Aftercare services to people with substance use disorders: analysis of South African policy

People with substance use disorders require comprehensive treatment, including planned aftercare, for improved treatment outcomes. However, access to treatment and aftercare is limited globally, as in South Africa, under-girded by a paucity of empirical research on substance use aftercare and reintegration policies. When examining South African substance use aftercare and reintegration policies, the complex local and international contexts require scrutiny. The aim of this paper is to establish the aftercare content in South African policies and to explore how these local policies respond to the national and international context. The Policy Analysis Triangle proposed by Walt and Gilson, Beer's Viable Systems Model and Thematic Analysis guided the analysis of eight selected policies. The analysis demonstrated that South African policies have undergone changes over the past years: from having no aftercare content to a minimal allowance for aftercare in policies. Policies embrace an acute treatment approach similar to the healthcare delivery in South Africa. Therefore, an Integrated Recovery Management Model for recovery (aftercare) service provision is recommended which should be aligned to local policies and context with due cognizance of the United Nations Office on Drugs and Crimes (UNODC), and World Health Organization (WHO) chronic treatment approach.