Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown

South African Family Practice

Field Value
Title Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown
Creator Siemens, Jo-Marie A. Bhoora, Urvisha Janse van Rensburg, Michelle
Subject family medicine, primary care, rural medicine substance use; opioid dependence; COVID-19; adherence; methadone; COSUP; homeless shelters
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.
Publisher AOSIS
Contributor The Community Oriented Substance Use Programme (COSUP), University of Pretoria Family Medicine Department
Date 2023-09-05
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — cross-sectional, descriptive study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v65i1.5708
Source South African Family Practice; Vol 65, No 1 (2023): Part 4; 7 pages 2078-6204 2078-6190
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
Coverage South Africa, City of Tshwane March 2020 - September 2020. Street-based substance users in shelters during covid 19 lockdown
Rights Copyright (c) 2023 Jo-Marie A. Siemens, Urvisha Bhoora, Michelle Janse van Rensburg