Around the world, drug prohibitionist and its consequent stigma limit the autonomy and protections for people who use drugs. The World Drug Report 2022 estimates that there are 11.2 million people across the world injecting drugs, often unable to access clean injecting equipment. The lack of drug regulation means governments are responsible for exacerbating drug-related harms, and chronically under-fund harm reduction interventions. For meaningful harm reduction and decriminalisation to happen, governments need to engage with people who use drugs to see the harmful reality that prohibition creates, and ensure that future solutions are co-created with those most affected by criminalisation.
In South Africa, the exact number of drug overdose deaths remain unknown, with both fatal and non-fatal opioid overdoses still occurring amongst populations of people who use drugs and particularly affects people living on the street who inject drugs. Drug-related harms are also exacerbated by needle sharing amongst people who inject drugs, increasing the risk of blood-borne virus (BBV) transmission. A 2019 South African study showed a 43% prevalence of HCV amongst a group of respondents who injected drugs, highlighting the lack of research done into this population.
Peer-led organisations play a key role in reaching marginalised drug-using populations to ensure that even the most isolated groups are supported when and if needed. However, peer-led outreach programmes are not just about providing clean injection equipment or harm reduction advice; they’re about connecting with individuals on a personal level, as well as treating people with compassion and respect.