Fotini Leobilla dedicated her life to preventing drug overdoses in Athens, Greece. In the early 1980s, she began using opioids and continued using them until her husband died of an overdose in 1998. Through her recovery, she continues to recognize the shame that keeps people from get treatment. She is “haunted by the countless overdose victims” she has encountered along the way.
Athens is one of many cities around the world working to combat the opioid crisis. Worldwide, about a third of the approximately 600,000 annual deaths from drug use are caused by overdose, in most cases from opioid overdose.
In addition to expanding access to treatment for substance use disorders, in March 2023, Greece, through the Ministry of Health and OKANA with the strong support of Prime Minister Mitsotakis, took steps to expand access to a drug capable of reversing an opioid overdose in seconds by prioritizing policies allowing the use of naloxone.
The city of Athens played a catalytic role in joining the Partnership for healthy cities which helps support this initiative and has added its weight to an alliance of local agencies committed to improving emergency responses and treatment of people who use drugs. Athens Mayor Kostas Bakoyannis and the Ministry of Health, along with industry stakeholders, are leading the campaign to create a new national law that would make naloxone more accessible, including to friends and relatives of people who use drugs.
As a result, naloxone is now available in Greece to most health workers, but Fotini wants to further expand access so that anyone who uses drugs or may witness an opioid overdose can have the drug at hand.
The City of Athens’ strategy builds on decades of investment in harm reduction services provided by OKANA and the Addiction Organization (KETHEA) who have developed an extensive support system for people living with substance use disorders.
Globally, only one in five people living with a substance use disorder receive treatment, highlighting significant barriers to accessing care.
But in Greece, OKANA President Athanasios Theocharis helped pave the way for a comprehensive, long-term treatment approach accessible to anyone struggling with opioid addiction.
This inclusive therapy encompasses the restoration of physical and mental health, as well as the reintegration of individuals into society. Among its services, OKANA offers 64 facilities including opioid substitution therapy treatment centers, 75 prevention centers and a drug consumption room.
Currently, naloxone is administered by OKANA healthcare professionals and street workers on the ground, saving lives. To date, 373 experts have been trained and 131 overdose cases have been successfully reversed using naloxone to save lives.
Bakoyannis made naloxone a central part of the city’s strategy to prevent opioid overdose deaths by adding medication to the toolbox and empowering more communities (family, friends and work crews). street) trained to approach people and establish relationships of trust.
This approach is consistent with WHO guidelines on Community Management of Opioid Overdoseswhich recommends that people who may witness an opioid overdose have access to naloxone and be informed about its administration to help prevent an opioid overdose.
“Drugs like naloxone and methadone are deemed essential by WHO to prevent and respond to drug overdoses and to treat drug use disorders,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, at the recent launch of the Global Coalition for combatting synthetic drug threats in Washington, DC, USA.
The city of Athens was recognized for this initiative in March by the World Health Organization, Bloomberg Philanthropies and Vital Strategies at the inaugural Healthy Cities Partnership Summit in London.
Mayor Bakoyannis cited cooperation and coordination as key elements of this initiative: “Gone are the days when each of us did what we wanted, guided by our own good intentions. We must unite our voice with that of every agency, scientist and family to change the legislative framework governing naloxone. Too many Athenians do not have access to it due to bureaucratic procedures. The failure of this model is obvious, it has reinforced stigma rather than awareness.”
George Kalamitsis, president of the Hellenic Liver Patients Association-Prometheus, which is part of the city coalition, said: “There is no real stereotype for people living with opioid addiction, such as users poor people often represented in the media. In truth, the victims are our family members, our spouses, our fellow students and our colleagues.
Fotini Leobilla knows all too well the importance of making naloxone more accessible. She remembers using opioids with someone who had overdosed, but fear of her own legal consequences almost led her to abandon her friend. Instead, she called emergency services so they could help her. Emergency responders were able to locate the victim, provide naloxone, and immediately reverse the overdose.
Fotini draws on her personal experience to explain why she continues to advocate for new resources and support structures. “It is with an urgency born of my own experiences that I plead for this life-saving antidote to be adopted and made widely accessible. Naloxone is not just a medication; it’s a beacon of hope, a second chance, and an opportunity to reclaim lives otherwise lost in the shadows of addiction.