Abstract:
BACKGROUND : Despite increasing substance use globally, substance use treatment utilisation remains low. This study
sought to explore and measure substance use treatment barriers among young adults in South Africa.
METHODS : The study was done in collaboration with the Community-Oriented Substance Use Programme run in
Tshwane, South Africa. A mixed methods approach employing focus group discussions with key informants (n = 15),
a survey with a random sample of people using substances and receiving treatment (n = 206), and individual semistructured
interviews (n = 15) was used. Descriptive statistics and thematic analysis were used to analyse data.
RESULTS : Contextual barriers seemed more prominent than attitudinal barriers in the South African context. Fragmented
services, stigma-related factors, an information gap and lack of resources and support (contextual factors),
perceived lack of treatment efficacy, privacy concerns, and denial and unreadiness to give up (attitudinal factors) were
treatment barriers that emerged as themes in both quantitative and qualitative data. Culture and religion/spirituality
emerged as an important barrier/facilitator theme in the qualitative data.
CONCLUSION : Interventions need to embrace contextual factors such as culture, and more resources should be channelled
towards substance use treatment. Multi-level stakeholder engagement is needed to minimise stigmatising
behaviours from the community and to raise awareness of available treatment services. There is a need for strategies
to integrate cultural factors, such as religion/spirituality and traditional healing, into treatment processes so that they
complementarily work together with pharmacological treatments to improve health outcomes.
