Interview with Odysseas the first DCR created in Greece...

Published February 09, 2014 by Bernard BERTRAND, www.salledeconsommation.fr 1

Interview with Odysseas: the first Drug Consumption Room created in Greece

The Organisation Against Drugs (ΟΚΑΝΑ) was established pursuant to Law 2161/93i which was passed unanimously by the Greek Parliament, and has been operational since 1995 as a legal person that is governed by private law and reports to the Ministry of Health and Social Solidarity.

Its constituent instrument stipulates that OKANA shall:

• plan, promote, coordinate and implement a national policy on prevention, treatment and rehabilitation of drug addicts,

• address the drug problem at a national level, provide valid and documented information, and raise public awareness,

• establish and effectively manage prevention centres, treatment units and social and professional reintegration centres.

OKANA has always endeavoured to combine the roles of national coordinator and services and programmes provider in the fields of prevention, treatment and reintegration. To hammer out and coordinate national drug policies, OKANA works together with national (ministries, treatment programmes, local government authorities, universities etc.), European and international organisations (the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the Pompidou Group of the Council of Europe, the World Health Organisation, the United Nations etc.). To look into the drug problem in Greece, OKANA works closely with the National Documentation and Information Centre on Drugs and Drug Addiction (EKTEPN). When it comes to prevention, OKANA has liaised with local government authorities in order to create an extended network of Prevention Centres all over Greece alongside several treatment and social reintegration programmes meeting the different needs of addicted persons. OKANA provides an ever-increasing network of services in order to meet the multifaceted prevention, treatment, social and professional reintegration, and harm reduction needs in the best possible way. The National Action Plan 2011-2012 provides for the planning and implementation of OKANA's new programmes and services.


Situation in Athens

Odysseas* is the first supervised facility for drug injection created in Greece. It is sub-project included within a pilot program which is co-funded by the EU through the National Strategic Reference Framework. The aim is to meet the needs that have arisen in response to increased drug use in Greece, mostly in public spaces and the implications of this phenomenon on public health. More specifically, the following factors were of outmost importance to establish the first drug consumption room in Athens:

• The large amount of active drug users out of substitutions programs due to the waiting list; • The significant increase in transmission of HIV/AIDS among IDUs in Attica reached

1500% compared to 2010ii; • The ongoing debate about the social disturbance caused by public drug use and therefore the

need to protect public heatlh. Objectives of the DCR

The objectives of “ODYSSEAS” facility are:

• Reducing public nuisance due to public injecting use;

• Reducing transmission of infectious diseases such as HIV, Hepatitis B & C;

• Protection of mental health in preschool and school age, by reducing public drug use;

• Early intervention in case of overdose, reducing mortality;

• Providing a gateway to drug treatment and other health and social care services.

Services offered by the DCR

• Approaching and informing IDUs for the operation and the available services of ‘ODYSSEAS’ by our street-workers;

• Exploring IDUs perception concerning public drug use and Overdose (OD) using;

Legislative context to permit the opening of the DCR

Up till now there is no legislative context concerning DCRs and ‘ODYSSEAS’ is working as a pilot scientific program. We hope that all the necessary actions, leading to legislative accordance will take place as soon as possible. Political opposition

Like any innovative program, the opening of ‘ODYSSEAS’ could have caused political opposition. Till now ‘ODYSSEAS’ have received only positive reactions in national level. Moreover, the feedback and the support from abroad were both warm and welcoming.

*The name “ODYSSEAS”, is linked to the Greek verb “odussomai” (to be wroth against, to hate someone) which means to be wrathful but as well, the one hated by the Gods, the one who has caused resentment. It is also linked to the Greek verb “odunao” (I cause pain) with the meaning of ‘one who causes and feels pain’.


• Assessment and intake (to determine eligibility for using the service, to sign a consent form information on facility’s rules, to obtain information on drugs to be used, to assess health status and examine the need for referral to other health care services);

• Supervised injection area (IDUs are given advices on safer and more hygienic drug use, the necessary consumption equipment is provided included sterile syringes and needles, water for injection, filters, swabs, cookers etc. Also condoms are provided);

• Monitoring of the effects of drug use among clients who have left the supervised injection area and resuscitation with the use of reversing agents in case of Overdose (OD);

• Psycho-social services: counseling, motivate clients to seek further treatment, providing information about treatment options, referral to other health-care services;

• Risk reduction education and health promotion advices (safe use- safe sex). Operation of the DCR

Our pilot program “Sub-project 3: organization and operation of supervised station in Athens for healthcare of active drug users, early intervention in overdose management and preparation for deug dependence treatment programs” operates since January 2013. Shooting room ‘ODYSSEAS’ operates since October 3, 2013.

Beneficiaries have access to a double seated injection room which can accommodate two people per every half hour. The materials we provide for safe injecting are syringes, hubcap, citric acid, candle, disinfecting wipes. Also, there is a sink where they have to wash their hands before injecting and we provide condoms which they can take with them. In addition, in the injecting room there is a bed for the drug users in case of emergency. As far as the patterns of drug consumption are concerned, for the time being, only injecting drug use is allowed. The continuous growth of the total number of individuals approaching ‘ODYSSEAS’ daily in combination with the small facility, will presumably affect in a negative way the facility’s provided services. So, hopefully within the next months we will be able to transfer our facility into a much bigger building with 10-12 available seats.


Involvement of drug users in the operation of the DCR

Not yet, but we are planning activities in order for the drug users to engage in a more energetic role within ‘ODYSSEAS’. The team

Our scientific team consists of 14 persons.

• Papakonstantinou Anastasios : Psychiatrist/Psychotherapist/Sexologist – scientific supervisor of ‘ODYSSEAS’.

• Galinaki Sofia : MSc Health Psychologist – deputy scientific supervisor of ‘ODYSSEAS’. • 2 Consultant Anaesthesiologist. • 2 RN Nurse. • 2 RN MSc Nurse. • 1 Socio-therapist. • 1 Social-worker. • 4 Street-worker. Choise of the location and relationship with the neighborhood

The location has been chosen based on two important criteria. Firstly, because of the already established service of OKANA ‘DASU’ (Direct Assistance and Support Unit) which offers a variety of medical services, social care service, needle exchange service, legal support service, first aid mobile unit). Secondly, allows us direct access to the target group of our interest (IDUs) as the area attracts a great number of drug users.

The site is located at the towncenter, where the drug activity mainly takes place. The town center as well as the surrounding areas are primarily commercial zones. Moreover, community seems to have adapted well to the presence of 'ODYSSEAS’ due to the fact that OKANA’s services have been an integral part of the locals. In addition, all the necessary steps to inform the proper authorities for our service were taken. That means that the local drug enforcing units have been notified of our program in order to ensure their support and co-operation.


Odysseas address

21, 3rd Septemvriou Street, Omonoia Athens - Greece (Omonoia metro station in 150m) Hours and days of operation

At the moment and since this is a pilot phase, the unit is open from 08.00 am till 16.00, 5 days/week, Monday to Friday. Hours and days of operation will be extended within the next month in order to meet the growing needs of our clients. Financial partners It is a sub-project included within a pilot program which is co-funded by the EU, through the National Strategic Reference Framework, and the national public funds. First results - Data for 2013


Thank you to Galinaki Sofia MSc Health Psychologist deputy scientific supervisor of ‘ODYSSEAS’

Information : www.okana.gr i Country legal profiles: Greece, European Monitoring Centre for Drugs and Drug Addiction <http://www.emcdda.europa.eu/html.cfm/index5174EN.html?pluginMethod=eldd.countryprofiles&country=GR> ii Marianella Kloka1, The HIV epidemic among injecting drug users in Greece during the economic crisis, Drug Policy Dialogue in South Eastern Europe, DIOGENIS Association Νr 4, 2014 <http://www.diogenis.info/ckfinder/userfiles/files/Briefing_Paper_No_4_HIV_2014_doc.pdf>

Interview with Odysseas the first DCR created in Greece...

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