Substitution therapy in Greece: a troubled story


When the Prime Minister of Greece decided to visit a substitution therapy centre in the heart of Athens a couple of weeks ago, several newspapers reported the government's renewed pledge to support the troubled organisation that provides the methadone and buprenorphine treatment and was recently left out of the cutback plans that have been announced to help relieve Greece's current economic pains.

The Organisation Against Drugs (OKANA in Greek) is a legal person governed by private law which began work in 1995 and is under the supervision of the Ministry of Health and Welfare. It has a double role as a national coordinating body and as a body developing prevention programmes and services, treatment and reintegration processes for drug users. A recent report on the organisation's current situation painted a rather grim picture. Years of 'mismanagement' and money-saving plans that were never adopted, units that have never worked to this day but have employed and paid people regularly and others that purchase supplies at the highest cost without having conducted any appropriate market research. 

Even after the announced boost of 10, 7 million euros by the Health Minister Mrs. Gennimata, the organisation's deficit still remains very high and the figures that depict the situation accurately are sadly not the financial ones. More than 6.000 people are waiting in lists to receive substitution treatment and in some cases will never be able to be a part of the programme as the wait can reach up to a 6 year period during which their life is endangered every single time they use heroin.

I met one of the people who wanted to be on that list as a Greek-English interpreter for his NHS appointments here in the UK. He told me about his friend who waited and waited for years and died a week before he was scheduled to receive his first treatment. Tired of waiting and wanting to turn his life around, D. decided to come and receive methadone treatment in a foreign country without even having a basic level of English.

While waiting for his appointments to start, he used to talk to me about the difficulty of living in a house with other people who were using while he wanted to stay clean, how he felt that he was 'doing time' in that house and how much he wanted to return back to Greece. His return he said would be like being released from prison.

One day I noticed that the clock on the wall had the wrong time and I pointed it out. 'There's nothing wrong with the clock', he said, 'it has stopped at this time because junkies do not like watching the time go by; they get stressed, they panic'.

For all the people on the OKANA lists, time goes by in a painfully slow way, the clock is stopped and the only thing that gets them through the wait is hope. Hope that by starting the treatment they can start changing their life. D. came to the UK hoping that the methadone he couldn't get his hands on in Greece would be the starting point for him.

The Prime Minister's visit and the recent financial boost of the organisation can be interpreted as steps towards the right direction but nevertheless they are only baby-steps compared to the leaps that need to be done to cover the distance.

It has been quite a bumpy ride for the OKANA organisation since its inception with politicians either obejcting to its existence in general -the Greek communist party believes that replacement therapy promotes 'narco-culture'- either ignoring its needs and the needs of people it has been designed to treat, as the revelations of mismanagement prove. On the other hand, as many of the organisations treatment centres are based in commercial and residential areas around Athens and other large Greek cities, the locals have been in many cases incredibly defiant against the programmes and the patients who, as they claim, degrade their communities. Claims like these are even supported by the current Mayor of Athens (and former Minister of Health), who in recent statements stood for moving the treatment centres further out in regional hospitals so that the city of Athens can be 'freed from scenes which are not respective of our culture'.

Aside from the need for clear institutional frameworks and financial support to the work of the OKANA, what is also necessary is the change in attitude of a society that sees drug users as a problem that needs to be transferred elsewhere, to be solved magically on its own. Whole-hearted support is vital for them; social exclusion and stigmatisation of current and former users only hinders their way to recovery and reintegration and ruins their genuine effort to start living again free from addiction and not afraid to watch time go by.

Based on original Talking Drugs post in Greek:


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