{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:27:22Z","timestamp":1787038042414,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug Testing and Analysis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study presents findings from the European Syringe Collection and Analysis Project Enterprise (ESCAPE) conducted in Greece between 2022 and 2024. Used syringes were collected through harm reduction services and needle distribution and collection programs coordinated by EOPAE in Athens, Thessaloniki, and Patras, and analyzed using standardized ESCAPE extraction procedures followed by ultra\u2010high performance liquid chromatography\u2013tandem mass spectrometry (UHPLC\u2010MS\/MS). A total of 2122 syringes were included in the study. Substantial geographical variability in injected drug\u2010use patterns was identified across the participating cities. Athens demonstrated persistent opioid predominance accompanied by high cocaine co\u2010detection, extensive adulteration, and frequent multiple drug co\u2010detections. Methamphetamine was detected exclusively in Athens, demonstrating a transient increase during 2023. Thessaloniki exhibited a progressively cocaine\u2010dominant profile, with cocaine detections increasing markedly during the study period, while opioids remained consistently prevalent. In contrast, Patras demonstrated a distinct buprenorphine\u2010centered profile associated with comparatively lower adulteration prevalence and fewer multiple drug category co\u2010detections. Increasing detections of benzodiazepines, methadone, and pregabalin were observed across all cities during 2024. Fentanyl was detected in all participating cities during the final study year, although prevalence remained low. Adulterants, including caffeine and paracetamol, were highly prevalent in Athens and Thessaloniki but substantially less frequent in Patras. The present findings demonstrate substantial regional heterogeneity in injected drug\u2010use patterns within Greece and support syringe residue analysis as a rapid and highly informative surveillance approach capable of identifying temporal drug\u2010market changes, emerging synthetic opioids, adulteration patterns, and evolving patterns of injected drug use.<\/jats:p>","DOI":"10.1002\/dta.70138","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:02:18Z","timestamp":1787036538000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Monitoring Injected Drug Use in Greece Through Syringe Residue Analysis: A Multicity Study Within the ESCAPE Network"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-0881","authenticated-orcid":false,"given":"Christina","family":"Matiaki","sequence":"first","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7285-5209","authenticated-orcid":false,"given":"Anastasios","family":"Trakakis","sequence":"additional","affiliation":[{"name":"National Organization for Prevention and Addiction Treatment (EOPAE)  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Theocharis","sequence":"additional","affiliation":[{"name":"National Organization for Prevention and Addiction Treatment (EOPAE)  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3024-731X","authenticated-orcid":false,"given":"Chara","family":"Parpala","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chara","family":"Kotsailidou","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0831-1387","authenticated-orcid":false,"given":"Alexandros","family":"Psarianos","sequence":"additional","affiliation":[{"name":"National Organization for Prevention and Addiction Treatment (EOPAE)  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9403-8846","authenticated-orcid":false,"given":"Emmanouil","family":"Chatzichristofis","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-704X","authenticated-orcid":false,"given":"Eleni","family":"Zagelidu","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Roussou","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8252-7521","authenticated-orcid":false,"given":"Nikolaos","family":"Raikos","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1008-508X","authenticated-orcid":false,"given":"Orthodoxia","family":"Mastrogianni","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, Department of Medicine University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.drugpo.2014.09.010","article-title":"Drug Analysis of Residual Content of Used Syringes: A New Approach for Improving Knowledge of Injected Drugs and Drug User Practices","volume":"26","author":"N\u00e9fau T.","year":"2015","journal-title":"International Journal on Drug Policy"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpba.2025.117311","article-title":"The Role of Syringe Residue Analysis in Identifying Substances Consumed in Sexualized Drug Use Practices","volume":"270","author":"Pernas\u2010Fraguela C.","year":"2026","journal-title":"Journal of Pharmaceutical and Biomedical Analysis"},{"issue":"3","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/dar.13803","article-title":"A Snapshot of Injecting Drug Consumption From the Analysis of Used Syringes Within the Medically Supervised Injecting Centre in Sydney, Australia","volume":"43","author":"Fursman H.","year":"2024","journal-title":"Drug and Alcohol Review"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1002\/dta.2759","article-title":"Determination of Drug Residues in Used Syringe Needles","volume":"12","author":"Gjerde H.","year":"2020","journal-title":"Drug Testing and Analysis"},{"key":"e_1_2_9_6_1","volume-title":"An Analysis of Drugs in Used Syringes From Sentinel European Cities: Results From the ESCAPE Project, 2018 and 2019","author":"European 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