ArticleAfrican journal of primary health care & family medicine2020
Harm reduction in practice - The Community Oriented Substance Use Programme in Tshwane.
Article in African journal of primary health care & family medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Characteristics of women on opioid substitution therapy in primary healthcare in Tshwane (South Africa): a retrospective observational study.BJGP open · 2025Article
- Article
- Exploring factors underlying the use of nyaope in Tshwane, South Africa: A qualitative study.Journal of the colleges of medicine of South Africa · 2025Article
- The burden of unlawful use of opioid and associated epidemiological characteristics in Africa: A scoping review.PloS one · 2025Article
- Involuntary discharge from drug or alcohol treatment programs in Vancouver, Canada.Harm reduction journal · 2024Article
- The Impact of Drugs and Substance Abuse on Viral Pathogenesis-A South African Perspective.Viruses · 2024Review
- Evaluating client functioning in a harm reduction program in South Africa: insights from a tool derived from the International Classification of Functioning, Disability and Health.Frontiers in rehabilitation sciences · 2024Article
- Exploring the perspectives of community members on use of Nyaope in Tshwane, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Mental health symptoms among homeless shelter residents during COVID-19 lockdown in Tshwane, South Africa.African journal of primary health care & family medicine · 2023Article
- A simplified point-of-service model for hepatitis C in people who inject drugs in South Africa.Harm reduction journal · 2023Article
- Retention of service users on opioid substitution therapy in the City of Tshwane, South Africa.African journal of primary health care & family medicine · 2023Article
- The demography and disease burden of the homeless shelter population of Tshwane during COVID-19.African journal of primary health care & family medicine · 2022Article
- Treatment barriers among young adults living with a substance use disorder in Tshwane, South Africa.Substance abuse treatment, prevention, and policy · 2022Article
- Managing acute opioid withdrawal with tramadol during COVID-19 lockdown in a peri-urban setting.African journal of primary health care & family medicine · 2022Article
- Factors associated with smoking and transitioning to nyaope injection amongst women in the City of Tshwane Municipality: A self-report by women.Health SA = SA Gesondheid · 2022Article
- Article
- The role played by family physicians in providing health services for the sheltered homeless populations during COVID-19 lockdown in the Tshwane district.African journal of primary health care & family medicine · 2021Article
- A plea of those who are affected most by HIV: The utterances by women who inject Nyaope residing in the City of Tshwane Municipality, Gauteng.African journal of primary health care & family medicine · 2021Article
- Harm reduction in an emergency response to homelessness during South Africa's COVID-19 lockdown.Harm reduction journal · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Community Oriented Substance Use Programme (COSUP) is the first publicly funded, community-based programmatic response to the use of illegal substances in South Africa. It is founded on a systems thinking, public health and clinical care harm reduction approach.
aimTo describe the critical components, key issues and accomplishments in the initiation and delivery of evidence-based, community-oriented, substance-use health and care services.
settingThe Community Oriented Substance Use Programme is implemented by the University of Pretoria in four of seven Tshwane Metropolitan Municipality regions.
methodsQuantitative and qualitative data were extracted and triangulated from plans, reports, minutes and other documents.
resultsBetween 2016 and 2019, COSUP engaged in national and local policy and guidelines development. In Tshwane, it created practical working relations with 169 organisations and institutions and set up 17 service sites. These provide counselling, linkage to care and opioid substitution therapy services to 1513 adults (median age of 30 years), most of whom are male (90%), with similar proportions of clients who smoke (51%) or inject (49%) heroin. It also offers needle and syringe services (approximately 17 000 needles distributed/month) and has built human resource capacity in harm reduction among staff, clients and personnel in partner organisations.
conclusionThe Community Oriented Substance Use Programme offers an evidence-based, public-health informed, feasible alternative to an abstinence-based approach to substance use. However, to translate the programme's achievements into sustainable outcomes at scale requires health system integration; generalist, patient-centred care; affordable medication in a comprehensive package of harm reduction services; multisectoral partnerships; systematic, continuous capacity development; financial investment; and sustained political commitment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.