Opioid Substitution Therapy for Opioid Use Disorders

1. Drug Use Trends in South Africa:

   • Back in 2002, only around 2% of surveyed individuals reported using illicit drugs within the past three months. These drugs included marijuana, cocaine, amphetamines, inhalants, sedatives, hallucinogens, and opioids.
   • Fast forward to 2017, and that figure had climbed to 10%. Marijuana remains the most commonly used illicit drug, but harder substances like cocaine and opioids have also seen substantial increases.
   • Interestingly, people who had recently used drugs were less likely to have tested for HIV, which highlights an important intersection between substance use and health awareness¹.

2. Opioid Use and Dependence:

   • You’re absolutely right that opioid use—whether illicit or prescription—has become a pressing concern. Dependence on opioids is notably on the rise, and this has significant implications for individuals and communities.
   • The stigma surrounding opioid use often prevents people from seeking help. Breaking down these barriers and encouraging access to support is crucial.

3. Harm Reduction Approaches:

   • In harm reduction strategies, we aim to minimize the negative consequences associated with drug use while recognizing that complete abstinence may not be immediately achievable for everyone.
   • Two critical components of harm reduction are:
     • Pharmacological Element: This involves replacing illicit opioids with prescribed replacement opioids like methadone or buprenorphine. These medications help stabilize individuals and reduce withdrawal symptoms.
     • Psychosocial Element: Here, we provide counseling and support to help people make positive changes in their lives, recover from drug use, and eventually reduce or eliminate opioid dependence².

4. Psychosocial Counseling and Opioid Substitution Therapy:

   • Psychosocial Counseling: This form of therapy addresses the psychological and social aspects of addiction. It helps individuals cope with cravings, develop coping skills, and improve their overall well-being.
   • Opioid Substitution Therapy (OST): OST involves replacing illicit opioids with prescribed medications (such as methadone or buprenorphine). These medications stabilize individuals, reduce cravings, and allow them to function better in daily life.
   • The ultimate goal of OST is to help service users completely stop using illicit opioids. In the shorter term, it reduces risk factors associated with drug use, such as injecting, blood-borne virus transmission, and premature mortality³.

Remember, compassion and understanding play a vital role in supporting those affected by substance use. If you have any further questions or need additional information, feel free to ask! 😊🌿

Learn more: Opioid Substitution Treatment Guide for Keyworkers.²