Drug Abuse in the Global Village
Greece
EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE
Extent of Drug Abuse
It is estimated that there were 40,000 to 50,000 drug dependent persons in 1990 (WHO 1991).
A national population survey of drug abuse conducted in 1984 among those 12 to 64 of age (sample size 4,292) showed that 5.5 per cent of the respondents abused illicit drugs at least once in their life (9.1 per cent of the males and 2.5 per cent of the females) and 11.1 per cent ever abused licit drugs (6.5 per cent of the males and 14.9 per cent of the females). Cannabis was the most prevalent drug abused by both males and females. Among the 18 to 24 age group, life time prevalence of abuse of illicit drugs was 15.7 per cent males and 4.1 per cent female. About 16 per cent of the females and 6.7 per cent of the males indicated use of pharmaceutical drugs without medical prescription (Madianou, D. 1987).
A school survey (12 to 18 years old) conducted in 1984 and repeated in 1988 showed prevalence rates among the 12 to 18 years old of 3.9 per cent for cannabis, 1.1 per cent for hallucinogens, 1.6 per cent for cocaine and 1.5 per cent for heroin and other opiates. About 39 per cent consumed pain relievers, 25 per cent codeine and 10 per cent tranquilizers without prescriptions (WHO 1992).
A prevalence study identified 9,689 drug abusers (8,821 male and 868 female), who came to the attention of authorities in 51 counties of the country between 1973 and 1983. The average age of male abusers is 35.7 and that of females 31.2 (Madianou, D. 1987).
Table 1 shows the prevalence of the most abused drugs among a sample of 6,688 known drug abusers. Abuse of cannabis was most prevalent among males (53.3 per cent), followed by heroin and other opiates (27.9 per cent). Heroin and other opiates were most prevalent among females (51.2 per cent), followed by cannabis (30.3 per cent). For 32 per cent of the males and 19 per cent of the females, there was no information on which specific drug or drugs were abused (Madianou, D. 1987).
Table 1 Distribution of known drug abusers by sex and type of drug abused, 1973 to 1983.
Males Females
(N=5,893) (N=705)
Drug Number % Number %
Hashish 3,189 53.3 213 30.3
Heroin and other opiates 1,668 27.9 361 51.2
Hashish and LSD 960 16.0 102 14.4
Alcohol and hashish 90 1.5 14 2.0
LSD and heroin 76 1.3 15 2.1
(N= 6,688)
Source: D. Madianou, M.G. Madianos and C.N. Stefanis 1987 Preliminary results of two nation-wide epidemiological studies of known cases and general population survey. Dept. of Psychiatry, University of Athens. Bulletin on Narcotics Vol XXXIX, number 2.
Abuser Characteristics
Drug abuse by males exceeds that of females. Female to male ratio is estimated to be 1 to 9 according to a 1983 study based on police arrests and treatment records, 1 to 4 based on a 1983 national survey and 1 to 2 based on a 1988 school survey which includes pharmaceutical drugs (WHO 1992).
Abuse of psychotropic substances without medical prescription is more common among school children than abuse of illicit drugs. Drug abuse (both of illicit drugs and pharmaceutical preparations) increases with age. Older age males used more illicit drugs in a 1988 survey (WHO 1992).
The majority of the known drug abusers are males between 20 and 39 years of age according to a 1983 national survey, mainly single and from middle and working classes. Most had been arrested at least once and had been involved in other illegal activities (Madianou, D. 1987).
Regional Variations
Drug abuse is more prevalent in the major industrial metropolitan cities, and in particular in Athens (U.N. 1992).
Trends
An increase in abuse of cocaine, sedative type drugs, atropine type drugs and opiates other than heroin has been reported (U.N. 1992). Abuse of all other types of drugs are reported to be stable. The number of drug related deaths has increase steadily since 1980 (5 in 1980 to 72 in 1989) (Greece 1991).
The 1984 and 1988 school surveys show that ever use of illicit drugs has decreased in the 13 to 16 year old age group. An increase in illicit drug abuse among 13 to 16 years old youth from 6.5 per cent in 1984 to 8.1 per cent in 1988 was attributed mainly to older male teens. A decrease in the misuse of pharmaceutical drugs in this group has however been noted (Kokkevi 1990).
Mode of intake
Cannabis is smoked, volatile solvents inhaled, heroin and cocaine base and salts injected and other cocaine types are sniffed. Amphetamines and sedative types are ingested (U.N. 1992).
COSTS AND CONSEQUENCES OF ABUSE
Deaths due to drug abuse increased since 1980 (5 in 1980 to 72 in 1989) (see table 2) (Greece 1991).
AIDS/HIV seroprevalence: Of the total AIDS cases reported for February 1991 (445), 3.4 per cent were intravenous drug abusers and 0.7 per cent homosexual/bisexual intravenous drug abusers (15 and 3 respectively). In 1990, 3.2 per cent of the total AIDS cases were intravenous drug abusers. The annual prevalence of HIV infection in imprisoned intravenous drug abusers (166 total in 1990) was 1.8 per cent ( 1.1 per cent in 1989) (WHO 1991).
NATIONAL RESPONSES TO DRUG ABUSE
National Strategy
The national policy against drug abuse is implemented by respective services established at the Ministries of Health, Justice, Education, Civilization, Finance and Public Order. Non governmental organizations such as the Therapy Centre for dependent Individuals (KETHEA) provide prevention services, treatment and social reintegration programmes (Greece 1991).
Regional and local policy was directed primarily towards the supply of illicit drugs in the past. Since 1989, treatment and rehabilitation services at regional level have been expending and extensive prevention programmes has been underway (Greece 1991).
LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**
Treaty adherence
Greece is Party to the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances and the 1988 Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.
DEMAND REDUCTION ACTIVITIES
Primary Prevention
Prevention activities are carried out in secondary schools and in further and higher education. The school curricula is planned to be redefined so as to include appropriate information regarding drug abuse and the promotion of a drug free life (Greece 1991).
Information on drug abuse is available to the general public through mass media campaigns, a mobile information unit (KETHEA's PEGASUS which reached approximately 18,600 persons in 1992) and a large information centre in Athens (U.N. 1992).
Training is available to doctors, health workers and social worker. Targeted preventive programmes are carried out for parents, youth groups and street children (U.N. 1991).
Treatment and Rehabilitation
In the public sector, treatment centres with inpatient as well as outpatient services are available mainly in Athens. In the private sector, KETHEA provides treatment in 5 non-hospital residential units (About 400 patients a year), 5 rehabilitation centres (178 patients in 1992), 5 family therapy centres (1,805 patients, most women (1,263)), 6 induction centres (1,142 patients), and 5 counselling self-help group in prisons (69 patients). Vocational training and assistance in finding accommodation and employment are also available. Of the total 3,597 patients treated in 1992, the majority were male (1,994). Almost half (1,231) were seeking treatment for the first time (U.N. 1992).
Data on registered drug abusers (1,422) in a treatment centre in 1992 shows that heroin is the most prevalent drug abused (80 per cent), followed by sedatives (7.8 per cent). Abuse of heroin is more prevalent among men (84 per cent) 20 to 34 of age. Similarly, abuse of sedatives is more prevalent among men (74 per cent) in the 20 to 34 age group. Cannabis abuse accounts for 3.6 per cent of the registered abusers, mostly in the 15 to 19 age group. Other drugs abused are cocaine (2.6 per cent of the total registered abusers), multiple drug abuse (2.4 per cent), amphetamines (1.4 per cent) volatile solvents (0.8 per cent) and hallucinogens (0.3 per cent) (U.N. 1992). KETHEA provides detoxification services to about 500 addicts per year. Detoxification is part of a larger therapeutic programme (U.N. 1992).
All services, both public and non-profit (KETHEA) are free.
Substitution treatment using morphine type drugs (such as methadone) is not legal in Greece (Greece 1991).
SUPPLY REDUCTION ACTIVITIES
Arrests, Convictions and types of Offences
In 1990, a total of 2,128 persons were arrested for possession/abuse of illicit drugs and 1,230 for trafficking (U.N. 1990). Of these, most were related to cannabis (45.6 per cent), followed by heroin (43 per cent), depressants (6 per cent) and cocaine (2.7 per cent).
Seizures
Table 2 shows the quantities of drugs seized from 1980 to 1989. Quantities of cannabis seized have decrease from a peak of 23 tonnes in 1987 to 703 kg in 1989. A similar decrease was noted for cocaine seizures (almost 24 tonnes in 1987 to 2,350 in 1989). Heroin seizures also decreased from 70 kg in 1987 to 42 kg in 1989 (Greece 1991).
Table 2 Seizures, offences and drug related deaths 1980 to 1984.
Year 1980 1981 1982 1983 1984
Number of
offences 376 383 499 458 451
Number of
accused 769 883 1,043 877 834
persons
Cannabis (Kg) 503 5,400 29,910 2,960 4,050
Heroin (Kg) 7.4 15.5 101.5 237 17.5
Cocaine (gr) 53 - 48 128 117
Drug related 5 10 17 9 12
deaths
Table 2 (contd...) Seizures, offences and drug related deaths 1985 to 1989.
Year 1985 1986 1987 1988 1989
Number of
offences 762 1,368 1,820 1,964 2,084
Number of
accused 1,192 2,022 2,728 2,937 3,143
persons
Cannabis (Kg) 603 641 23,130 8,350 703
Heroin (Kg) 11 33 70 72 42
Cocaine (gr) 71 2,933 23,800 2,300 2,350
Drug related 10 28 56 62 72
deaths
Source: National Report of Greece to the First Pan-European Ministerial Conference on Illicit Drug Abuse Problems, Oslo, 9-10 May 1991.
Supply Source of Drugs
No information reported by 31st December 1993.
References and Notes
** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years .... (not available by January 15th 1994).
U.N. 1990,1991,1992. Replies to UNDCP Annual Reports Questionnaire for the years 1990, 1991 and 1992.
WHO 1991. AIDS among drug abusers in Europe, Review of recent developments. Copenhagen, WHO.
WHO 1992. European Summary on Drug Abuse. First Report (1985-1990). H. Klingemann, et al. WHO 1992.
Kokkevi 1990. The Epidemiology of Licit and Illicit Substance Use among High School Students in Greece.
Greece 1991. National Report of Greece to the First Pan-European Ministerial Conference on Illicit Drug Abuse Problems, Oslo, 9-10 May 1991.
Madianou, D. 1987. D. Madianou, M.G. Madianos and C.N. Stefanis 1987 Preliminary results of two nation-wide epidemiological studies of known cases and general population survey. Dept. of Psychiatry, University of Athens. Bulletin on Narcotics Vol XXXIX, number 2. 1987.