An exploration of transitioning from smoked to injected nyaope use among users in Tshwane district, south Africa

A phenomenological analysis

Abstract

Nyaope is a powerful opioid mix that is still commonly used in South African communities. People usually smoke it; however, intravenous use is gaining momentum. Injecting the substance increases the risk of getting blood-borne infections. The objective of this study is to explore the experiences and views of individuals who transitioned from smoking to injecting Nyaope, to gain an insight into drivers of transitioning and thus inform policy interventions. To understand what influences users to switch from smoking to injecting, a qualitative approach was utilized. Semi-structured, face to face interviews were conducted with 12 Nyaope users who met the eligibility criteria: at least 18 years old and above, mentally stable during data collection, and either preparing for rehabilitation, currently in treatment, or attending aftercare sessions after rehabilitation. The results of the study revealed five main drivers of transitions: peer influence, quicker and lasting substance effects, lack of constituents for a smoked joint, development of tolerance, and cost-saving measures. The findings highlight the need for a collaborative effort by key stakeholder to improve harm reduction strategies. While priority should be directed to those who are already injecting the substance, focus needs to be directed to those who are still smoking the substance to lower their chances of transitioning to injectable Nyaope.