Background and objectives
People on opioid agonist therapy (OAT) may experience challenges when changes to their medication take place. In 2022, the Community Oriented Substance Use Programme (COSUP) began transitioning stable clients from a 2mg/ml methadone formulation to a less expensive 10mg/ml formulation. Clients were made aware of the change beforehand. We sought to understand the experience and perceptions of clients before and after the switch to evaluate whether clients’ perception influences response to medication when transitioning.
Methods
A cross sectional study was conducted between November 2022 and July 2023 across 12 COSUP sites in Tshwane, South Africa. Data was collected using a paper-based survey that assessed clients’ perceptions before they switched. Drug use, taste, cravings, relationships and overall satisfaction were assessed before and one month after switching. Descriptive statistics were used to describe the sample.
Results
Fifty-six participants were switched. The median age was 37 (IQR 33-42) with most participants identifying as male (n=47, 85.5%). Most participants had positive views about switching to the new formulation. Some participants were concerned about overdose (n=13, 23%) and about increased heroin use (n=4, 7.1%). Only 2 participants (3.6%) reported using more heroin after switching. After the transition, most participants found that the new formulation managed their cravings and withdrawals (n=47, 85.7%) and there was happiness about the reduced volume of methadone needed daily (n=47, 83.9%).
Conclusion
it is invaluable to consider potential effects of altering health policies targeting vulnerable populations. Clients believe that being on Methadone as a maintenance therapy is better than using drugs. We observed a positive response to transition of a more economical methadone formulation in our programme. |