Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 21;15(1):13.
doi: 10.1186/s13722-020-00186-7.

Six-month retention and changes in quality of life and substance use from a low-threshold methadone maintenance therapy programme in Durban, South Africa

Andrew Scheibe  1   2 , Shaun Shelly  3   4 , Tara Gerardy  3 , Zara von Homeyer  3 , Andrea Schneider  3 , Kalvanya Padayachee  3 , Shalon Balaguru Naidoo  3 , Klaas Mtshweni  3 , Ayanda Matau  3 , Harry Hausler  3 , Monique Marks  5
Affiliations

Six-month retention and changes in quality of life and substance use from a low-threshold methadone maintenance therapy programme in Durban, South Africa

Andrew Scheibe et al. Addict Sci Clin Pract. .

Abstract

Background: Emerging data points to a potential heroin use epidemic in South Africa. Despite this, access to methadone maintenance therapy and other evidence-based treatment options remains negligible. We aimed to assess retention, changes in substance use and quality of life after 6 months on methadone maintenance therapy provided through a low-threshold service in Durban, South Africa.

Methods: We enrolled a cohort of 54 people with an opioid use disorder into the study. We reviewed and described baseline socio-demographic characteristics. Baseline and 6-month substance use was assessed using the World Health Organization's Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) and quality of life, using the SF-12. We compared changes at 6 months on methadone to baseline using the Wilcoxon signed rank test and paired-tests for the ASSIST and SF-12 scores, respectively. McNemar's test was used for comparisons between paired results of categorical variables relating to injecting frequency.

Results: The majority of the participants were young, Black African males, with a history of drug use spanning over 10 years. Retention after 6 months was 81%. After 6 months, the median heroin ASSIST score decreased from 37 to 9 (p < 0.0001) and the cannabis ASSIST score increased from 12.5 to 21 (p = 0.0003). The median mental health composite score of the SF-12 increased from 41.4 to 48.7 (p = 0.0254).

Conclusions: Interim findings suggest high retention, significant reductions in heroin use and improvements in mental health among participants retained on methadone maintenance therapy for 6 months. Further research into longer term outcomes and the reasons contributing to these changes would strengthen recommendations for the scale-up of methadone maintenance therapy in South Africa.

Keywords: Heroin use; Methadone maintenance therapy; Opioid agonist treatment; Opioid use.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests. Equity Pharmaceuticals did not have input in the planning or implementation of the study.

Figures

Fig. 1
Fig. 1
Overview of participant recruitment and enrolment
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lopez-Quintero C, Roth KB, Eaton WW, Wu L, Cottler LB, Bruce M, et al. Mortality among heroin users and users of other internationally regulated drugs: a 27-year follow-up of users in the Epidemiologic Catchment Area Program household samples. Drug Alcohol Depend. 2015;156:104–111. doi: 10.1016/j.drugalcdep.2015.08.030. - DOI - PMC - PubMed
    1. van Amsterdam J, Nutt D, Phillips L, van den Brink W. European rating of drug harms. J Psychopharmacol. 2015;29:655–660. doi: 10.1177/0269881115581980. - DOI - PubMed
    1. UNODC . World Drug Report Executive summary. Conclusions and Policy Implications. Vienna: United Nations Office on Drugs and Crime; 2018.
    1. Larney S, Peacock A, Leung J, Colledge S, Hickman M, Vickerman P, et al. Global, regional, and country-level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: a systematic review. Lancet Glob Heal. 2017;5:1–13. doi: 10.1016/S2214-109X(17)30373-X. - DOI - PMC - PubMed
    1. UNAIDS. Health, rights and drugs. Harm reduction, decriminalization and zero discrimination for people who use drugs. 2019.

Publication types

MeSH terms