OST heroin treatment denied to SA

A RECENT TV programme on Carte Blanche highlighted opioid substitution therapy (OST) for heroin addicts. As the mother of a son who has a heroin use disorder, I felt a need to write about this.

The reality is that in South Africa our rehabilitation facilities are not fully equipped to deal with heroin addicts. The relapse rate is about 93%.

It is also my view that the Narcotics Anonymous 12-step programme and meetings are not always the answer. It works for a few, but certainly not for the majority of heroin users.

It is important for us all to understand that the quest for abstinence is virtually impossible.

What people with heroin use disorders, like my son, need is proper medical treatment. This means providing them with opioid substitutes such as methadone and buprenorphine. At the moment this is not being done in our public hospitals and is simply fuelling a public health and public safety problem.

OST medication is also not available on our current medical aid schemes. As a result, we are denying people a right to chronic medication which was shown, worldwide, to work.

It is only in the non-profit sector that something is being done. The Urban Futures Centre at DUT (under the leadership of Professor Monique Marks) has started an OST demonstration project in Durban. Fifty low-income heroin users are receiving methadone in a highly supervised environment over 18 months, following international best practice. They are doing this in collaboration with the TB/ HIV Care Association.

The beneficiaries of this programme are doing really well. Through this project, they are not only providing a service to the beneficiaries but are also advocating for OST to be made available in the public sector and as an essential medicine.

It costs roughly R24 000 a year to treat a recovering addict with methadone. For single mothers like myself, this is almost impossible to afford but I am aware that it is the only way my son can lead a normal life. By taking methadone, the transformation in his life is remarkable.

Without medication like methadone, heroin addicts relapse not because they want to but because of the excruciatingly painful and debilitating cravings that come with withdrawal.

Abstaining from heroin is not simply something that happens after “detox”. It’s a lifelong issue that heroin users have to deal with.

The big question is: why has OST not been made available in South Africa? Why are we so far behind other countries internationally?

If our government really wanted to, they could get methadone cheaply, as in most countries where OST is widely available in the public sector.

Countless lives could be saved and relief brought to the suffering of many addicts and their families.

This is a plea to our Department of Health and Social Development to wake up and get proper treatment for heroin users before the epidemic gets worse and we lose more lives. ANG SMITH Durban