Volume 5: Issue No. 2, June 2003
Dear Readers
South African like other countries worldwide, is battling with how to combat drug abuse. Many people, whether in general begin experimentation with alcohol, tobacco and other drugs (particularly cannabis) at a young age. A small, but significant, number of these experiments will continue to experiment with a range of substances.
Drug use is influences by many factors including: attitudes; behaviours; family; school; work pressures; peers; community norms and expectations. Some people are at high risk of drug use because of their social circumstances including: poverty, relocation, family disintegration, discrimination, and sexual exploitation
The use of certain drugs is often higher amongst older adolescent, than children or adults. In the adolescent years, drug use is highly related to age, and also the cheapest and the most readily available type of substances such as glue, solvents and various forms of inhalants are commonly used. While with the adults the use of the type of substance is influenced more by the financial status of the individual.
Reviewing data from approximately 15000 patients who received treatment at over 20 specialist substance abuse treatment centres in Cape Town between July 1996 and June 2003, Dr Parry from the Medical Research Council indicated that treatment demand for dagga-related problems as a primary drug of abuse has increased by 11% points (from 4% to 15% of persons in treatment for substance abuse problems).
While treatment demand for heroin increased by 6% points (from 1% in 1996 to 7% in 2003)
A 50-percent reduction in the number of teens who smoke cigarettes can cut cannabis use by 16 to 28 percent, according to a new report.
The purpose of this article is to give an over view of the drug abuse in South Africa with a particular focus to the selected cites from five provinces.
The Directorate: HSSRCE is looking into the issue of electronic registration of all research that is conducted or commissioned out by the Department of Health. This will assist the Directorate in the establishment and maintenance of a proper research database. More information regarding this matter will be available in the intra-net once available.
The HSSRCE Directorate conducts monthly research forums whereby researchers are invited to present important issues of their research findings to the senior managers of the Department of Health. For more information on research forums contact Claudia Shilumani at (012) 312 0782 or e-mail: shiluc@health.gov.za
Data on treatment demands in South Africa is collectedin the following sites: Gauteng, Western Cape, Kwa -Zulu Natal, Mpumalanga and the Eastern Cape.
Age distribution
Analysis from the treatment Centers by age group and race, has shown an increase by persons over 20 yrs of age and by Black South Africans.
Fig1:Distribution of patients by age and race
% of patients in treatment <20 yrs of age |
% of patients in treatment classified as Blacks |
|||
2000a |
2002b |
2000a |
2002b |
|
| Cape Town | 17 |
24 |
7 |
14 |
| Durban | 19 |
22 |
17 |
31 |
| PE | N/A |
23 |
23 |
25 |
| Gauteng | 17 |
25 |
27 |
34 |
| Mpumalanga | 7 |
15 |
43 |
33 |
According to the report by the American Legacy Foundation and The National Center on Addiction and Substance Abuse (CASA) at Columbia University, 60 percent of repeat cannabis users smoked cigarettes first. Teens who smoke cigarettes are 14 times more likely than their counterparts who have never smoked or try cannabis, six times more likely to be able to buy cannabis in an hour or less and 18 times more likely to say most of their friends smoke cannabis. The findings are based on a survey of 1,987 teens aged 12 to 17 and show a troubling connection between teens who smoke cigarettes and cannabis use.
In South Africa, a study conducted by the MRC in selected treatment sites showed that the use of cannabis ("dagga") and Mandrax (methaqualone) alone or in combination ("white-pipes") continues to be high. Across sites between 13% (PE) and 26% (Durban) of patients attending specialist treatment centres had cannabis as their primary drug of abuse, compared to between 2% (Mpumalanga) and 25% (PE) for Mandrax. Over time treatment demand for cannabis has gone up in all sites. Between 40% (Cape Town) and 61% (Gauteng) of patients under 20 years of age had cannabis as their primary drug of abuse. In Cape Town 28% of patients had Mandrax as a primary or secondary drug of abuse, compared to 13% in Gauteng.
Mandrax seizures recorded by the FSL were generally down except in the Western and Eastern Cape. Nationally a big drop off in Mandrax seizures has been noted over the past two reporting periods (from the equivalent of almost 13 million tablets to 750 000 tablets).
The increases in treatment demand for cocaine related problems over time reported earlier for Cape Town, Durban and Gauteng have not continued and there has been a levelling off in treatment demand in these sites (Fig. 2).
Treatment demand for cocaine remains low in PE, but showed a sharp increase in Mpumalanga. Overall, 11%-14% of patients in treatment in Cape Town and Gauteng have cocaine as a primary or secondary drug of abuse. There are indications of an increase in cocaine use among Black Africans in Gauteng.
Seizures of cocaine HCL declined in all sites and nationally in the last reporting period (from 376 kg to 67 kg)
New drugs of abuse reported among treatment population in Cape Town between 1996 and 2003 included nexus, smart drink, malpitte, GHB, methcathinone, Khat, magic, mushrooms, PCP, and crystal methamphetamine.
Selected implications for policy/practice
Selected issues to monitor
Organisations involved with aspect of Drug Abuse
In conclusion, a broad range of globally abused substances is present in South Africa and the use and burden of illicit substances appear to be increasing. According to Dr Parry, there is a need for implementing effective programs targeting children at a young age and giving particular attention to alcohol, tobacco, dagga and Mandrax and increase the accessibility and utilization of treatment facilities, especially by young persons, females, and persons from disadvantaged communities.
Compiled by Matsie Ratsaka-Mothokoa
For more information, contributions or ideas on this issue of Research Update contact us:
The National Department of Health
Directorate: Health Systems Research, Research Co-ordination and Epidemiology
Private Bag X 828
Pretoria
0001
Tel: (012) 312 0960
Fax: (012) 312 0784
Email: HSRRCE@health.gov.za
Research Updates are quarterly publications of the Department of Health, focusing on the important/current research findings.