Year: 2009
Type: dissertation
Abstract: The history of heroin use disorder intervention has been characterised by fads and fashions. Some of the \ntreatments that have been used have been, at best ineffective, and at worst harmful, and occasionally even \ndangerous. It is a sad reflection upon the field that practices and procedures for the treatment of heroin use \ndisorders can so easily be introduced and applied without (or even contrary to) evidence. In South Africa, the \nfield of heroin use disorder intervention has been `in transition' since the outbreak of the heroin epidemic. Yet \ndespite growing evidence of an association between heroin dependents use of supplementary intervention \nservices (such as psychosocial and pharmacological/medical care) and intervention outcomes, and the fact that \ninternational emerging standards for substance use disorder intervention have called upon treatment intervention \nproviders to enhance traditional substance use disorder services with services that address clients' psychological \nand social needs, heroin use disorder intervention programmes in South Africa generally fail to meet these \nresearch-based intervention standards. Much of what is currently delivered as intervention is based upon current \nbest guesses of how to combine some science-based (for example, cognitive-behavioural therapy and \npharmacotherapies) and self-help (12-step programmes) approaches into optimal intervention protocols. As \nprogression is made in the twenty-first century, scientific information is now beginning to be used to guide the \nevolution and delivery of heroin use disorder care internationally. Regrettably, a scarcity of heroin use disorder \nintervention research is noted in South Africa. The present study delved into the insights of ten heroin use \ndisorder specialists, and synthesised the findings with the results of a previous study undertaken by the author \nrelating to forty long-term voluntarily abstinent heroin dependents. In terms of theory and practice, findings of the \nstudy suggest that the field is less in transition now than it was in 1995. It is an imperative that law-enforcement \naction be followed by an integrated programme of psychological, social and pharmacological outreach. These \nprogrammes will have to be expanded to address new demands and will need to include specialised skills \ntraining. Many interventions and procedures have begun to be integrated routinely into clinical practice.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2171315471