Harm Reduction / Low-Threshold Services

Low-threshold services aim to approach and assist users who have not joined a treatment programme mainly because they have not been motivated to, and because they do not accept they have a problem. These people can be approached through outreach work at drug dealing spots ('street work') or services admitting users unconditionally.

Low-threshold services aim to:

• provide medical help for health problems or refer users to other health services
• encourage and consolidate user contacts with the health system
• motivate users to join treatment programmes
• bring down drug-related crime rates
• promote harm reduction (preventing the transmission of infectious diseases)

In a harm reduction context, low-threshold services include needle exchange programmes and free condoms distribution. Such programmes are quite common in EU Member States.

Conscious of the need for a similar service in Greece, in 1997 OKANA set up a Direct Assistance and Support Unit (previously named Assistance Centre) to cater to drug users. Later on OKANA established the 1031 Hotline and the Drug Addicts Care Facility.

The Direct Assistance and Support Unit provides for harm-reduction services aimed to meet immediate health needs and transmission prevention needs with regard to AIDS, hepatitis and other STDs.

By means of its specially equipped and staffed clinics, the Unit provides primary health care to psychoactive substance users who are in need of specialised care. What this Centre does is very important, considering that users are really difficult and, many times, undesirable patients for mainstream health services to see to.

The Unit offers:

• medical services: general medicine clinic, dental clinic, microbiological laboratory
• social care services: counselling, psychological support, motivation to seek treatment, user referral to treatment programmes, information on the services provided by the Unit or other health service providers, seminar on safe use and behaviour patterns
• a mobile first aid unit: for drug use emergencies (in cooperation with the National Emergencies Centre, EKAV)
• a needle exchange service: users can exchange their used needles for sterilised ones
• a legal support service: provided to members of the OKANA's Substitution Units.

Direct Assistance and Support Unit: 21, Septemvriou 3rd St., 10432 Athens, Τel.: (+30)210-5224202, 5224276, 5224436, Fax: (+30)210-5224265

This OKANA hotline has been operational since September 2000. It is a member of the European Federation of Telephone Assistance Services (FESAT), and its experienced staff have received special training.

Respectful of the principles of confidentiality and anonymity, 1031 provides:

• immediate access to information about psychoactive substances and their use, prevention and Prevention Centres, treatment services, and OKANA programmes
• individual counselling on a short-term basis
• immediate help and psychological support in crisis situations related to substance use (withdrawal syndrome, suicidal behaviour, relapse prevention)

Moreover, this hotline helps keep a record of and evaluate caller problems and needs, which is a valuable input to furthering service development.

1031 provides reliable and valid information:

• to drug users, their friends and families
• to persons in urgent need of help in crisis situations
• to health professionals seeking specialised information
• to the general public

1031 Staff answer calls from 9am to 3pm Monday -Friday

The Addicts Care Facility of OKANA opened its doors in April 2003. It is a cosy, friendly and safe setting of multiple activities allowing psychoactive substance users outside treatment programmes to cover their basic hygiene and safety needs, to get psychosocial support in order to change their behaviour in a positive way, and to engage in creative activities.

This Facility is mainly addressed to psychoactive substance users who:

• shut themselves out of physical and psychosocial support services because of their negative and unsuccessful treatment experience from a treatment programme, outpatient clinic, hospital etc
• as members of an ethnic, linguistic, social, age or other minority (refugees, immigrants, Romanies, people prostituting themselves), they face serious objective difficulties in accessing information, have only a few rights and are distrustful of state authorities
• are homeless, have no family, are young adults still going through their initial addiction stage and distrustful of calls to improve their lives and face up to their problems

 At the Addicts Care Facility, users can meet the following basic needs:

• Board (meals, coffee, juice)
• Personal hygiene (taking a shower, shaving, doing one's laundry etc.)
• Health care (information on how to deal with existing or potential health problems, referrals, facilitation of tests to be taken etc.)
• Medical care provided in cooperation with the Direct Assistance and Support Unit and other similar health service providers
• Social care focusing on psychological support via individual and group counselling
• Information on substance use risks, possibilities for safer use, social welfare issues, community resources to be tapped into, treatment possibilities
• Getting away from the dealing spots
• Creative activities focusing on social skills, and recreational activities.

The Addicts Care Facility runs also a "streetwork" programme: free needle and condoms distribution at drug dealing spots

 Addicts Care Facility: 46, Kapodistriou St., from 8am to 3pm. tel.: (+30)210 5202799, (+30)210 5202899.