Every day that passes by, Kostas feels his body stronger and his mind more lucid. For the past four months he has been walking daily four kilometres in order to reach his destination. But he does not mind, because he chose to live.

Kostas is a member of Kethea therapeutic community for heroin addicts, and every day that passes by he struggles for his future. He is never sure whether he will be able to carry on the next day. Kostas, along with thousands of people involved in therapeutic programs, is crying for help. This is because he is facing the risk of returning to his old haunts and habits, as therapeutic programs are now at a dead end due to the reduction of government funds.

This is happening at a time when all indicators show that the problem of drug addiction is growing. Economic recession has led to a 20 percent increase in the number of heroin addicts in Greece and the number is growing with every year that passes, according to the Greek Documentation and Monitoring Center for Drugs

There are fears that when a country enters a period of economic austerity this may be accompanied by an increase in problematic forms of drug use, and, more specifically, in heroin abuse, the 2010 European Monitoring Centre for Drugs and Drug Addiction Annual Report noted. But are these fears justified? To find the answer, all you need to do is examine the data of other countries that have gone through socio-economic transitions and the changes in heroin abuse that followed these transitions.

The political-economic transitions that followed the dissolution of the Soviet Union in 1991 providee some interesting data. According to the Bulletin on Narcotics, a publication of the United Nations Office on Drugs and Crime, the economic downturn in Russia and the constantly diminishing Russian economy were followed by an increase in heroin abuse. The Russian Federation experienced a surge in heroin abuse: between 1991 and 2000, the number of drug addicts in the Russian Federation increased tenfold. In 2000, the number of drug addicts stood at 185.8 per 100,000 people, whereas in 1991 it had been 21.2 per 100,000. Opioids accounted for 90.1 per cent of the narcotics used. The United Nations Office on Drugs and Crime estimates that in 2010 Russia and Ukraine both had levels of problem opioid use that were two to four times higher than the E.U. average.

Of course statistics cannot be copy-pasted from one situation to another, as each situation is unique and has its own characteristics. But there is a great possibility that Greece’s financial crisis could be bringing on dire health consequences that even the most pessimistic observer could not have imagined.

It is a modern-day Greek tragedy, says Kleanthis Grivas, Doctor of Psychiatry at the Aristotle University of Thessaloniki, with a trembling voice. The situation is deteriorating day by day. According to a new study published in The Lancet, the world’s leading general medical journal, rising unemployment, depression and uncertainty have led to several serious health issues among Greeks, especially the most vulnerable ones. Heroin abuse is one of the health issues. According to estimates from the Documentation and Monitoring Centre for Drugs, the prevalence of heroin use reportedly rose by 20 percent in 2009, from 20,200 to 24,100 heroin users.

The problem can be divided in two parts, says Dr Charalambos Poulopoulos, Director of Kethea. On one hand we have an increase in the number of first-time diagnosed addicts due to the uncertainty and insecurity the crisis causes, while, on the other hand, ex-addicts go back to heroin use as they don’t receive the appropriate treatment – counselling, support groups, mental rehabilitation – anymore and find it hard to get the medication they need.

The economic crisis, which is associated with long-term unemployment, especially for youth, has significant effects on physical and mental health of citizens and promotes the proliferation of different forms of dependence, like heroin abuse. Some citizens, due to their inability to cope with such crisis outcomes as stress and uncertainty, will turn to heroin use.

The economic recession is affecting us all, but the burden is falling significantly on vulnerable groups and drug addicts are one of them, Poulopoulos says. Personal, family and social impasses created by crisis enhance risk factors for the growth of heroin abuse, while at the same time addicts and ex-addicts are socially excluded.

The absence of a positive outlook after treatment is making the mobilization of addicts to change lifestyle more difficult. The social integration of ex-addicts becomes increasingly difficult due to high unemployment rates, while the uncertainty and intense pressure may increase the likelihood of relapsing to heroin use. Ex-addicts may choose to return to their old habits as their hope for a better future vanishes.

There is no reason to quit heroin, George, a homeless heroin addict said, a tear rolling down his cheek. What for? People with master’s and university degrees lose their jobs and their homes. Who is going to deal with me? There is no future for me.

Okana, Kethea and 18ano, the three major rehabilitation centers for drug addicts, all mainly dependent on government grants, are struggling for their existence during this economic downturn. Their management and staff have to deal with the reduction of subsidies by 50 percent, downsizing, and merging of institutions, which lead to the failure to provide services to drug addicts and to the closure of treatment and rehabilitation units, according to evidence presented at a press conference in June 2011. In order to deal with these problems, Kethea voluntarily reduced its costs from 2009 to 2011 by 12.6 percent and adopted a strategy of self-funding. But a recent government decision calls for cuts of 11,730.000 euros from Kethea and 15,000,000 euros from Okana, which is more than 50 percent of their grant and leads them to a dead end. Now, they have to overcome the problems to protect the thousands of people in treatment and rehabilitation and help them.

The situation is worsening day by day. The number of heroin addicts is increasing while at the same time therapeutic programs are at risk of shutting down due to the reduction of government funds. Which, for Gerasimos Notaras, president of Kethea, is no excuse to keep soldiering on. We believe that we should not allow the financial responsibility to make us forget our duty towards life, he said.