Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown
Background: Temporary shelters were established for street-based people during the national level 5 coronavirus disease 2019 (COVID-19) lockdown. However, street-based substance users’ need to access substances was not addressed, resulting in large numbers of people experiencing withdrawal. The Comm...
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| Format: | Article |
| Language: | English |
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AOSIS
2023-09-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/5708 |
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| _version_ | 1849340266420371456 |
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| author | Jo-Marie A. Siemens Urvisha Bhoora Michelle Janse van Rensburg |
| author_facet | Jo-Marie A. Siemens Urvisha Bhoora Michelle Janse van Rensburg |
| author_sort | Jo-Marie A. Siemens |
| collection | DOAJ |
| description | Background: Temporary shelters were established for street-based people during the national level 5 coronavirus disease 2019 (COVID-19) lockdown. However, street-based substance users’ need to access substances was not addressed, resulting in large numbers of people experiencing withdrawal. The Community Oriented Substance Use Programme (COSUP) in Tshwane provided methadone to manage opioid withdrawal.
Methods: A cross-sectional, descriptive study was conducted using the daily methadone dosing records from shelters in Tshwane between March 2020 and September 2020.
Results: The final analysis included 495 participants, of which 64 (12.9%) were initiated on 20 mg – 30 mg of methadone, 397 (80.2%) on 40 mg – 50 mg, and 34 (6.9%) on 60 mg – 70 mg. A total of 194 (39.2%) participants continued their initiation dose for 1–2 months, after which 126 (64.9%) had their doses increased, and 68 (35.1%) had their doses decreased. Approximately 12 (2.4%) participants were weaned off methadone after 1–3 months and 46 (9.3%) after 4–6 months. In all, 100 (20.2%) participants left the shelter prematurely and did not continue with methadone. A total of 126 (25.5%) participants continued to stay in the shelters and received methadone for 6 months, with 125 (25.3%) participants leaving the shelter with continued follow-up at a COSUP site.
Conclusion: This study demonstrates variability in methadone dosing regimens among shelter residents. As the lockdown measures eased, many chose to leave the shelters, while others remained to receive methadone and other services. The COSUP appears to be effective during periods of increased vulnerability, since a large number of participants were successfully followed up.
Contribution: Opioid dependence is a persistent, lifelong disease. It is multifaceted with complex environmental and individual determinants. This study highlighted the use of opioid substitution therapy during a period of increased vulnerability. |
| format | Article |
| id | doaj-art-c5359ea804924fbb82032a48729c6f37 |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-c5359ea804924fbb82032a48729c6f372025-08-20T03:43:57ZengAOSISSouth African Family Practice2078-61902078-62042023-09-01651e1e710.4102/safp.v65i1.57084351Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdownJo-Marie A. Siemens0Urvisha Bhoora1Michelle Janse van Rensburg2Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, PretoriaDepartment of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and The Community Oriented Substance Use Programme (COSUP), TshwaneDepartment of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and The Community Oriented Substance Use Programme (COSUP), TshwaneBackground: Temporary shelters were established for street-based people during the national level 5 coronavirus disease 2019 (COVID-19) lockdown. However, street-based substance users’ need to access substances was not addressed, resulting in large numbers of people experiencing withdrawal. The Community Oriented Substance Use Programme (COSUP) in Tshwane provided methadone to manage opioid withdrawal. Methods: A cross-sectional, descriptive study was conducted using the daily methadone dosing records from shelters in Tshwane between March 2020 and September 2020. Results: The final analysis included 495 participants, of which 64 (12.9%) were initiated on 20 mg – 30 mg of methadone, 397 (80.2%) on 40 mg – 50 mg, and 34 (6.9%) on 60 mg – 70 mg. A total of 194 (39.2%) participants continued their initiation dose for 1–2 months, after which 126 (64.9%) had their doses increased, and 68 (35.1%) had their doses decreased. Approximately 12 (2.4%) participants were weaned off methadone after 1–3 months and 46 (9.3%) after 4–6 months. In all, 100 (20.2%) participants left the shelter prematurely and did not continue with methadone. A total of 126 (25.5%) participants continued to stay in the shelters and received methadone for 6 months, with 125 (25.3%) participants leaving the shelter with continued follow-up at a COSUP site. Conclusion: This study demonstrates variability in methadone dosing regimens among shelter residents. As the lockdown measures eased, many chose to leave the shelters, while others remained to receive methadone and other services. The COSUP appears to be effective during periods of increased vulnerability, since a large number of participants were successfully followed up. Contribution: Opioid dependence is a persistent, lifelong disease. It is multifaceted with complex environmental and individual determinants. This study highlighted the use of opioid substitution therapy during a period of increased vulnerability.https://safpj.co.za/index.php/safpj/article/view/5708substance useopioid dependencecovid-19adherencemethadonecosuphomeless shelters |
| spellingShingle | Jo-Marie A. Siemens Urvisha Bhoora Michelle Janse van Rensburg Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown South African Family Practice substance use opioid dependence covid-19 adherence methadone cosup homeless shelters |
| title | Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown |
| title_full | Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown |
| title_fullStr | Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown |
| title_full_unstemmed | Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown |
| title_short | Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown |
| title_sort | methadone use for acute opioid withdrawal in tshwane shelters during the covid 19 lockdown |
| topic | substance use opioid dependence covid-19 adherence methadone cosup homeless shelters |
| url | https://safpj.co.za/index.php/safpj/article/view/5708 |
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