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Arch Hellen Med, 31(Supplement 1), 2014, 35-42


Pharmacologically assisted treatment of opioid dependence in Greece today:
measureable results and challenges for the future

M. Malliori1, C. Golna2,3, K. Souliotis4,5, A.E. Philalithis,6 A. Hatzakis2
11st Department of Psychiatry, Medical School, University of Athens, Athens,
2Department of Hygiene, Epidemiology & Medical Statistics at Athens University Medical School, Athens,
3Hepatitis B and C Public Policy Association,
4Department of Social and Educational Policy, Faculty of Social and Political Sciences, University of Peloponnese, Corinth,
5Center for Health Services Research, Department of Hygiene, Epidemiology & Medical Statistics, Medical School, University of Athens, Athens,
6Department of Social Medicine, Faculty of Medicine, University of Crete, Greece

In 2011, 20,473 Problem Drug Users aged 15-64 were estimated to be living in Greece. Of them, only 4,771 were on pharmacologically assisted treatment, at a coverage rate of a mere 21%. Another 5,558 were waiting to get on treatment for 7.6 years in Athens and 4.4 years in Thessaloniki. In mid-2011, OKANA, opened up access to pharmacologically assisted treatment (OST) in 33 additional centers in general hospitals across the country and increased coverage from 21% to 40%. Within 12 months, the waiting list to get on treatment was halved (to 3.6 years) in Athens and almost eradicated in Thessaloniki and the rest of Greece. A substantial, 7-fold increase in Needle and Syringe Programme (NSP) coverage, was also implemented particularly in Athens, in a coordinated effort of state organizations and NGOs to manage the explosion of HIV incidence amongst People Who Inject Drugs (PWIDs). The systematic and measurable improvement in treatment coverage, which was in turn reflected in decreases in HIV/AIDS incidence amongst PWIDs, was important as an urgent and imperative first step to address the HIV/AIDS challenge. Yet, it cannot be further improved yet, to cover the waiting list of 2,600 people (as of December 2013) or sustained under severe budget cuts, without structural changes in the way treatment is provided. Such changes would help address specific and persistent challenges, as: a) the ongoing increase in the (diversified) need to access treatment in circumstances of severe budget cuts, b) the ongoing integration and support of the treatment process through to recovery and, c) the ongoing management of addicto-phobia and social stigma.

Key words: Economic crisis, Harm reduction, People who inject drugs, Pharmacologically assisted treatment of opioid dependence, Waiting list.

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