Fighting drugs with drugs
A contentious heroin treatment is gaining ground in SA rehabilitation centres
FRIDAY JANUARY 26 2018
AGROUNDBREAKING rehabilitation is set to change the lives of some 60 heroin users in Cape Town. Shaun Shelly, who established the first non-abstinence focused community programme for drug users in Cape Town, explained the benefits of treating heroin addicts with methadone.
Methadone can be used for treating an opioid withdrawal, or may be taken on a long-term basis to prevent a relapse to abused opioids, like heroin.
According to Home Detox SA, methadone was initially rolled out in an effort to combat heroin addiction worldwide.
“Methadone however came with its own problems and many heroin addicts become addicted to both heroin and methadone or just methadone. Methadone is one of the most addictive substances on the planet. It is little surprise then that South Africa has many suffering methadone addicts.”
While the treatment comes with its own problems, Shelly believes in it.
“In Cape Town, we started a small cohort of about 60 people. With this treatment we see an increased rate of people moving to more stable accommodation and we see improved health.”
He said the drug is not available in the public sector and is 10 times more expensive in South Africa than anywhere else in the world.
He said before getting into the programme, addicts would first undergo medical assessment.
“After the medical check what would happen is they get initiated with methadone and you have to be careful in the first 14 days as there are risks, as they top up on heroin and that type of thing. Then we build up a dose until they are stable.”
He said the methadone lessens dependency and users would only need one dose, as opposed to multiple doses like with heroin.
“It helps them find some stability and less frequent drug use… it makes sure that you are not craving and if you are and take heroin, it doesn’t have the same effect.”
He said they have four programmes across the country and they have a good retention rate.
Dr Abdul Kader Domingo, senior lecturer in the Department of Psychiatry at Stellenbosch University and a specialist psychiatrist said heroin is the most commonly abused drug in the country.
“Some healthcare practitioners are concerned about the utilisation of these medications to manage an opioid addiction, that it is ‘merely substituting one drug for another drug’. This view is in my opinion a misguided one, as this form of therapy allows individuals to make a shift from being a drug addict to becoming a patient, provides them with access to treatment that has been shown to improve abstinence rates, is considered the best pharmacological treatment for opioid addiction and allows them the opportunity to rehabilitate and re-establish themselves in the community.”
He said while service accessibility may vary, South Africa has several organisations providing treatment for substance use disorders. “The biggest hurdle facing individuals with chronic addiction is the stigma associated with it.”