Dear Steps…

Dear Steps… - Steps Org


The first day Louis and I joined your team, I have to admit I was nervous and a bit scared. I had never experienced such intimacy working with drug users in their own environment. I had never seen people injecting heroin before. It was a strange feeling watching people come collect a needle from us, opening it up immediately and inject themselves a few meters away. But what I have come to learn is that this trust and intimacy of the way you work and relationships you have built with these people is what makes STEPS so unique.

Working closely with sex workers has been a valuable experience for me. In particular one woman, has taught me about life on the streets and the daily routine of being a sex worker. On my first day with Steps I met this woman who was known to STEPS previously, she had a severe skin infection on her hands. A complicated illness that seemed to be due to her weakened immune system and was likely caused by a sexually transmitted infection. Due to street embrace I was able to see her three times a week, progressively healing her hands, cleaning them and giving her antibiotics to treat the cause. This allowed us both to focus on a mutual goal but also gave me the opportunity to gain some insight of her life. As her hands healed, it became clear that her skin condition was a superficial manifestation of the real struggles she has to endure. Sleeping in a bed depended on her getting a client that day. The food she ate, cigarettes she smoked and drugs she was able to buy all depended on the number of clients she had; and as her hands healed the less frequently I would see her. It was a bitter-sweet feeling as I knew that when she was not sitting in her usual place, she was working or using drugs. To a certain extent I felt I was perpetuating the cycle of her misfortune, but I had to disregard my centered thoughts and realise I was giving her relief and treating her to the limit of my abilities. The difficulty with this kind of work is that there is a limit to what you can give someone. Despite saying she wanted to get off the streets I know that I alone would not be able to change her social situation, as much as I wanted to, but recognising this is crucial as we can only provide people with support and dignity, to enable them to access services that could help.

The emotions I felt working with STEPS ranged from frustration and sadness to happiness and gratification. For a few weeks we saw the same man, with a cage and pins around his legs from a previous surgery. His leg was infected and he needed emergency treatment. The first few times he did not want to go to the hospital as he was afraid of withdrawing if he were to be admitted for a few hours. So we cleaned his leg as best we could, despite his severe pain. After a few more times cleaning his wounds and a few days he agreed to go with us. When we arrived at hospital the doctors refused to treat him, as he was an IVDU and missed his previous outpatient appointment. I managed to convince them to see him the next day, and with great success his pins and cage were removed, we gave him antibiotics and I felt a change in his energy and seemed determined to focus on his health.

Dear Steps… - Steps Org

That week we tried to get him into a hostel so he could get off the streets and have access to services to enable him to get better. But he was refused a bed due to the fact he had crutches and was not ‘independent’. For a whole week and a half I didn’t see him. Yesterday I saw him for the first time and he did not seem as enthusiastic to see us. He had not finished his antibiotics and he was not able to speak to us very well, a friend of his said he had been using a lot recently. Despite this he did not have an open wound anymore and his pain seemed to be improving. However, it makes me frustrated that he was refused access to the hostel as I really felt he was determined to improve his health and as a result may be able to receive support to get off the streets. From this emotional experience I believe sorting out an open wound has changed his quality of life and his appreciation for us taking time to look after him was an incredible feeling. Working with drug users is challenging as their top priority is getting their next hit; health is the last thing on their mind and as a medic we need to acknowledge this and be patient with their progress. You can not change people and you can not force people to seek medical care, but what we can do is be available to help them when they do seek help and treat them with dignity and respect. Passing judgement on someone’s lifestyle will hinder your relationship with them and further push them away from seeking the services they need.

Wound cleaning is not complex, but what I have learnt is that simply taking the time to clean someone’s injury, gives them an opportunity to speak. Being able to listen to someone is a powerful skill and being able to simply listen and be empathetic is sometimes the best medicine. You are never going to change someone’s social situation in a 10 minute conversation. But what you can do is make them feel dignified, give them humanity and support for a brief moment. Because it may be the only time that day or week that someone has just been there to listen.

What STEPS has taught me, for my future career is that being a doctor is more than fixing a biological problem. It is about making people feel safe, heard and not alone. I hope that I will take this away and keep this as my goal for being a medical professional.

I also want to praise your style, professionalism and the safety of the way you work. Caring for eachother and keeping each other’s safety at the forefront of your minds has really stood out to me. It is a very rare and beautiful thing which you must be proud of, and thank you for extending this care to myself and Louis, and making us feel secure when we carry out our work. Thank you for the opportunity to work so closely with your team for the past 8 weeks. I have truly developed as a person and am looking forward to how this experience will shape my career.

Love from Issy.


Press Release: One lawyer | A “street” programme supporting street-connected people

The “Street Lawyering” programme is providing legal aid in vulnerable groups of people/persons who live on the street, such as homeless, users of psychoactive substances and sex workers.

Welfare state was created to balance society’s weaknesses. However, lots of socially marginalized people cannot address to state services for a variety of reasons, including their situation/status but also the structure and operation of the system.

One lawyer | A “street” programme supporting street-connected people

People in the bounds of wretchedness, victims of the financial crisis, drug users, sex workers, recognized refugees, migrants without legal documents in search for food, now can discuss their legal issues or other problems that in many cases may be responsible for the situation they are into and get information regarding their rights.

The aim of the action is the investigation of legal and pending issues of street-connected people which, apart from the personal burden, often are the cause of the situation they are in. An attempt to investigate and resolve these issues may be the first way out, the start for an overall integration, or even the reduction of fear towards the unknown; justice, police, administrative and bureaucratic procedures. At the same time, we aim to discuss with relevant stakeholders all the legal changes and possible interventions in order to improve access to rights and living conditions for homeless people.

Our lawyer, Katerina Pournara, participating in STEPS’s field team is in the streets in the center of Athens providing legal aid to the abovementioned vulnerable groups, three days per week. “Usually the lawyer sits on his or her desk providing advice or solutions already determined from the initial request. By inverting the common practice, in a world already moving upside down, we got out on the street to understand the truth, investigate the request, provide advice and assistance to people who at this point may not be able to ask for it”, she highlights on the work she has taken over through the programme.

For more information:

Tassos Smetopoulos, Street Actions Coordinator/Legal Representative of Steps.

Email: [email protected], Tel: 6931471277


Guide for Exchange/ Sharing of used Syringes, 1st Edition, November 2018

During street-work, especially in open drug scenes, specific rules need to be followed for the safety of the street-workers and the broader population. Notably, the procedures need to be clear and strictly followed when the street-work includes exchange and collection of used syringes, as the danger of infection gets higher.

In this guide you can find the framework of a street-work team’s function is analysed for the case of syringe collection and/or exchange.

The guide/handbook is provided either on its own or after a 2 hours training seminar in the framework of social and solidarity economy. The guide/handbook is provided either on its own or after a 2 hours training seminar in the framework of social and solidarity economy. For more information you can contact us at [email protected] or by pressing here.

Download for free the guide: Opiate Overdose [[pdf]] EN | ES | GR


Would you save the one you love?

Would you save the one you love?

World 2019.

“Thank you, I do not want any more, I have eaten a lot of sugar today”
“This course is super-salty but super-tasty.”
“It is the sixth coffee that I drink today to keep working!”
“I want you, I want like crazy!”
“Give me just one more minute, I finish that game and turn the pc off.”
“ …Heroin’s overdose. (S)He does not breath, do come quickly!”

All of the above is a kind of overdose. Isn’t it that all of us experience moments of overdose? Sugar, salt, coffee, pc and love may not instantly kill you but heroin – as any opioid – does.

If you have an overdose from some opioid and the medical staff will not arrive on time, you die. This is the reality!

Specifically, more than 60.000 people in the world die every year from drugs’ overdose.

Is there any antidote to overdose? Yes. Naloxone.

What is naloxone?

In 2014, the World Health Organisation (WHO) positions naloxone as an elementary medicine and it edits guidelines for its proper use, In 2017-2020, naloxone is consisted in the EU and the UN’s policies for drugs. It is an emergency medicine, which brings the body back to normal functioning until medical personnel arrive.

It is an emergency medicine, which brings the body back to normal functioning until medical personnel arrive. Naloxone is the substance that can literally reverse the effects of an opioid (such as heroin) on the body and is used in cases of overdose in order to bring the human back to life.

It can pass into the blood in two ways: intravenous use, via a syringe, or in a nasal spray. Within a maximum of 5 minutes after its administration, naloxone restores the person’s breathing.

In order to save someone from an overdose, naloxone can be used by a simple, unskilled medical person, with the help of a naloxone package containing everything necessary for its safe use. All it takes is a brief training to anyone possibly in need to use it.

Only in the EU countries and based on official data, in 2018, 8,200 lives were lost due to overdose. From 2012 onwards there is a 62% increase in deaths.

At the moment, the Take-Home Naloxone program is being implemented in 10 European countries, including Britain, Denmark, Germany, Estonia, Scotland and Wales.

At the same time, in 7 European countries, it is possible to use naloxone in areas of supervised use, in the context of reducing the harm from the use of psychoactive substances.

Greece 2019

The creation of supervisory sites was approved by the Greek parliament by 229 votes, and the national drug plan is a step ahead of its implementation. Free access to naloxone packages with all the essentials for safe use, however, is missing from the plan. Naloxone remains the privilege of medical personnel.

That may be late and when it is, the overdose of heroin -as we said- has the power to kill you – and this never comes late.

Greece 2019. Would you save the one you love?

The claim is clear:

Naloxone should finally be removed from the list of only hospital drugs and made immediately available to the users themselves, their parents, friends, companions and anyone close to people with problematic opioid use.

Support our campaign for the free disposal of naloxone today! – #naloxone-saves-lives #give-naloxone-kits-now

You can find more at:


Press Release: International Overdose Awareness Day

Today, August 31, is the International Overdose Awareness Day.

Today, we claim the information, prevention and reduction of overdose and consequently the deaths it causes.

What is an overdose?

According to the IOAD, “[a]n overdose means having more of a drug (or combination of drugs) than your body can cope with. There are a number of signs and symptoms that show someone has overdosed, and these differ with the type of drug used. All drugs can cause an overdose, including prescription medication prescribed by a doctor.”

International Image:

Deaths from drug overdoses remain higher than the annual total number of deaths from road accidents and AIDS, and their rapid growth in recent years has reduced overall life expectancy in the United States.
In the US from 2013 to 2017 the number of overdose deaths increased by 90%.
In 2017, 70,237 deaths were recorded in the US and 8,238 in EU member states.
4% of all deaths in Europe, between the ages of 15-39, are due to drug overdose.
Two out of three drug overdose deaths in 2018 were related to opioids (most of them due to a combination of drugs). The largest percentage is due to the use of synthetic opioids (fentanyl).
Deaths from illicit psychostimulants, such as methamphetamine, increased by more than 250 percent between 2008 and 2015 and by 33% between 2016-2017.
The COVID-19 pandemic period has also dramatically affected overdose deaths, with a record number of deaths in many US states and provinces, with concerns about a larger increase over the year.

Let’s talk about Greece
Numbers and Recording of Deaths

According to the National Center for Documentation and Information on Drugs (EKTPN) there is a reduction in overdose deaths in the years 2005-2016, while a 50% increase is reported in 2017-2018.

However, the way in which deaths are recorded in Greece is the subject of intense criticism and controversy both nationally and internationally. Until 2017, the recording comes from the Drugs Department of the Public Security Department of the Hellenic Police and since then EKTEPN in collaboration with ELSTAT is investigating the issue further.

Greece is the only European country without official data in the EMCDDA (European Monitoring Center for Drugs and Drug Addiction).

Harm Reduction Policies

Harm reduction in relation to drugs seeks to minimise the harm (prevalence of diseases, deaths, etc.), but without necessarily imposing the reduction of consumption. Some of its policies are:

1. Drug Consumption Rooms (DCR)

The DCRs aim to promote the health of active drug users, protect the public health, prevent and intervene to address overdose, mobilize and link to treatment programs, promote social inclusion.

The creation of DRC was legislated in 2019, 6 years after the closure of ODYSSEA, the first DCR that OKANA had opened. However, today and being a year after the legislation, no action has been taken towards their operation.

2. Naloxone

Naloxone can bring back to life a person who has had drug overdose. It can be administered intravenously or in the form of a spray, inhaled through the nose. Within a maximum of 5 minutes after its administration, naloxone restores breathing and presents no contraindications at all.

In Europe, its disposal and administration as a harm reduction measure is a common and widespread practice (in DCRs and individually in Take-Home programs).

In Greece, naloxone is only available as a hospital drug and individual access is absent even from national drug planning.

3. Clean use kits provision to street-connected people

The provision of clean injectable material by street-workers is a limited but existed practice in Greece. Outreach actions are usually carried out by KETHEA, OKANA, KELPNO, and other Civil Society organizations.
The supply of inhaled material is completely absent from the Greek field, although the use increases sharply and alongside the subsequent deaths. In Athens, we observe a dramatic increase in the use of “sisa”, that is crystal methamphetamine of questionable quality, that deteriorated health rapidly.
The provision of harm reduction kits lacks institutional coverage. The organizations that provide them act under an uncertain legal framework.


‘Good practices’ are numerous internationally. The only one responsible for overdose deaths is the state and the policies that have been pursued for the last 30 years, at least.

Political parties may alternate, but death policies remain, targeting and stigmatizing people. Social stigma and repression increase the risk of death, as it isolates and marginalizes the person who does not have substantial access to public health, treatment and information services.

During the last year, the repression – mainly on the occasion of the COVID-19 era – is the main narrative of an authoritarian government whose only concern is its image.

The lives of people who make problematic use of psychoactive substances count!
Press Release in .pdf here | Contact details here.