From over-the-counter cough syrups and prescribed painkillers to street economies of heroin and fentanyl, opioid substances and uses have ignited global debates about national drug policy reform. This book is the first to focus on these issues in South Africa, through a range of disciplinary perspectives. In twelve chapters, scholars from community medicine, pharmacology, social science and the humanities, along with civic actors and researchers, present their evidence-based arguments and insights, and explore possibilities for harm reduction approaches in South Africa. Chapters cover three core areas:: dilemmas of drug policy; contradictions of care and treatment; and the issue of stigma. Opioids invites wider conversation, asking us to imagine policy responses that can better protect the constitutional dignity, health and access to healthcare of people using drugs as well as of their families and communities.
Contents Acknowledgements Editor’s Introduction Part One:: Drug policy in a historical context Chapter 1- An overdose in the archive:: Opioids and harm in South African history Part Two:: Dilemmas and opportunities in policy and care Chapter 2- What questions should the national medicines regulatory authority be asking about opioids? Chapter 3- Balancing harms and the role of the courts in psychoactive substance policy reform:: lessons from a cannabis case? Chapter 4- Reducing harm for users of heroin in Tshwane:: Some reflections about health justice, communities and medical care Chapter 5- Reimagining the problem:: substance use in tuberculosis patients in Cape Town Part Three:: Involving research:: Seeing problems and possibilities in the city Chapter 6- Not really like you see in the news:: nyaope users’ lives in Johannesburg Chapter 7- The value of trading a harmful drug for a less harmful drug in Durban Chapter 8- Complexities, hopes, possibilities - People who use drugs doing research in Cape Town:: reflections on inclusion and methodologies Part Four:: Perspectives on Treatment and Harm Chapter 9- The relevance of harm reduction in South Africa:: notes from the frontlines of a movement Chapter 10- Incompatible knots in harm reduction:: a philosophical analysis Chapter 11- Stigma, treatment, and harm reduction in comparative perspective About the contributors Index
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