Drug use in Athens rose dramatically after economic crisis

In Greece, the economic situation has been dire in recent years: Unemployment is near 30%, and public spending has been slashed because of austerity measures imposed by the European Union. A new study looking at the Greek capital’s wastewater shows how the public has responded to the societal stress: The use of many legal and illegal substances—particularly antipsychotics and antidepressants—has skyrocketed since the EU bailout plan took effect in 2010 (Environ. Sci. Technol. 2016, DOI: 10.1021/acs.est.6b02417).

Nikolaos S. Thomaidis of the University of Athens and colleagues collected wastewater samples from Athens’s treatment plant for about a week each year from 2010 to 2014. Then they used liquid chromatography and mass spectrometry to screen for 148 legal and illegal drugs and their related metabolites.

The team found huge increases in the levels of antipsychotics (35-fold), benzodiazepines (19-fold), and antidepressants (11-fold), correlating with the fall of Greece’s gross domestic product and the climb in unemployment. Drugs to treat ulcers, epilepsy, and hypertension also increased. Antibiotics and nonsteroidal anti-inflammatory drugs decreased—likely because of cuts to health spending—but the researchers found a doubling in the levels of illegal methamphetamines.

All the findings suggest that the general health of Greece’s population got worse during this period—and in particular, their mental health, Thomaidis says. The data show a leveling off of some drugs, as the economic situation begins to stabilize.

Kevin V. Thomas of the Norwegian Institute for Water Research says the approach of linking wastewater with a particular societal event is novel and useful. But he warns that the correlation the researchers found doesn’t necessarily equate to causation: “You can’t definitively say whether those changes would have happened anywa­y.”