that the two regions where most of the offences were committed were again Macedonia and Attica in the years 2005-2008, too."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), pp. 127-128.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

10. Sentences for Drug Convictions in Greece, 2009

"The maximum sentences imposed for drug use, possession or cultivation of a small quantity for personal use is prison sentences of one year. Of the sentences imposed for drug trafficking / dealing, the total of penalties 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 99.4% of them are prison sentences for a term or for life.
"The vast majority (99.2%) 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 total of the trafficking / dealing cases.
"Age wise, 77.0% 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%), 2007 (77.0%) and 2008 (79.0%)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 129.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

11. Prevalence of Problem Drug Use in Greece, 2011

"The probable number of problem drug users in Greece continues to be estimated every year by the internationally recommended 'capture-recapture' method, based on the annual data from the
Treatment Demand Indicator. An appropriate statistical model is fitted to the records from three sources of information: KETHEA, 18 ANO and the rest of the network of treatment services reporting to the Focal Point. This permits the estimation of the 'hidden population' of people who are problem drug users but did not happen to be recorded by any of these sources in the year in question. Because of this method of estimation, the definition of a problem drug user is someone who may eventually attend the treatment services because of his or her use of opiates. The lack of data in the appropriate form from other sources that might record problem drug users, such as the Police, is regrettable as it prevents checking and possible improvement of our current estimates.
"The estimated total number of problem drug users aged 15-64 years with main substance heroin was 20,473 in the year 2011, with 95% confidence interval from 18 529 to 22 688. This is down from the previous year’s estimate of 22,515 (95% c.i. from 20,202 to 25,171), although as always it is necessary to take into account that the confidence intervals are very wide. However, the 2010 estimate was in turn down from the 2009 figure of 24,097 (95% c.i. 21,362 – 27,272) and thus it appears that the generally increasing trend which had been observed since 2002 may have come to an end. Table 4.1 gives the breakdown of the estimated number of problem drug users by gender, age and place of residence. Table 4.2 presents corresponding estimates of the number of drug users who reported that they had injected in the previous month. The estimated total of 7 847 (95% c.i. 6,904 – 9,951) is likewise reduced in comparison to the previous two years."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 55.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

12. Rise in Problem Drug Use in Greece Attributable to Eurozone Economic Downturn

"According to the latest data from the Greek Documentation and Monitoring Centre for Drugs, the number of persons with problematic drug use (heroin as the primary addictive substance) rose by 11.6% between 2008 and 2010 (from 20,181 cases in 2008 to 22,515 cases in 2010)53,54; among those aged 35 to 64 years, the increase was far more intense at 88.2% (from 4875 cases in 2008 to 9176 cases in 2010). Taking into account that in 2010 the average age for initiation of injection drug use was estimated at 22.4 years old,54 this sharp increase of older heroin users in Greece indicates probable relapses rather than new cases, presumably associated with the ongoing economic downturn."

E. Kondilis, et al., "Economic Crisis, Restrictive Policies, and the Population’s
Health and Health Care: The Greek Case," American Journal of Public Health. 2013 Jun;103(6):973-9. doi: 10.2105/AJPH.2012.301126. Epub 2013 Apr 18.
http://www.ncbi.nlm.nih.gov/p…
http://ajph.aphapublications…

13. HIV Prevalence and Injection Drug Use in Greece

"According to KEELPNO [Hellenic Center for Disease Control and Prevention] (2012), throughout the recent years no more than 20 cases which had IDU as a probable source of transmission were reported annually in Greece (Figure 6.1). IDUs never represented more than 2–3% of all total reported cases (Figure 6.2). In 2011, a total of 256 HIV cases were attributed to injecting drug use, with this route of transmission representing 26.8% of all reported cases that year (Figure 6.1 and Figure 6.2). Between January 1st and August 31st 2012, 768 HIV cases have already been recorded in KEELPNO’s surveillance system, 314 of which (40.8%) were reported as IDU cases (Figure 6.1 and Figure 6.2) (Nikolopoulos 2012).
"Among the 2011 IDU cases, four in every 5 (about 80%) were males, one in every 2 (about 55%) aged between 25-34 years and four in every 5 (about 80%) Greek nationals (Table 6.1) (note that as between January 1st and August 31st 2012 a significant increase has been observed in the number of non-Greek IDU cases an increase which also reflects changes in testing policy)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), pp. 92-93.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

14. Evidence of Rising Prevalence of HIV Among IDUs in Greece

"In 2011, data on serological and behavioural indicators were collected on a total of 2,329 IDUs (not accounting for double counts; data from 63 out of the 70 sites in the DRID [Drug Related Infectious Diseases] network). The number of tests conducted in 2011 in the three different data and the demographic characteristics of the IDUs tested are presented in Table 6.2 and Table 6.3, respectively.
"NFP’s [National Focal Point's] data corroborate KEELPNO’s evidence for sharp increases in the number of HIV cases involving IDU and possible rise in the infection in this group. Before 2011, the HIV prevalence among IDUs annually tested in the treatment settings never exceeded 2% (DRID data, Figure 6.3). In 2011, data reported from all sources showed a sharp increase in the number of IDUs diagnosed with HIV and a significant increase in the HIV prevalence in this population reaching levels as high as 4.4% at the national level (Figure 6.3); even higher in Athens (around 8%). Among the HIV positive cases in 2011, 85.9% were males, 56.3% 25-34 years of age and 88.0% were opioid users (8.0% also injected stimulants). Finally, 98.3% were HCV co-infected."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 94.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

15. Hepatitis C Prevalence and Injection Drug Use in Greece

"According to DRID data, HCV antibody prevalence in IDUs has been consistently high and increasing over the last 10 years in Greece. In 2011, prevalence rates ranged between 62.4% and 79.3%, depending on the source of data (Figure 6.4). Compared to 2010, in 2011 HCV infection rates remained stable in data source 1 (national sample), but increased significantly in data sources 2 (national sample) and 3 (Athens sample) (Figure 6.4)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 96.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

16. Impact of the Eurozone Economic Downtown on IDU-Related HIV

"Trends in infectious diseases hold particular interest. Whereas tuberculosis incidence continued its declining trend (according to the Hellenic Centre for Disease Control and Prevention, reported new cases of tuberculosis decreased by 26.8% between 2007 and 2010),55 Greece surprisingly faced 3 infectious disease outbreaks in a period of less than 18 months, between July 2010 and December 2011: an outbreak of West Nile virus infection in northern Greece between July and October 2010, including 197 patients with neuroinvasive disease and 35 deaths56; an outbreak of malaria in southern Greece between May and October 2011, including 63 cases, of which 40 reported no travel history to endemic countries57; and worsening trends in HIV infection between 2010 and 2011, such as a 57.2% increase in newly diagnosed cases of HIV-1 infection (from 607 new cases in 2010 to 954 cases in 2011) and a 1506.7% increase of newly diagnosed cases of HIV-1 infection among injection drug users (from 15 cases in 2010 to 241 cases in 2011).58
"In all 3 examples, outbreaks were initially attributed to environmental risk factors59,60 or to migrant populations.60,61 Nevertheless, the public health measures that have been retrospectively implemented for the control of the epidemics (intensified distribution of needles and condoms among injection drug users, intensification of vector- and mosquito-control activities) imply that the risks of transmission had not been addressed through prevention, most likely because of the dismantling of services previously provided by national and regional public health agencies. For example, the number of needles and condoms that were freely distributed to injection drug users by public preventive programs decreased sharply in 2010 (by approximately 31% compared with 2009) just before the marked increase in newly diagnosed cases of HIV-1 infection.62 Mosquito-control activities implemented by public local authorities also were delayed in 2011 because of financial problems.63"

E. Kondilis, et al., "Economic Crisis, Restrictive Policies, and the Population’s
Health and Health Care: The Greek Case," American Journal of Public Health. 2013 Jun;103(6):973-9. doi: 10.2105/AJPH.2012.301126. Epub 2013 Apr 18.
http://www.ncbi.nlm.nih.gov/p…
http://ajph.aphapublications…

17. Treatment Service Availability in Greece, 2011

"In 2011, a total of 92 treatment units offered drug treatment in Greece: 42 OST units (33 buprenorphine and 9 providing mainly methadone); 43 drug-free treatment programmes (11 inpatient/adults; 19 outpatient/adults, 12 outpatient/adolescents; and 1 detoxification unit) (Figure 5.1); and 7 drug-free treatment programmes for imprisoned and released drug users (see Chapter 9 for prison data).
"Alongside the treatment units, in 2011 there were 45 counselling centres in total: 31 counselling centres for adults and 10 for adolescents and young adults and 4 counselling centres for released drug users (see Chapter 9 for prison data).
"The main developments in the availability of treatment services in 2011 are the following6:
"• OKANA launched 22 new OST units within public general hospitals in Athens, Piraeus and Thessaloniki, while 5 OST units (2 in Athens, 2 in Piraeus and 1 in Thessaloniki) suspended operations. In specific, in August 2011, the number of OKANA OST Units was 25, and two months later it was doubled to 42. In August 2012, 52 units operated across the country, while it is estimated that 13 additional units will be ready to operate in next months (Micha 2012). Most of the units are hosted in hospitals and staffed by the existing ????? and/or hospital staff.
"• KETHEA launched a Treatment Programme for Women in Eleonas prison, Thebes, which became operational late in December 2010.
"• OKANA ATRAPOS (the detoxification unit for adolescents in Athens), which had been in the evaluation phase in 2010, suspended operations.
"• OKANA NAFTILOS (the treatment unit for adolescents in Thessaloniki) suspended operations.
"• KETHEA EXANTAS (counselling and early intervention centre) no longer offers treatment services."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), pp. 59-61.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

18. Treatment Utilization in Greece, 2011

"In 2011, the total capacity of the treatment units (main treatment phase) was 7,853 slots (data for 75 of the 78 treatment units) (Figure 5.2). Most of the treatment slots were offered in OST units (6,789, 86.5%, Figure 5.10), and 13.5% (1,064, Figure 5.5) were offered by drug-free treatment programmes. Compared to 2010, in 2011 the treatment capacity increased by 18.8%, sustaining the increasing trend observed in the entire 2002-2011 period (Figure 5.2), which is a direct consequence of the increasing number of treatment units over the years (Figure 5.1).
"In 2011, the total number of people in treatment (main phase) was 9,047 (Figure 5.2), of whom 6,783 (75.0%) were offered services in OST, and 2,264 (25.0%) in drug-free settings. In addition, 4,934 (54.5%) were in continuous treatment (mainly OST), while 4,113 (45.5%) were admitted to the main phase of the treatment in the reporting year (Figure 5.2).
"In the period 2002-2011, the annual total number of individuals receiving treatment has been consistently increasing (Figure 5.2). In 2011, there has been a 9.1% increase in the number of people who received main treatment compared to 2010, with new admissions being the only group driving this increase (31.0% increase between the two years)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), p. 61.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

19. 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%)."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), p. 48.
http://www.emcdda.europa.eu/a…

20. 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."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), p. 48.
http://www.emcdda.europa.eu/a…

21. Opioid Substitution Treatment (OST) in Greece, Capacity and Client Data

"42 OST units currently operate in Greece of which nine (9) methadone substitution units and thirty-three (33) buprenorphine substitution units. Only OKANA provides substitution treatment services.
"Capacity and treated population
"As shown in Figure 5.10, the total capacity of OST units in 2011 was 6 789 (data for 38 of the 39 OST units). A total of 6,783 individuals9 were offered OST services, 32.7% (n=2 218) of whom were in methadone –and 67.3% (n=4 565) in buprenorphine OST units (Figure 5.10).
"In 2011 the total capacity of the OST programme increased by 28.1% over 2010, was 41.3% higher compared to 2008 and quintupled compared to 2002, while there is no difference in capacity between 2008 and 2009 (Figure 5.11). As it is shown in Figure 5.11 the increase in the capacity of OST from 2008 to 2011 is mostly attributed to the increase in the capacity of the buprenorphine (increased by 100%), while the capacity in methadone decreased by 13%.
"The total number of people in treatment is continuously increasing between 2002 and 2011. More specifically, in 2011 the total number of clients in OST increased by 8.3% over 2010 and 34.4% compared to 2008, whereas it was quadrupled compared to 2002 (Figure 5.12). In 2011 admissions increased by 43.7% compared to 2010, mostly because of the opening of the OST units (Figure 5.1).
"The increase between 2008 and 2011 is due to the increased number of clients by 106% in buprenorphine, while the number of clients in methadone decreased by 22% (Figure 5.13)."

University Mental Health Research Institute, "2012 National Report (2011 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Athens, Greece: UMHRI, 2012), pp. 68-70.
http://www.emcdda.europa.eu/h…
http://www.emcdda.europa.eu/a…

22. National Drug Strategy

Laws and Policies

"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."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), pp. 11-12.
http://www.emcdda.europa.eu/a…

23. 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 ????? and/or hospital staff."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), pp. 43-44.
http://www.emcdda.europa.eu/a…

24. 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 ????? 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 ?????/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."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), pp. xiii-ix.
http://www.emcdda.europa.eu/a…

25. 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."

University Mental Health Research Institute, "2011 National Report (2010 Data) to the EMCDDA by the Reitox National Focal Point: Greece: New Development, Trends and in-depth information on selected issues" (Lisbon, Portugal: EMCDDA, 2011), p. 2.
http://www.emcdda.europa.eu/a…