Substance use and abuse in South Africa. Central Drug Authority briefing

Women in The Presidency

06 September 2011
Chairperson: Ms D Ramodibe (ANC)
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Meeting Summary

The Central Drug Authority presented a summary of the snapshot survey conducted between June 2010 and March 2011 to gather quantitative and qualitative data on substance abuse in all nine provinces of South Africa.

The research indicated high rates of substance abuse in South Africa; the use of drugs was twice the global average and South Africa was amongst the top 10 nations in alcohol consumption. Better parenting and access to recreational facilities were some of the ideas identified to combat the scourge of substance abuse. Drinking patterns of adolescents mirrored those of adults, and adolescents who abused drugs or alcohol were more likely to engage in risky sexual behavior and acts of violence.  International research showed that substance abuse amongst women occurred for different reasons than among men. Women were drawn to substance abuse out of loneliness while men were likely to abuse drugs or alcohol to gain group acceptance. Consequently women required a different treatment programme and one that provided child care.

The Chairperson stated that it was mothers who ran homes and the majority of women took this issue very seriously. She asked when the master plan would be rolled out, wanted clarity on the relationship between the Central Drug Authority and other departments, and asked if the number of treatment centres could address the need. Parental guidance was very important and it was crucial that rural communities were reached through the roll out of the master plan. Part of the committees oversight function would be to visit treatment centres and make sure they were providing an adequate service. Members asked what relationship the Authority had with the Police and Justice and Constitutional Development departments, if drugs were being brought in from abroad, asked for clarity on the difference between spirituality and religion, and if the media attracted young people to drugs and alcohol, A Democratic Alliance Member was concerned at the breakdown of society; people were under pressure and drugs were a means of escape. South Africa needed parks, especially in low income areas. She asked what contact the Authority had had with municipalities, and suggested that Members of Parliament could lobby for more funding at a national level for those basics. A second Democratic Alliance Member asked what access to information people living in rural areas had, if the Authority's work extended to farms, if the lack of social workers impacted on reaching goals, and if the Authority experienced difficulty in reaching rural areas because of insufficiency of transport infrastructure. 

The Minister's Special Advisor said that the Minister would be embarking on several campaigns to take social development to communities, while examining policy issues around family development in her engagement with the ministerial council next week.

Meeting report

Introduction
The Chairperson welcomed the representatives from the Central Drug Authority (CDA) and accepted the apologies from the Minister and Deputy Minister who were both unable to attend as they were abroad.

Central Drug Authority. Substance use and abuse in South Africa. Presentation
Dr Ray Eberlein, Member: Central Drug Authority (CDA), made a comprehensive presentation on substance use and abuse in South Africa. His presentation was a summary of a snapshot survey conducted between June 2010 and March 2011 to garner a better understanding of substance abuse across the nine provinces.

Some of the objectives of the study were to create awareness of substance abuse, assess community members’ knowledge of substance use and identify the drugs used in different localities. A pilot study was first conducted in Gauteng in June 2010. Data collected from the national survey was analysed both quantitatively and qualitatively. The bulk of the respondents were women and information was primarily obtained from mothers and grandmothers.  People were surveyed in both urban and rural settings. The definition of rural for the purposes of the survey was quite flexible.  65% of those surveyed admitted to having a drug user in their home. The most frequently used drugs were alcohol, cannabis, tobacco, and glue.  Smokers were now somewhat socially ostracized and this had reduced the use of tobacco. Glue was most common amongst children as it helped them to keep warm and make their tummies seem full.  Tik was most frequently used in Cape Town and was not widely used in other parts of the country. Someone who used tik continually for two or three years would have physiological problems and would have to be treated for both physiological issues and drug addiction. Heroin was used throughout the world and if a surplus of poppies was produced in Afghanistan it would increase the availability in South Africa.

Only 40% of the respondents were aware of or had any knowledge of support services. Most people were unconcerned by the health risks associated with drug use and abuse. The factors that people felt increased abuse were availability, family history, poverty, unemployment, influence, and lack of parenting. There was no scientific research to show a link between family history and drug abuse. The ideas to address the drug problem that the respondents identified were improved parenting skills, and recreation facilities for young people. Spiritual values were also highlighted as an important influence to combat drug use.

South Africa’s drug problem was contextualized by a comparison with global trends.  The statistics showed that the use of cannabis, cocaine, and tik was twice as much in South Africa as worldwide. Alcohol abuse was a major problem in South Africa and an estimated two million people could be classified as problem drinkers. The socio-economic cost of alcohol abuse was an estimated R130 billion per year. Concerning statistics were presented on alcohol use. More than 37% of adults were binge drinkers; 10% of drivers on a Monday morning were drunk; and an estimated 7 000 deaths occurred per annum due to driving under the influence of alcohol. Both male and female high school learners had drinking patterns which echoed those of adults. Adolescents who abused alcohol were more likely to engage in risky sexual behavior, have learning difficulties, and were more likely to be expelled from school. Young people were dependent on alcohol and drugs at an early an age as twelve. Drug dealers targeted schools in particular and drugs were disguised as lip balms, tattoos and lollipops. Former drug dealers interviewed claimed to make as much as R18 000 per day and a dependent could spend an average of R5 000 per day.

Substance abuse amongst women was different from that of men. With women, addiction occurred more rapidly and, based on overseas research, it seemed that women were ploy-drug users, and therefore required different treatment. Research showed that men were likely to abuse a substance to be accepted and join a gang, whereas women were likely to abuse alcohol or drugs as a response to loneliness and rejection.  He added that women were also more likely to abuse over the counter medication. Women who were dependent on drugs were 46% more likely to be victims of rape and physical abuse and were also more likely to be victims of incest. Historically, treatment centres had catered primarily for men. Centres for women needed to have child care facilities and provide support for mothers for the duration of the treatment period, which could last up to 90 days. Some of the interventions identified by the people during the survey were that parents needed support and help to be better parents. There was a need for recreation facilities. Taverns should be closed down or the operating hours of taverns should be reduced as taverns were identified as an entry point to both alcohol and drugs.

(Please see attached presentation document for full details, tables and charts.)

Discussion
The Chairperson opened the discussion by stating that mothers were the ones who ran homes and that the majority of women took this issue very seriously. She asked when the master plan would be rolled out, and wanted clarity on the relationship between the CDA and other departments.

Dr Eberlein answered that the draft of the master plan has been completed and that the CDA was at present touring the country and consulting with people who worked in the field of substance abuse. The Minister had also extended the term of the old CDA so that there was a smooth transition when the new CDA took over.

Ms M Nxumalo (ANC) asked what relationship the CDA had with the Police and Justice and Constitutional Development departments. She asked if drugs were being brought in from abroad?

Dr Eberlein responded that the CDA was a statuary body, and that membership consisted of 12 experts, and officials from 14 departments and two state entities. The CDA co-ordinated this group and monitored and evaluated the master plan to combat drug and substance abuse that these different entities produced. Police and justice formed part of the CDA. He pointed to out that one of the issues raised was enforcement of law and that greater enforcement was required.

Mr C Kekana (ANC) asked for clarity on the difference between spirituality and religion. He also asked what the root cause of the substance abuse problem was. He asked if media influence was considerable in attracting young people to drugs and alcohol.

Dr Eberlein answered that research done into treatment showed that when a family shared a coherent set of values the chances of children becoming substance abusers became lower. Spiritually-based professional treatment centres were more successful as participants attempted to carve out a new way of life for themselves.  He added that the drug business was the second most profitable business in the world, after arms. The people running the business were relentless in their effort to sell their product. He said that the media was influential but research had shown that, where there had been success in addressing the problem, the culture of communities had changed.  In French households drinking was acceptable but being drunk was unacceptable, and so there needed to be a shift in what communities found acceptable behavior.

Ms D Robinson (DA) stated that she was concerned with the breakdown of society; she said that people were under pressure and drugs were a means of escape. She added that she felt South Africa needed parks, especially in low income areas, and wanted to know what contact the CDA had had with municipalities, and suggested that MPs could lobby for more funding at a national level for those basics.

Dr Eberlein answered that he has been working in the area for many years and that 50 years ago smoking cannabis was unusual, but so was using a telephone. The world was more complex and many people struggled to adapt; the fact that alcohol and drugs were so easily available made it easy to develop a dependency on these substances. Attitudes towards substance abuse had to change and people needed to be educated on the dangers of substance abuse and availability had to be curbed. He highlighted that 1/3 of people who become dependent become sober and stayed that way, 1/3 relapsed one or more times, and 1/3 relapsed continually. What was needed was long term treatment and a change of attitude. The CDA had contact with 238 municipalities and each municipality had a drug action committee.

The Chairperson asked if the number of treatment centres could address the need.

Dr Eberlein answered that there were roughly 80 treatment centres in the country and that these could treat 20 000 a year, but that the demand was nine to 15 times more.

Ms P Duncan (DA) asked what access to information people living in rural areas had, and if the
CDA's work reached out to farms, and she wanted to know if the lack of social workers impacted on reaching goals. She also added that some programmes were unable to reach rural areas because of insufficient transport infrastructure and wanted to know if the CDA had a similar experience.

Dr Eberlein responded that rural areas were included in CDA plans and that the CDA had representation at the provincial level to make sure that information flowed from the top to the bottom. He also said that the standardization of the legislation to regulate the sale of alcohol was important and that the Department of Trade and Industry was looking into the re-zoning of taverns. He added there was a problem reaching people due to poor transport infrastructure – four wheel drive vehicles with trailers would be a feasible option. He agreed that there was a shortage of social workers, but said that the solution to the problem did not depend on social workers but rather should involve everyone.

Ms Robinson made a follow up statement on parks. Abroad, parents went out with their children to parks and  one idea would be to ring fence an amount for parks. She also asked what the “cannabis paper” revealed and how many deaths per year could be attributed to cannabis.

Dr Eberlein commented that youth centres and sporting activities were important factors to address the problem. He said that the CDA would look into ring fencing; regarding the cannabis paper, he said it was not finalized yet as there had been a change of attitude abroad: in the USA, 140 thousand people were using cannabis legally. There was a shift in thinking and a move in certain countries to legalise and decriminalize cannabis. He replied that it was difficult to determine the deaths per annum as death certificates did not reflect the deaths as a result of drugs due to sensitivity for the surviving family.

Mr Kekane stated that South Africa should revive a culture of sport and extra mural activities.

Mr Sipho Shezi , Special Advisor to the Minister, stated that the Minister would, in the following weeks, announce a roll-out of a plan according to resource allocation. The Minister would be embarking on several campaigns to take social development to communities.  The Minister would also be looking in to policy issues around family development in her engagement with the ministerial council next week.

The Chairperson stated that parental guidance was very important and that it was crucial that rural communities were reached through the roll out of the master plan. She said that part of the Committee's oversight function would be to visit treatment centres and make sure that they were providing an adequate service.

The meeting was adjourned.



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