In the late 2000s, an ostensibly novel illicit drug known as nyaope, began to proliferate across South Africa’s poorest communities. While no mention of the substance can be found prior to 2005, it soon became one of the most widely used illegal drugs across the country.

Among many academics, nyaope represents a novel illicit substance unique to South Africa's townships. Core ingredients are often said to include low-grade heroin, rat poison, detergents and anti-retroviral medication (ARV). According to this narrative, the drug's rising popularity among the poor can be attributed to the fact that it contains so many cheap additives, creating a market for a low-priced heroin (which was previously a more middle-class drug confined to white neighborhoods in Johannesburg).

My thesis is partially aimed at critically evaluating this narrative. It hypothesises that the term nyaope largely developed as a street term for heroin, rather than as a name of a new drug, and that that its widespread use is more likely to have been driven by changes in international heroin supply routes (which increased supply and lowered prices) and domestic-level factors within South Africa (which increased demand).

Moreover, the thesis aims to investigate how the conceptualisation of nyaope as a novel drug has impacted South Africa. For instance, it is commonly believed that ARVs are a core ingredient in nyaope, despite the fact that the evidence for this is very limited. This thesis aims to explore how this has affected government policy on ARV distribution, and how it has affected the attitudes of health workers toward people who use drugs.