Joshua Kangsley and Adeeb Williams are part of a small group of heroin users trying to get “clean”. They attend an opioid substitution programme and group therapy on an almost daily basis. They receive doses of methadone meant to wean them off their heroin addiction.
During a group counselling session, many of the addicts fidget. Some of them scratch their legs and their arms. Itching is a side effect of opioids. One member of the group puts a wet handkerchief over his bald head. He says he’s sweating from the short walk from the local train station to the counselling centre in Woodstock. But he also admits that the cause of his perspiration is because he has contracted hepatitis C from sharing infected needles.
Being an addict on the street is hard, the two men say. But trying to break the habit is the hardest. One drug rehabilitation member, who only wants to be known as Angelo, describes the feeling of trying to work heroin out of the system.
“That [cold] turkey feeling is terrible. It’s uncomfortable. If ever you were to plan to organise anything, one wouldn’t be able to do it properly, because your mind is only fixed on one thing: How I’m going to fix this problem of withdrawal? You can’t sit still. It’s painful,” he says.
Nongovernmental organisations such as TB HIV Care are advocating for safe spaces for drug-addicted people to administer their drugs, and some run drug substitution programmes.
“Safe drug consumption spaces allow people who inject drugs to use their drugs under the supervision of a nurse, and potentially in a space that is linked to other services, including treatment for substance- use disorders. This reduces [the chances of] overdose, transmission of blood-borne infections and other health complications associated with injecting,” says Rudolph Basson, of TB HIV Care.
He says, when harm reduction services and opioid substitution therapy are not available, people who use heroin will continue to injecting.
The programme reduces the injecting of drugs in public spaces and addicts are not subjected to as much police harassment.
The Cape Central Improvement District (CCID), a public-private partnership between the City of Cape Town and business, also tries to take this approach.
The CCID’s Tasso Evangelinos says, although they do alert the police and social development services if they notice people injecting, they don’t advocate punitive steps.
“We rather attempt to deal with the contributing factors, taking a long-term view whereby we seek to assist the person in turning their life around. We have engaged with the responsible authorities on a social level and have arranged space for drug addicts who are looking to recover at the city’s new Safe Space Project.”