The current issue includes very interesting papers, some of which deal with issues that may be discussed for the first time in Greece. One of these is the article co-authored by Eleftheria Kokkini, Charalampos Poulopoulos and Chara Spiliopoulou, which presents the results after having reviewed the records of 5,467 people who died during the period 2012-2016, 3.25% (178 cases) of those cases were users of psychotropic substances, positive for at least one addictive substance.
The research was conducted at the Laboratory of Forensic Medicine and Toxicology of the Medical School of the University of Athens. The main substances identified by the research and the toxicological tests in blood and urine samples are heroin, benzodiazepines, tetrahydrocannabinol (THC) and alcohol. The study also underlines that substance use doesn’t always follow the same rule for everyone, so what would normally be considered a minor heart rate raise caused by cannabis might be “painful for someone who suffers from angina”, and the parallel use of alcohol and benzodiazepines may be proven fatal (Shapiro, 2009, p. 18 & 20). In the current research, it becomes evident that all the above have been identified as organic causes while in several cases where cannabis was detected what was mentioned as the cause of death was “recent myocardial infarction” and a coroner might note that “The use of cannabis has been implicated for the sudden death in the midst of causing cardiac arrhythmias” or “There is significant scientific evidence that cannabis (especially when associated with alcohol abuse) can cause cardiovascular events even sudden death”.
Other organic causes that were researched were related to liver cirrhosis, respiratory infection, absorption of gastric contents etc. Other than intoxication, an overdose, may lead to other problems as well such as chocking on one’s vomit in the case of loss of senses (Shapiro, 2009).
For the majority, the individuals are male (89.90%) and the average age of individuals is 41.99 years. Intoxication by addictive substances was the cause of death in 96 cases (53.9%), suicide for 22 (12.4%) and organic cause related to substances, or not, in 60 cases (33.7%). The majority of deaths seems to have occurred in a home setting (62.9%) and only 16.90% of users’ deaths were reported to have taken place in a park, on the street or other outdoor area. The proportion of men / women shows that 89.9% of the cases were male and 10.1% female, with a female / male ratio of 1/10, which is the same as that from treatment units in Greece, with about one in ten being a woman.
The results of this study confirm other scientific data suggesting that opioids and benzodiazepines are the leading cause of death from poisoning by addictive substances, and that home is the leading place of death of psychotropic drug users.
The above findings can help in designing and implementing programs to prevent sudden death from substance use and lead policies in the right direction. As the researchers say, the experience of losing a person from drugs or alcohol can be extremely traumatic, but at the same time it can be exploited in the context of a drug action plan involving Interventions at Home and Education of Significant Others in the Prevention of deaths.
Another equally interesting article, signed by Christina Kelessenli, refers to people with a life sentence who participate in a KETHEA drug treatment program within a detention facility. The study presented attempts to highlight the conflict that arises between the legal framework, a system that deals with the addicts as life-threatening offenders and the therapeutic framework and the right of addicted perpetrators to health and treatment.
The research with the incarcerated individuals is extremely limited. The study presented in this issue is probably the first in Greece in this field, that focuses on the reality of the individuals who have been convicted to life sentences, and at the same time they are part of a therapeutic community with the correctional setting. What becomes also evident is that the individuals who are addicted to drugs and end up in prison usually come from marginalised groups and thus experience social exclusion long before they are incarcerated. The study focuses on the need to develop research around this population and all the issues related to its needs and proposes a series of policies and interventions to address the issue.
The qualitative study by Nikolaou and Smyrnaki explores parents-addicts’ relationships up until adolescence and young adulthood, including active use and treatment periods, in order to identify problematic communication features that help initiate and maintain dependence. The survey was carried out with the participation of the members of the Social Reintegration Center of the IANOS Rehabilitation Center, which is part of the Psychiatric Hospital of Thessaloniki. Fourteen semi-structured interviews were conducted with dependent men aged 30-45.
Her findings show that in most cases, there is a history of dysfunctional communication that seems to have a negative effect on the child’s later psycho-emotional development and the path towards dependence. The study highlights the concepts of the co-dependence and interdependence of parents, but at the same time shows that the addict, due to chronic social and emotional weaknesses, hesitates to leave the family. These results are clearly linked to the findings of the article by Kokkini, Poulopoulos, Spiliopoulou and its urge for Home Intervention programs. The conclusions are yours!