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Reducing harm caused by drug use

In the vast landscape of South Africa’s AIDS response, there exists a group that is often overlooked and marginalised—the people who use drugs. This underserved population faces a heightened risk of HIV, TB, and Hepatitis, trapped in a cycle of poverty, unemployment, and social inequality. However, there is hope. NACOSA’s People Who Use Drugs Programme, funded by the Global Fund and in collaboration with organizations like TB/HIV Care, is working tirelessly to provide support, education, and harm reduction strategies to reduce the devastating impact of drug use on individuals and communities.

At the heart of this initiative are the peer educators who selflessly dedicate themselves to helping others. One such individual is Justin Deary. For Justin, his role is more than just a job—it’s an opportunity to make a difference. By simply being present, knowing people by name, and asking about their day, Justin offers the human connection. It is through these small acts of kindness that he earns their trust, allowing him to provide vital information, support, and guidance. The power of the human connection lies in the ability to share experiences and provide a safe space for individuals to express their thoughts and emotions. When someone like Justin shares his own journey of recovery, it becomes a beacon of hope for people who are still struggling. It shows them that change is possible, and that they are not alone.

The Harsh Reality

According to a report by the United Nations Office on Drugs and Crime (UNODC), South Africa has the highest number of people who inject drugs in sub-Saharan Africa, with a significant portion using heroin. Statistics reveal an estimated 400,000 people using heroin and approximately 82,500 injecting drugs in the country. In Cape Town alone, NACOSA recorded 1,434 people who inject drugs.

The root causes behind this surge in heroin use can be traced back to poverty, unemployment, and social inequality. Unfortunately, the consequences of long-term heroin use are grave, leading to physical and mental health problems, economic hardships, and an increased risk of overdose and death. Injecting drug use further exposes people to a range of health risks, including HIV, hepatitis, and abscesses.

Heroin use has become synonymous with the spread of infectious diseases such as HIV/AIDS and hepatitis C. Data from NACOSA’s programme reveals that 83% of people who inject drugs are infected with Hepatitis C, while HIV prevalence stands at 21.8%, largely attributed to the sharing of contaminated needles and injecting equipment.

Gloved hands using a syringe to dispense methadone into brown bottles

Preparing methadone for clients on the People Who Use Drugs Programme.

In response to this, harm reduction strategies have emerged as a crucial component in reducing the harm caused by drug use. Interventions such as needle and syringe programmes, opioid substitution therapy, and access to drug treatment and rehabilitation services have proven effective in addressing heroin use. NACOSA’s People Who Use Drugs Programme takes a holistic approach, providing harm reduction packs containing clean needles, water, cookers, and sharps bins for safe disposal. Additionally, the program offers education, counselling, opioid substitution therapy, and referrals to treatment and rehabilitation facilities.

The programme strives to empower and support individuals who use drugs. By offering harm reduction strategies, education, and a compassionate human touch, this program is making a significant difference in the lives of the people who are often forgotten and marginalised.

Together, we can break the cycle of despair and provide a path towards recovery, health, and hope for South Africa’s underserved drug users. It is through these collective efforts that we can build a society where no one is left behind.

Read the learning from the peer educator approach: Microplanning with Drug Users

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