Dialogue on Low Success Rate of Rehabilitating Drug Users in SA

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Professor Nirmala Gopal.
Professor Nirmala Gopal.

UKZN’s Professor Nirmala Gopal of the Discipline of Criminology and Forensic Studies (College of Humanities)has initiated an interdisciplinary dialogue with academics from the College of Health Sciences informed by her research into why the success rate of rehabilitating drug users is significantly low in South Africa.

‘Drug addiction has reached epidemic proportions among the youth in South Africa,’ said Gopal. ‘The devastating effects of drug addiction impact on the user, the family and community. Drug addiction is correlated to gangsterism and drug wars resulting in many deaths and the perpetuation of violent communities.  The type of collaboration we have started assures vital progress in identifying, preventing, and treating drug addiction holistically.’

Gopal’s knowledge of the social and psychological reasons for the low rehabilitation success led to her recognising a possible caveat in empirical work on the neurobiology of drug addiction.

She then invited colleagues at the Catalysis and Peptide Research Unit, who were extremely receptive to the idea, and the collaboration was formalized. This resulted in a first of its kind study.

In the research, Gopal together with academics from pharmaceutical sciences used mass spectrometry imaging (MSI) in order to determine the localisation and distribution of methadone and naltrexone in the rodent brain in order to better understand their mechanisms of action.

MSI image analysis showed that the drugs were highly localised in the striatal and hippocampal regions, including the nucleus caudate, putamen and the upper cortex.

These areas are strongly implicated in the development of addiction and are the major pathways that mediate brain stimulation during reward and now pave the way for many studies into the exact mechanism of action of these drugs and aid clinicians in making informed choices in addiction therapy.

Consequently, she then headed a project that resulted in the publication of a ground-breaking paper in the Journal of Addiction Biology.

Her work showcases opioid addiction as a serious public health concern with severe health and social implications requiring extensive therapeutic efforts to keep users drug free.

The two main pharmacological interventions in the treatment of addiction involve management with methadone an mu (μ)-opioid receptor agonist, and treatment with naltrexone, μ-opioid, kappa (κ)-opioid and delta (δ)-opioid antagonist. The use of these drugs is coupled with psychological therapy in the form of counselling.

Deputy Vice-Chancellor of Research Professor Deresh Ramjugernath said, ‘UKZN promotes interdisciplinary, multidisciplinary, and transdisciplinary research. We also want to encourage research that has both social and economic impact and relevance. Professor Gopal’s project on drug addiction and the initiative between the College of Humanities and the College of Health Sciences is a good example of the type of research we want to see at our University.’

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