Unveiling the grip of opioid addiction in South Africa: a call for community-centred interventions

Abstract

In anticipation of the forthcoming rollout of opioid substitution therapy (OST), this paper discusses the nature of heroin, which is commonly referred to as whoonga or nyaope in South Africa, examining its addictive properties as a foundation for community interventions, including harm reduction. Analysing its chemical composition enables the classification of the main substance as an opioid. Identifying common cheaper adulterants added to produce or sell more product, to make it less potent or to mimic its effects and potentially increasing its desirability to consumers, helps to dispel misconceptions such as the inclusion of rat poison or antiretroviral agents, and aids in relevant treatment approaches and strategies. This paper further seeks to initiate crucial conversations to raise awareness of the drug and its effects. The emphasis is on psychoeducation as a foundational step in enabling communities to comprehend the complexities of opioid addiction, its pervasive grip on individuals, and the formidable obstacles to cessation. Such understanding fosters empathy and lays the groundwork for comprehensive and supportive care for individuals struggling with opioid addiction. Drawing from successful models in other countries, the paper supports proposals of expanding OST to the community and primary healthcare settings, involving primary healthcare nurses, clinical associates, and mental health professionals not only to increase access to treatment but also to enhance support for those affected by opioid addiction.