The project, run by the Durban University of Technology’s Urban Futures Centre together with TB HIV Care, is the first of its kind in South Africa. It administers methadone to heroin users as an opioid substitution.
Opioids are drugs that act on the nervous system to relieve pain.
Methadone is a legal and regulated medication. It has been used since the 1960s as a safe and effective medication for assisting with withdrawal from heroin and for longer term maintenance for people who have been heroin users but who have opted to abstain from heroin use or to radically reduce its use.
While methadone does not create the same “high” as heroin, it works the same way on the opioid receptors as heroin does.
Heroin comes in many forms, and in South Africa at present, it is most widely used on the streets in the form of whoonga, sugars or nyaope.
Professor Monique Marks from the Centre said the project had yielded positive results and they are currently discussing the possibility with the national department of adding methadone to the essential medicines list.
“The department is very open to rolling out Opioid Substitution Therapy (OST) nationally,” she said.
She explained that in KwaZulu-Natal, the department was supportive of the programme. “A number of hospitals have contacted me, especially psychiatrists and psychologists, asking for more information on OST.”
Marks explained that each beneficiary was supposed to be on methadone for 18 months and while many had completed this cycle and were no longer on methadone, some were still using the services at the drop-in centre in Umbilo.
“Some have chosen to continue with methadone at their own cost. There are still a number of beneficiaries who will only complete the 18 months in March,” said Marks.
The project not only included the administering of methadone, but also entailed tracking their changing quality of life. The indicators used in this tracking were the reintegration of beneficiaries with their families, and watching their improvement in health.
Marks said they had also started looking at another holistic intervention for drug users which was an integrated harm reduction space and this was currently in operation temporarily at the drop-in centre in Umbilo as well as on Esplanade.
“This is while we are in talks with the eThekwini Municipality to get a state-of-the-art centre built for this purpose of an integrated harm reduction space which will be called the ‘Africa Centre for Hope’,” she said.
Marks said this centre was being championed by deputy Mayor Fawzia Peer and services would be run by non-profit organisations.
“Some of these services would include the OST programme, needle and syringe programme, an overdose prevention space and a space for a feeding scheme.
“We would like to include a primary health care facility in the centre too.”