The agony of ‘turkey­ing’ that is felt by street-based drug users

Cape Times - - METRO - MJ STOWE

“They don’t un­der­stand what it’s like to turkey, to ex­pe­ri­ence this. They never will, but they laugh and mock me

THE coro­n­avirus dis­ease 2019 (Covid19) is cur­rently a global pan­demic.

To re­duce the risk of trans­mit­ting the virus, coun­tries all around the world are im­ple­ment­ing var­i­ous re­stric­tions on pub­lic move­ment and con­tact.

In South Africa, there is cur­rently a lock­down pe­riod, which was ini­ti­ated on March 16 and is cur­rently sched­uled to be in place un­til the end of the month.

Un­der this lock­down, in­di­vid­u­als may not leave their place of res­i­dence ex­cept for clearly de­fined rea­sons, out­lined by the South African Gov­ern­ment.

These re­stric­tions have a sub­stan­tial impact on street-based peo­ple, es­pe­cially those who use drugs and are likely to ex­pe­ri­ence ad­di­tional com­pli­ca­tions when their move­ments are restricted.

Liv­ing on the street and not be­ing able to move around is prob­lem­atic, par­tic­u­larly if there is a need to pur­chase drugs on a daily ba­sis.

Un­for­tu­nately, those who are heroin (nyaope, unga, whoonga) de­pen­dent face the chal­lenge of need­ing daily doses of the drug.

Street-based peo­ple have to risk be­ing stopped and de­tained by the po­lice dur­ing their jour­ney to ac­quire drugs, of­ten re­sult­ing in dire con­se­quences. There have also been re­ports of sell­ers in­creas­ing the prices of their prod­ucts, as well as some users pool­ing their money, buy­ing greater quan­ti­ties and then re­selling among their com­mu­ni­ties at an in­flated cost.

These chal­lenges to the street-based drug user are com­pounded by the fact that the source of money they usu­ally make use of, is un­avail­able dur­ing the lock­down.

With most mid­dle-class peo­ple at home iso­lat­ing, there is very lit­tle op­por­tu­nity to make money through “scur­rel­ing” or by sell­ing var­i­ous items to peo­ple mov­ing through the streets.

In Cape Town, street-based peo­ple, who cur­rently have no fixed place of res­i­dence, are be­ing re­lo­cated to var­i­ous se­cure sites.

The­o­ret­i­cally, this re­lo­ca­tion is vol­un­tary, and con­sent is given by the in­di­vid­u­als be­ing moved, how­ever, there have been numer­ous re­ports that con­tra­dict this.

There have been many in­di­vid­u­als who ex­pressed in­ter­est in be­ing taken to a se­cure site, based on in­for­ma­tion and anec­do­tal re­ports on the con­di­tions and fa­cil­i­ties of­fered at the se­cure sites.

Civil so­ci­ety or­gan­i­sa­tions have fa­cil­i­tated the trans­fer of many street-based peo­ple to the se­cure sites, en­sur­ing that they are able to take their es­sen­tial be­long­ings to the site and that they ar­rive safely. On-site, in­di­vid­u­als are al­lo­cated to a des­ig­nated tent, where they will re­side for an un­de­ter­mined pe­riod of time.

At the Strand­fontein site, in­di­vid­u­als sleep close to one an­other and, in ad­di­tion to the po­ten­tial ex­po­sure to Covid-19, those ex­pe­ri­enc­ing se­vere opi­oid with­drawals are af­forded lit­tle to no pri­vacy, un­less they brought a small camp­ing tent with them.

On my ini­tial visit to the site, I fo­cused on iden­ti­fy­ing and record­ing the de­tails of those ex­pe­ri­enc­ing with­drawal from opi­oids.

My ap­proach was to en­gage com­pas­sion­ately with those in with­drawal, to lis­ten em­pa­thet­i­cally, and ac­knowl­edge the pain and dis­tress they were ex­pe­ri­enc­ing.

Over the four hours I spent on site, I en­gaged with more than 25 peo­ple who were go­ing through painful with­drawals.

The sever­ity of with­drawal symp­toms ranged from mild to se­vere.

Wit­ness­ing friends and clients, who I have had long-stand­ing re­la­tion­ships with, go­ing through the ex­cru­ci­at­ing ex­pe­ri­ence of opi­oid with­drawal, broke my heart.

No one should have to through this.

And for those who don’t have the lived-ex­pe­ri­ence of go­ing through opi­oid with­drawal, the over­whelm­ing pain and dis­tress can make liv­ing seem un­bear­able.

What this looked like, was hu­man-be­ings vom­it­ing, cry­ing, and beg­ging for as­sis­tance of any kind.

Any­thing to stop the “turkey­ing” (col­lo­quial term for “with­draw­ing”) and al­le­vi­ate the in­de­scrib­able pain, al­low­ing for them to fall asleep, even if for a minute.

To look into a hu­man be­ing’s eyes, who is go­ing through this, is a sober­ing ex­pe­ri­ence – that reaches the core of your soul and tugs on any sense of em­pa­thy one may have.

While sit­ting with a friend, next to his tent, he cried: “Why me?” As the tears streamed down his face, stick­ing to his clammy skin, he said to me: “They don’t un­der­stand what it’s like to turkey, to ex­pe­ri­ence this. They never will, but they laugh and mock me”. suf­fer

I never asked my friend who “they” were, but I could only as­sume it was oth­ers re­sid­ing un­der the same tent.

I sat with my friend for a while longer, mostly in si­lence, as he tried to close his eyes and dis­so­ci­ate from the pain.

While dev­as­tat­ing, I left with some op­ti­mism – know­ing that there are or­gan­i­sa­tions and in­di­vid­u­als who care, and who were work­ing re­lent­lessly to en­sure oth­ers, like my suf­fer­ing friend, re­ceive sup­port and re­lief.

As I write this, I can say that many of my friends, and oth­ers I met dur­ing my visit – who were suf­fer­ing – have re­ceived sup­port.

Many of those in mild to mod­er­ate with­drawal have been given an ad­e­quate sup­ply of symp­to­matic med­i­ca­tion to re­lieve some de­bil­i­tat­ing symp­toms, while oth­ers have been ini­ti­ated on an opi­oid sub­sti­tu­tion ther­apy pro­gramme, where they are cur­rently re­ceiv­ing methadone or buprenor­phine-nalox­one.

Cur­rently, there is a co-or­di­nated ef­fort from mul­ti­ple stake­hold­ers to try and up­scale this sup­port.

In ad­di­tion, mul­ti­ple en­ti­ties have pledged fi­nan­cial as­sis­tance to en­sure that the sup­port is sus­tained into the fu­ture.

Stowe is the na­tional ad­vo­cacy and re­gion co-or­di­na­tor for the South African Net­work of Peo­ple Who Use Drugs

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