The Community Oriented Substance Use Programme (COSUP) is a fairly new programme with tremendous progress in a very short period of time. It is a response to the prevalence of substance use in communities around Tshwane and the impact this has on people’s lives, their families and the societies that they live in. The use of substances is increasing at an alarming rate and it threatens the future of South Africa at many levels. This has been evidenced by the number of new clients that are being registered each and every day at the different COSUP sites.

In working at one of these COSUP sites, I have come to realize and understand the desperate nature of people who are on substances – to be rescued from either their dependency on the substance or to be taught about the substance use, such as the management and safer use of drugs (substances) and understanding health risks associated with the use of substances. This is done by providing Methadone/Suboxone substitution therapy to the people who are ready and willing to stop using the drugs (mainly opioids), but due to withdrawal symptoms they failed to quit on their own. One approach that is being used at COSUP sites to help people who may not be able or do not want to stop using the drugs but would like to use them safely is called harm reduction. This kind of intervention helps people to understand the health risks associated with excessive use of the substances and/or sharing of needles among those who are injecting.

I believe COSUP can be the answer and the solution to some of the most pressing problems that are faced by the people who use drugs, the communities around Tshwane and the country as a whole. The government can look into this as a solution to South Africa’s current crisis of substance abuse and invest in it. As a medical student, I personally would love to form part of the group of COSUP health care workers upon completion of my studies, because I have realized the impact this will have on the lives of the people who are using drugs, since they also provide primary health care to the homeless people who use substances.