During the implementation of COPC, the extent and the complexity of harmful substance use and how it impacts the health and social functioning of individuals, families and communities has become increasingly evident. The use of substances and related harms is considered to be a priority in many communities. Drug and alcohol use is recognised as contributing to the burden of disease, levels of crime, family conflict, economic instability and conflict in the community in the current policy landscape. Supply and demand reduction through law enforcement action and abstinence-based treatment have been the dominant approaches to dealing with substance use. Current responses are ineffectual.
Given the health risks and the social need for an effective response, the City of Tshwane and the Department of Family Medicine (UP) have developed a community-oriented substance use programme (COSUP) that uses a harm reduction approach to prevent and manage substance abuse, reduce and/or contain injecting drug-driven HIV and TB infection, and improve the quality of life of individuals and families affected by substance abuse. As a multidisciplinary and multi-sectoral challenge, the COSUP collaboration works in partnership with a range of government and university departments and third-sector organisations, including the Gauteng Department of Health, and the Up Department of Social Work and Criminology, OUT, the Tshwane Leadership forum etc.
The COSUP project is being implemented in the City of Tshwane, and if effective, could be rapidly scaled up. Constant collection of data and program observation for monitoring and evaluation and measuring its impacts is essential to determine outcomes and inform strategies for improvement. The study aims to investigate COSUP as a community-based, multi-disciplinary, multi-sectoral harm reduction approach to substance use in Tshwane. Using a mixed-methods approach, it will draw on data generated from screening processes, network development and service delivery information that is generated in the course of service development and implementation. In addition, specific qualitative and quantitative enquiries will be developed and included as issues requiring further research emerge.
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