Pioneering methadone programme gives hope to thousands in Dar es Salaam

In a discreet corner of the Mwananyamala District Hospital grounds, in Dar es Salaam, a group of young people queue up outside a small window to get their daily fix of methadone. Others are taking refuge from the intense heat in the few shady spots available in the dusty yard behind the low building housing the methadone clinic. There are few women to be seen but that, as explained by Dr Pilly Sahid Mutoka, the Assistant Medical Officer at the clinic, is because women drug users suffer greater stigma than men and are less comfortable about declaring their drug problem.

In recent years, Dar es Salaam has seen an increase in illicit drug use, particularly heroin, as the large port city has become a pit stop for smugglers en route from Afghanistan to Europe and the rest of Africa. The heroin sold is not great quality but it is cheaply available, with one dose costing as little as one US dollar.

Widespread heroin use in an African country may seem unusual but what is even more surprising is the fact that two hospitals in Dar es Salaam now make methadone available as treatment for addiction. Methadone maintenance treatment – which has been around for over 40 years – is regarded by WHO as the most effective therapy for heroin users. But due to stigma many countries, including a number of wealthier ones, have not yet accepted the use of methadone to curb heroin addition and, globally, fewer than 10% of heroin users needing treatment can access it...

Continue reading the full article from WHO's Medicines and Health products section.