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Arch Hellen Med, 33(4), July-August 2016, 550-561


Report of the European ATOME project:
Access to opioid medication in Europe (2009–2014):
Conclusions on the situation in Greece

Μ. Bouri,1 Α. Tserkezoglou,2 Μ. Μystakidou,3 S. Κaranikolas,4 C. Spiliopoulou5
1Regional Pediatric Clinic, Primary National Health Network, First Health Region of Attiki, Athens,
2"Galilee" Palliative Care Unit, Holy Metropolitan Diocese of Mesogaia and Lavreotiki, Spata,
3"Jenny Karezi" Palliative Care Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Athens,
4Lawyer, Athens,
5Laboratory of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, Greece

The ATOME (Access to Opioid Medication in Europe) project was initiated in 2009 by the Access to Controlled Medications Programme of WHO, co-led by national and international partners and funded under the 7th Framework Programme of the European Community. The core purpose of the project was the improvement of accessibility and availability of opioids in 12 European countries for which statistical data showed inadequate per capita morphine consumption. Participating countries, including Greece, were each invited to form a national team which collaborated with the project consortium throughout the program. The ATOME project followed two parallel tracks: (a) Analysis of national policies and national circumstances that affect the accessibility and availability of opioids, and (b) review of relevant national legislation in order to indentify possible barriers to opioid accessibility, including their availability, rational use and reasons for underuse. Recommendations were also made with the purpose of optimizing the legislation and national policies so as make opioid medicines readily available and accessible for rational medical use, while preventing abuse and dependence. Potential barriers to accessing opioids in Greece have been identified in the areas of legislation and policy. The ATOME committee recommends that the Greek legislation should be revised to provide a legal framework that focuses on optimizing healthcare outcomes while preventing diversion and dependence. Regarding the policy barriers identified in Greece, the ATOME project recommendations include increasing the awareness of governmental officials regarding the importance of pain management, extending education and training for healthcare professionals concerning the medical use of opioids, developing palliative care training and continuing education programs for health professionals, sensitizing the public on the role of opioids in pain palliation, and developing and implementing guidelines on opioid substitution treatment. Some of the suggestions were included in the recent (2013) revision of the Greek legislation regarding opioids; continuing efforts are needed, however, to facilitate improvements at various strategic levels while preserving a balance between availability and accessibility of opioids and prevention of misuse and diversion.

Key words: Accessibility and availability, Controlled medicines legislation, Opioids, Palliative care.

© Archives of Hellenic Medicine