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Healing the dragon : heroin use disorder intervention

The history of heroin use disorder intervention has been characterised by fads and fashions. Some of the
treatments that have been used have been, at best ineffective, and at worst harmful, and occasionally even
dangerous. It is a sad reflection upon the field that practices and procedures for the treatment of heroin use
disorders can so easily be introduced and applied without (or even contrary to) evidence. In South Africa, the
field of heroin use disorder intervention has been `in transition' since the outbreak of the heroin epidemic. Yet
despite growing evidence of an association between heroin dependents use of supplementary intervention
services (such as psychosocial and pharmacological/medical care) and intervention outcomes, and the fact that
international emerging standards for substance use disorder intervention have called upon treatment intervention
providers to enhance traditional substance use disorder services with services that address clients' psychological
and social needs, heroin use disorder intervention programmes in South Africa generally fail to meet these
research-based intervention standards. Much of what is currently delivered as intervention is based upon current
best guesses of how to combine some science-based (for example, cognitive-behavioural therapy and
pharmacotherapies) and self-help (12-step programmes) approaches into optimal intervention protocols. As
progression is made in the twenty-first century, scientific information is now beginning to be used to guide the
evolution and delivery of heroin use disorder care internationally. Regrettably, a scarcity of heroin use disorder
intervention research is noted in South Africa. The present study delved into the insights of ten heroin use
disorder specialists, and synthesised the findings with the results of a previous study undertaken by the author
relating to forty long-term voluntarily abstinent heroin dependents. In terms of theory and practice, findings of the
study suggest that the field is less in transition now than it was in 1995. It is an imperative that law-enforcement
action be followed by an integrated programme of psychological, social and pharmacological outreach. These
programmes will have to be expanded to address new demands and will need to include specialised skills
training. Many interventions and procedures have begun to be integrated routinely into clinical practice. / Psychology / (D. Phil. (Psychology))

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:unisa/oai:uir.unisa.ac.za:10500/2317
Date30 June 2008
CreatorsSantos, Monika Maria Lucia Freitas dos
ContributorsVan Staden, F.J. (Prof.), djagegjj@unisa.ac.za
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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