A qualitative study of the experiences of outpatient substance abuse treatment in the City of Cape Town, 2010-2015 : a service user's perspective
Globally, substance abuse has had a profound impact on society, compounding factors around public health and safety, as well as the social fabric of family systems and communities. The substance abuse problem is complex and requires a comprehensive approach to addressing the phenomenon. Treatment for substance abuse is one aspect of addressing the problem and aims to reduce the harm associated with the use thereof. Treatment demand has increased consistently in South Africa over the past few years and the need for services has been articulated in key legislative and policy documents. Substance abuse is a well-researched field in South Africa; however, limited research exists that captures the experience and perceptions of service users that received outpatient treatment. Various studies conducted in Cape Town in the Western Cape have confirmed an inextricable link between substance abuse and the structural challenges present in historically disadvantaged communities. This study explores the experiences of service users who had completed an outpatient substance-abuse treatment programme in the City of Cape Town's health clinics in Parkwood and Delft South. The objectives of the study are to explore the individual-level and service-level factors impacting on service users' experiences of outpatient substance-abuse treatment, to explore the outcomes of outpatient substance-abuse treatment for service users and to make service-level recommendations and recommendations for further study. Nine research participants for the qualitative study were purposively sampled, as they required certain attributes to respond to the area of study. Data was collected in the form of semi-structured interviews in order to allow for the in-depth exploration into the experiences of service users. Data was analysed with the use of conceptual analysis, where themes were thematically grouped and analysed. Key findings in the study were that the City's outpatient treatment programme is designed exclusively for adult service users. It was, however, found that the age of substance use and the onset of abuse occurred between the ages of 11 and 17-years. The study highlighted the need for the City to modify its outpatient programme to address the needs of youth service users and children of service users to facilitate their adjustment to a parent in recovery. A further finding in the study was the challenges experienced by service users, particularly female service users. It emerged that female service users experienced more stigmatisation than males accessing the service. The need for aftercare treatment post-treatment was a gap identified in the study. In the exploratory study, participants' experiences and perceptions of the City's outpatient programme were positive. The scope of the study was therefore narrow. Recovery, however, remains a challenge for service users due to triggers brought on by structural challenges present in disadvantaged communities, again highlighting the need for coordinated efforts by all government spheres to address the scourge of substance abuse. As a prospect for further study, it is proposed that the long-term impact of the City’s outpatient programme be considered with a larger sample of participants.