Saskia Jünger, health scientist at the University Hospital of Bonn (Germany) and member of the ATOME Project Management Team; Marjolein Vranken, pharmacist and lawyer at the Utrecht Institute for Pharmaceutical Sciences (the Netherlands) and member of the ATOME team; Aliki Tserkezoglou, Scientific Director of Galilee Palliative Care Unit and leader of the Greece ATOME country team.
Unrelenting commitment despite adverse conditions
On 20 November 2012, the 4th of 12 ATOME national conferences was held in Athens, Greece, with the aim to improve access to opioid medication. Marinos Skandamis, the General Secretary of the Ministry of Justice, Transparency and Human Rights, officially opened the conference.
More than 50 delegates – mostly physicians, lawyers, pharmacists, policy makers and representatives from non-governmental organisations – attended this conference. Despite the fragile financial and political situation, participants listened, discussed and worked on the national strategic action plan with an unrelenting commitment to their goal of improving access to opioids in Greece. Their engagement was reflected in vigorous arguments and discussions following presentations from national and international speakers.
Hand in hand
Different perspectives from within the country and from outside provided a condensed view of issues about opioid availability in Greece, which together reinforced the momentum of change.
Associate Professor Erifili Argira, anaesthesiologist at the pain clinic of Aretaieion University Hospital, highlighted the pitfalls in current practice she experiences in her work as a medical specialist:
“Legislation in Greece is mostly concerned with abuse and fear of opioid dependence, being a criminalisation model rather than a public-health model to facilitate care and reduce harm. Our legislation is adding to the stigma of illegality to those in need of opioids.”
Marjolein Vranken, lawyer and pharmacist at Utrecht University, confirmed these findings with the results of the legislation analysis that had been conducted within the ATOME project: major barriers had been identified in the areas of prescribing, dispensing, and use of stigmatising language in the Greek legislation. Dr Spiridon Karanikolas, Legal Advisor at the Ministry of Justice, Transparency and Human Rights, introduced the national strategic action plan that had been worked out during a previous ATOME workshop. Five key objectives had been identified to improve Greek-controlled substances legislation and were submitted to the Ministry, including more adequate regulations on dosage, treatment duration, as well as incorporation of international treatment guidelines.
Waiting for too long
Inadequate opioid availability not only affects pain treatment and palliative care, but also the medical treatment of drug dependence. “It is unacceptable for someone to wait several years for treatment”, says Associate Professor Melpomeni Malliori, President of OKANA, the Greek Organisation Against Drugs. When she started her work at OKANA in 2010, there was a long waiting list; more than 5,000 people had applied for treatment and waiting times were up to seven years. The association managed to reduce the waiting list with a gradual increase of treatment units between 2010 and today.
A high level of energy was noticeable when the results of different working groups were presented at the end of the day. In addition to changing legislation and improving education, raising awareness, and implementing treatment guidelines for the correct use of opioids in palliative care and in harm reduction were highlighted as major objectives for the next weeks, months and years. Dr Willem Scholten (WHO) closed this intensive day by emphasising the importance of communicating the outcomes of this conference to journals, to the general public, and to have the recommendations adopted by relevant professional associations: “If you keep what happened here today a secret – nothing will change.”
Find out more…
Visit the ATOME website, or click here to read previous posts about ATOME projects. And please look out for more information on the development of palliative care in Greece in a forthcoming post by Associate Professor Kyriaki Mystakidou and Matina Symeonidi.