‘I went for rehab many times and it never worked, but the harm reduction process has given me renewed hope’. Perceptions on the effectiveness of harm reduction and community-based opioid substitution therapy
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‘I went for rehab many times and it never worked, but the harm reduction process has given me renewed hope’. Perceptions on the effectiveness of harm reduction and community-based opioid substitution therapy
ISSUE ADDRESSED : The accessibility of opioid substitution therapy (OST), one of the
recommended treatments for opioid dependence, remains low.
This study sought to explore the perceived effectiveness of OST from the
perspectives of peer outreach workers and OST clients in a community-based harm
reduction programme.
METHODS : The research was done within the Community-Oriented Substance Use
Programme (COSUP) in Tshwane, South Africa. Fifteen peer educators (13 males and
2 females) took part in two focus group discussions. Thereafter, there were semistructured
interviews in which 15 OST clients (11 males and 4 females) participated.
A convenience cross-sectional study was used. Interviews were audio-recorded.
Using thematic analysis, themes were examined to evaluate how OST and the harm
reduction approach were perceived to contribute to the improved health status of
people with opioid dependence.
RESULTS : Peer outreach workers and COSUP clients significantly endorsed OST as an
effective treatment for opioid dependence. Participants perceived greater effectiveness
of OST compared to abstinence-centred inpatient rehabilitation programmes.
However, there were sentiments that more community education on OST was
needed to motivate people with opioid dependence to access services and to address
misconceptions about OST.
CONCLUSIONS : There is a lack of multi-level and multi-sectoral engagement of various
stakeholders in opioid dependence services, needed to accelerate utilisation of OST
services.
SO WHAT? The research unpacks the need for an integrated approach to service use
optimisation, and the need to evaluate the role that increased awareness and community
education on harm reduction strategies can play in enhancing the utilisation
of OST services.
Description:
DATA AVAILABILITY STATEMENT :
The data that support the findings of this study are available from
University of Pretoria. Restrictions apply to the availability of these
data, which were used under license for this study. Data are available
from the author(s) with the permission of University of Pretoria.