Challenges faced by service users attending substance abuse aftercare programs in selected treatment centres in South Africa.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i3.2477Keywords:
Aftercare, Substance use disorders, Service users, Recovery, Relapse, South AfricaAbstract
Background:
Substance use disorders (SUDs) remain a significant public health and social welfare concern in South Africa, with relapse following treatment continuing to undermine recovery outcomes. While considerable scholarly and policy attention has been directed towards treatment and rehabilitation programmes, aftercare services remain comparatively under-explored, particularly from the perspectives of service users themselves. Aftercare programmes are intended to support individuals as they transition from structured treatment environments back into their communities; however, limited empirical evidence exists regarding the challenges service users encounter during this critical stage of recovery.
Methodology:
This qualitative study explored the social, economic, emotional, and psychological challenges experienced by service users attending substance abuse aftercare programmes at selected treatment centres in Limpopo and Mpumalanga provinces. A purposive sample of ten participants currently enrolled in aftercare programmes was recruited. Data were collected through semi-structured interviews that allowed participants to reflect on their lived experiences of recovery following rehabilitation. The interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis to identify recurring patterns, meanings, and contextual factors shaping participants’ recovery experiences.
Results:
The findings indicate that, despite completing rehabilitation, service users continue to experience multiple and intersecting challenges that threaten sustained recovery. Prominent challenges included persistent social stigma, limited employment opportunities, strained family relationships, and ongoing emotional distress. Participants also reported psychological difficulties such as anxiety, depressive symptoms, and unresolved trauma, which often intensified feelings of vulnerability during reintegration into community life. These factors collectively heightened the risk of relapse.
Conclusion:
The study highlights that recovery from substance use disorders extends far beyond the completion of formal treatment and requires sustained psychosocial and structural support.
Recommendations:
Strengthening aftercare services through integrated psychosocial support, skills development initiatives, and community-based recovery interventions is essential for promoting long-term recovery and reducing relapse among individuals with substance use disorders in South Africa.
References
American Addiction Centers. (2023). Addiction as a coping mechanism and healthy alternatives. https://americanaddictioncenters.org/sobriety-guide/coping-mechanism
American Addiction Centers. (2023). Addiction recovery and aftercare: Programs, activities, and support
Asenahabi, B. M. (2019). Basics of research design: A guide to selecting an appropriate research design. International Journal of Contemporary Applied Research, 6(5), 76–89.
Best, D., Musgrove, A., & Hall, L. (2018). The bridge between social identity and community capital on the path to recovery and desistance. Probation Journal, 65(4), 394–406. https://doi.org/10.1177/0264550518800118
Bhandari, P. (2022). What is qualitative research? Methods and examples. Scribbr. https://www.scribbr.co.uk/research-methods/introduction-to-qualitative-research/
Bowen, S., Chawla, N., & Marlatt, G. A. (2015). Mindfulness-based relapse prevention for addictive behaviors: A systematic review and meta-analysis. Journal of the American Medical Association, 313(14), 1415–1424. https://doi.org/10.1001/jama.2015.3300
Davidson, L., Bellamy, C., Guy, K., & Miller, R. (2012). Peer support among persons with severe mental illness: A review of evidence and experience. World Psychiatry, 11(2), 123–128. https://doi.org/10.1016/j.wpsyc.2012.05.009
Department of Social Development. (2023). Prevention of and treatment for substance use disorders policy. https://www.gov.za/sites/default/files/gcis_document/202311/49720gon4076.pdf
Doughty, C., & Tse, S. (2011). Can consumer-led mental health services be equally effective? An integrative review of CLMH services in high-income countries. Community Mental Health Journal, 47(3), 252–266. https://doi.org/10.1007/s10597-010-9321-5
Eden, A. H. (2016). Post-treatment indicator: A review of relapse causes. SAGE.
Feng, L., Lee, J., & Gibson, M. (2020). The importance of empathy in social work relationships. Journal of Social Work.
Gibbons, E. (2019). Challenges experienced by service users during substance dependency aftercare and reintegration services (Doctoral dissertation, Stellenbosch University).
Giles, D. C., & Hamilton, S. (2022). Thematic analysis: A practical guide. Sage.
Giles, D. C., Hamilton, S. J., & McCullough, A. (2022). Building trust in supportive relationships: A qualitative study. Journal of Community Psychology.
Guenzel, N., & McChargue, D. (2023). Addiction relapse prevention. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551500/
Hauber, P. S., & Riordan, B. C. (2021). Guideline for the treatment of alcohol problems. https://hdl.handle.net/2123/281486
Hilton, B. T., Betancourt, H., Morrell, H. E., Lee, H., & Doegey, J. A. (2018). Substance abuse among American Indians and Alaska Natives: An integrative cultural framework for advancing research. International Journal of Mental Health and Addiction, 16(2), 507–523. https://doi.org/10.1007/s11469-017-9849-1
Kabisa, E., Biracyaza, E., Habagusenga, J. D. A., & Umubyeyi, A. (2021). Determinants and prevalence of relapse among patients with substance use disorders: Case of Icyizere Psychotherapeutic Centre. Substance Abuse Treatment, Prevention, and Policy, 16(1), 1–12. https://doi.org/10.1186/s13011-021-00347-0
Khanyi, V., & Malesa, K. J. (2022). Challenges faced by social workers in rendering services to Nyaope substance users. Social Work/Maatskaplike Werk, 58(1), 30–45. https://doi.org/10.15270/58-1-1008
Karimunhenga, T. N., & Thembinkosi, P. S. (2025). Perceptions of Social Workers Regarding the Psychosocial Drivers of Gangs and Violence in Cape Town, South Africa. African Journal of Development Studies, 15(3), 99.
Magaldi, D., & Berler, M. (2020). Semi-structured interviews. In the Encyclopedia of Research Design. Springer. https://doi.org/10.1007/978-3-319-24612-3_857
Matsebula, C. N., & Singwane, T. P. (2025). Mental Illness amongst Family Members: Perceptions of Family Caregivers at a Selected Hospital in Mpumalanga, South Africa. e-BANGI Journal, 22(2).
Matsebula, C. N., Singwane, T. P., & Rapholo, F. S. (2026). Social workers' experiences of rendering psychosocial services in mental healthcare settings in South Africa. Discover mental health.
McDonagh, D., & Reddy, J. (2015). Drug and alcohol family support needs analysis report. Western Region Drugs Task Force.
Mpanza, D. M., Govender, P., & Voce, A. (2022). Perspectives of service providers on aftercare service provision for persons with substance use disorders at a rural district in South Africa. Substance Abuse Treatment, Prevention, and Policy.
Nikolopoulou, K. (2022). What is purposive sampling? Definition and examples. Scribbr. https://www.scribbr.com/methodology/purposive-sampling/
NorthStar Recovery Centre. (2022). Drug rehab: The psychological factors in Southborough, MA. NorthStar Recovery Centre.
South African Community Epidemiology Network on Drug Use. (2018). SACENDU news update.
Singwane, T. P., & Geyer, S. (2025). Alcohol harm reduction interventions in the Global South: A scoping review. Alcohol Studies, 24(1), 17.
United Nations Office on Drugs and Crime. (2021). World Drug Report. https://www.unodc.org/res/WDR-2023/WDR23_Exsum_fin_DP.pdf
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405. https://doi.org/10.1111/nhs.12048
World Health Organization. (2020). International standards for the treatment of drug use disorders: Revised edition incorporating results of field-testing. WHO.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Thembinkosi Peter Singwane, Bridget Xolile Lukhele, Cedrick Molatelo Makgopo

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
















