PRIORITISING EVIDENCE-BASED TREATMENT FOR DRUG USE DISORDERS: INSIGHTS FROM JOHANNESBURG WORKSHOP

By Morapedi Sibeko

• Quality treatment for drug use disorders is a critical global priority, underscored by the United Nations Sustainable Development Goals 2020–2030, specifically Goal 3.5. In South Africa, high rates of alcohol and drug misuse highlight the urgent need for evidence-based approaches to improve treatment outcomes and community safety.
• In South Africa, the Prevention of and Treatment for Substance Misuse Act, 2008, requires evidence-based methods to improve outcomes and ensure long-term recovery.
• A recent Johannesburg workshop highlighted the need to adapt these practices to South Africa’s diverse population, stressing cultural sensitivity and community involvement in effective treatment.

Quality treatment for drug use disorders is recognised globally as a priority, highlighted by the United Nations Sustainable Development Goals 2020–2030, particularly Goal 3.5. According to a paper published in the International Journal of Drug Policy, in South Africa, 10.3% of adults (aged 15 and older) consume alcohol excessively, while 8.6% use illegal drugs. Addressing drug use disorders is not only essential for individual well-being but also a crucial component of social welfare and community safety, requiring approaches that are both scientifically sound and humane.

In line with the Prevention of and Treatment for Substance Misuse Act, 2008 (Act No. 70 of 2008), establishing and implementing guidelines for substance misuse within a social context is vital. This legislation stresses the importance of evidence-based procedures as the foundation of effective treatment, with approaches grounded in research and integrated methods. These methods improve patient outcomes and increase the likelihood of long-term recovery. Beyond individual benefits, evidence-based practices are crucial for upholding the legal and ethical obligations defined by the Act, promoting public health, and addressing broader social issues associated with drug use disorders.

At the Workshop on the Adaptation of Key Quality Standards for Service Appraisal for Quality Assurance in Treatment for Drug Use Disorders, held in Johannesburg, Ms Vathiswa Dlangamandla, Deputy Director for Substance Abuse Policy, highlighted the Department of Social Development’s (DSD) commitment to evidence-based approaches. She stated, “The Prevention of and Treatment for Substance Use Disorders Policy offers a framework that promotes the use of evidence-based prevention, care and treatment, rehabilitation, and support services.” She emphasised that treatment services and interventions should be grounded in scientific research and tailored to meet the unique needs of each service user based on the severity of their disorder.

Professor Sibeko from the Department of Psychiatry & Mental Health at the University of Cape Town elaborated on the ethical considerations involved in developing evidence-based interventions, particularly for individuals receiving involuntary care. He explained, “When it comes to individuals receiving involuntary care, additional ethical considerations come into play. Not only must the service be proven safe in general, but it must also specifically protect the wellbeing and dignity of the person receiving care, as well as appropriately address their individual needs in a way that takes into account the broader supportive resources available to them, such as family, community, and general recovery resources.”

Professor Sibeko further stressed that South Africa’s complex cultural, social, and economic landscape requires careful adaptation of evidence-based practices to effectively address the diverse needs of its populations. “It is imperative to modify therapies to conform to these variations to ensure that treatment modalities are effective and inclusive of all populations,” he stated. He noted that cultural norms and belief systems significantly impact health behaviours, and integrating indigenous knowledge can enhance the acceptance and adherence to treatment plans. “Engaging with target communities is crucial for adapting interventions. Communities have a deep understanding of disease perception and can provide valuable guidance on how to effectively connect with and support those in need,” he concluded.

Ultimately, evidence-based treatment remains the cornerstone of effective care for individuals with drug use disorders, offering the best opportunity for recovery and reintegration into society.