Abstract
BACKGROUND: This study examined shifts in the productivity and efficiency of Opioid Substitution Treatment (OST) units in Greece from 2019 to 2022. OST units address withdrawal symptoms in individuals discontinuing psychoactive substances. They also offer mental health care, primary healthcare, psychosocial support, and other integrated services, aiming to provide holistic addiction treatment and promote social reintegration. METHODS: We assessed the contributions of 54 OST units addressing opioid addiction using non-parametric Malmquist Data Envelopment Analysis (DEA). Data were collected from all OST units operating in Greece during this period, with a focus on key external factors such as the COVID-19 pandemic and rising global trends in stimulant and synthetic opioid use. RESULTS: The analysis revealed a productivity decline in 2020, followed by improvements in the next two years. However, technical efficiency declined, suggesting a decrease in resource utilization. CONCLUSIONS: This dip in efficiency likely reflects the impact of emerging drug trends, particularly stimulants and synthetic opioids, which lack standardized treatment protocols. These findings highlight the urgent need for new treatment options to address evolving addiction trends. The study also underscored the need for improved data collection and monitoring to optimize resource allocation and enhance operational efficiency in OST units. Strengthening evidence-based policies and expanding access with low-threshold treatment services could improve patient outcomes and the overall effectiveness of OST programs.