The University of Pretoria’s Department of Family Medicine’s work with the City of Tshwane to assist drug users reduce and stop their drug usage is yielding results.

The Department is implementing a ground-breaking new approach to address the harmful use of substances and their impact on communities through a community-oriented substance use programme (COSUP), which engages with people who use drugs, usually before they develop a serious dependency. COSUP offers a range of interventions that are non-confrontational, collaborative and based on the best available scientific knowledge appropriate for the local context.

The project is an offshoot of a community-oriented primary care approach, which the Department oversees, whereby health care workers visit households with the aim of improving the health of people and reducing the severity of disease.

The COSUP programme began in August 2016 with eight sites (and an additional six satellite sites in Mamelodi and Soshanguve) operational across the City of Tshwane. Over 2 500 people are enrolled, with 450 on medication to assist them in reducing and stopping their nyaope use. Several of these people are now employed or receiving training to help them earn a livelihood.  

Project leader, Dr Lorinda Kroukamp, believes that the project will not only show that people who use drugs can become participating members of society and will reduce the harm and impact related to the use of drugs, but will also cost less than traditional approaches.

‘Coming from a background in the pharmaceutical business and being involved with the roll-out of programmes focusing on increasing access to affordable healthcare, including medicines, in Africa, I am aware of the need to ensure that projects are sustainable, practical and appropriate to the setting. Most importantly they must be cost-effective. For years we have been spending millions on building rehabs, but they can only help a few people at a time, and the evidence shows they are not very successful.’

Dr Kroukamp explained that COSUP is built on existing services and structures, and is in the community; therefore, it is cheaper, more responsive, and people can access it when and where they need help.

A beneficiary of the project, Jacob Chanda, says: ‘Life just keeps getting better since I discovered the COSUP programme. Now I am even back at night school and help others who need this help. I have attended a life skills course at PopUp (People Upliftment Programme) and I am ready for the next phase of my life, thanks to COSUP!’