COVID 19—impact on substance use treatment utilisation and provision in South Africa

Background

The coronavirus disease 2019 (COVID-19) pandemic has affected persons suffering from substance use disorders (SUDs) all around the world. The purpose of this study was to investigate changes in the number of SUD treatment episodes provided during the pandemic's peak, as well as SUD treatment providers' perceptions of the impact of COVID-19-related restrictions on people with SUDs and the delivery of SUD treatment services in South Africa.

Methods

We used administrative data collected as part of the South African Community Epidemiology Network on Drug Use (SACENDU) project to assess whether the number of treatment episodes changed during the height of COVID-19 restrictions. We used data from an online survey of SUD treatment providers to assess providers’ perceptions of the impact of COVID-19 on SUD treatment delivery. Eight seven SUD facilities were recruited to participate in the online survey.

Results

The survey was completed by 63 organisations (out of a total of 86), generating a 73.2 %. During the COVID-19 lockout, about half of the sample (n = 30; 47.6 %) believed the need for SUD treatment had stayed the same or increased. During COVID-19 lockdowns, half of the sample (n = 32; 50.7 %) reported limited access of SUD services. Participants stated that the lack of services during the COVID-19 shutdown had a detrimental impact on patients participating in their programs as well as those wishing to utilise the service. Furthermore, changes in service delivery appeared to raise patients' anxiety, aggravate pre-existing mental health problems, and, in some cases, be the cause of relapse. Furthermore, patient disengagement and attrition from therapy were judged to have increased throughout this time period. Whilst 47.6% (n = 30) of providers agreed with the value of the alcohol ban, 23.8% (n = 15) of providers thought it had unintended negative consequences.

Conclusion

Based on the findings, it is clear that SUD treatment services in South Africa were greatly impacted during the COVID-19 pandemic, and much more so during the pandemic's onset. More effective means of affordably expanding access to SUD treatment for all South Africans and improving the country's preparation for future health emergencies should be found in collaboration with service providers.