In Athens, Ingrid met Marios, Positive Voice's Harm reduction officer and an ex-user himself. “At Positive Voice they were a bit emotional. A client had died of Aids that week,” says Ingrid. “That person was diagnosed too late so that the disease was already too advanced. Go figure, in 2022 someone in the European Union dies of Aids because of late diagnosis.”

Positive Voice is an organisation that focuses on HIV testing and care and has contact with groups that have an increased risk of HIV, including people who use drugs. “In the Netherlands, just a few drug users have HIV, but that is not the case in Greece.” Positive Voice tests people on the street for HIV, they hand out clean needles and provide wound care on the spot. They do this together with five hundred volunteers.

Undertaking fieldwork

“Drug-related problems are major in Greece. Marios took me to an 'open drug scene', just a few blocks away from where carefree tourists enjoy the sun at outdoor cafes. I've never seen so many people injecting on the street. I saw the hands of thirty-year-old persons full of abscesses and totally swollen from injecting. In four hours, I saw around hundred users who were clearly high, hanging around in the streets and some of them injecting in front of the needle exchange."

There are no drug consumption rooms in Greece. “Between a mini-market and the entrance of a house, there were about eight guys hanging around, to whom we gave bags of clean gear. Fences were placed in front of the stairs of the house so that they couldn't use them. I thought: why is the mini-market not intervening? But when I looked inside I saw that the cashier was high himself. Who knows, maybe he deals from the mini-market.”

“The fieldwork on the street is very different from in the Netherlands. When I was a outreach worker, I really had to search for people who use drugs outside. And the main thing I had to give them was a Mainline magazine and a chat. Here, Positive Voice hands out scarce clean needles and the people really want to talk and can be found everywhere. According to the outreach workers, they really appreciate non judgemental contact with people outside the scene.

The most commonly used drugs are heroin and meth, but both are usually of low quality. It is mainly black tar heroin and Shisha meth. But they also seem to use something made from cooked fentanyl patches and codeine. Most of the people who use drugs I saw are between twenty and forty years old. But there also seem to be young refugees who are recruited as drug couriers and later became dependent on drugs. The street-based populations consists of men and women and ranges from Greeks to migrants and refugees. According to Marios, there were Iraqis, Afghans, Syrians, Romanians, and Kurds among them.”

Crisis upon crisis

“This problem has escalated through multiple crises. Due to the financial crisis in 2008, poverty increased, life expectations of all Greeks have deteriorated and there have been huge cuts in health care. Consequently, fewer clean needles are available and as a result, there was a huge peak in new HIV cases. Between 2010 and 2012, there was an increase in the number of infections in Athens from about thirty to a few hundred.” On top of that came the refugee crisis in 2014-2015. “Those people fled their homeland because of the war and end up here in the next bucket of misery.”

"I think the situation for people who use drugs in Athens is terrible. Something has to be done here. I came here with the question: what do the drug-using migrants need? But it’s not only migrants that need better care, also the Greeks. You think: basic care for people who use drugs is fine in the European Union. But it is far from even ok.”

Project and contact

Find more information about our project for vulnerable migrants who use drugs in the European Union on our project page. Or feel free to reach out to us via info@mainline.nl. 

The Positive Voice outreach team in Athens. Photo: Dimitris Bouras