How Has Greece's Economy Affected Drug Usage? — Chromatography Explores

Austerity. Unemployment. Recession. All these are common effects of the financial crisis in 2007/8. The crisis has affected most people in Europe. Some countries suffered more than most as they effectively went bankrupt — Greece being the most well-known example. But what about drug consumption?

No money for the prescription

Researchers from the National and Kapodistrian University of Athens have recently published a paper on the results of an investigation into legal and illicit drug use in Greece during the aftermath of the financial crisis. And it isn’t a case of people just turning to illegal drugs to combat feelings brought on by the crisis. The economic crisis had a direct impact on the legal pharmaceuticals that were available during the crisis.

As part of the plethora of cuts that the Greek government had to make between 2010 and 2014, over two billion Euros had to be cut from the drug expenditure budget. Studies have suggested that this had an impact on the use of pharmaceuticals with a decrease in their use as government and household budgets tightened. The studies have also suggested that there was an increase in the use of illicit drugs during the same period. But how do you check?

Sewage epidemiology — you can’t keep a secret

Rather than turn to surveys and questionnaires — the best way to check the consumption in pharmaceuticals and illegal drugs is to measure them. Wastewater-based — or sewage-based — epidemiology is the method that is now preferred to gather data on community drug use. It is a method that is still in its infancy, but as the errors and uncertainties are reduced, the method is fast becoming the recognised gold-standard procedure for checking what you’ve been popping.

The process begins by taking samples of wastewater from the community to be checked. These samples are then analysed, typically — as in the Greek case — using liquid chromatography with tandem mass spectrometry (LC-MS/MS), a method discussed in the article, A Modified QuEChERS Approach for the Extraction of Common Prescription and Illicit Drugs from Liver Prior to LC-MS/MS Analysis.

Then comes the part of the analysis that still needs work. The researchers then back-calculate the drug consumption using daily sewer loads, population data and knowledge of the drug and how it breaks down in the body and water. From this, a daily drug use per population can be calculated.

It’s all Greek to me

The Greek study found an increase in psychoactive drugs during the period of monitoring (2010-2014) — with anti-psychotics, benzodiazepines and antidepressants all showing a marked increase during the period. This evidence correlated with the increased incidence of mental illness in the population during the economic crisis.

Other findings include a decrease in antibiotics and NSAIDs — a finding they suggest is related to the reduced expenditure in public health. Conversely, methamphetamine use increased whilst no clear trend could be seen in cocaine or cannabis use.

Remember, big brother is watching.