Transcript CDA

SUBSTANCE USE AND ABUSE IN
SOUTH AFRICA
A presentation by the
Central Drug Authority
to the
Portfolio Committee
On
Social Development
8 November 2011
1
SNAPSHOT SURVEY:
JUNE 2010 TO MARCH 2011
A PICTURE OF THE DRUG
SITUATION IN SOUTH AFRICA AS
REFLECTED BY COMMUNITIES
IN THE NINE PROVINCES
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CONTENTS
National Statistics and Research on substance
abuse
Nature and type of substance abuse
Effects of substance abuse on women and
children
Measures for preventing and combating
substance abuse i.a.w. the NDMP
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OBJECTIVES OF THE STUDY
• Create awareness regarding substance abuse .
• Assess community members’ knowledge of substance use and
abuse.
• Identify the types of drugs used in communities.
• Establish awareness of substance abuse prevention and
treatment services in their communities.
• Assess community members’ awareness of their roles and
responsibilities regarding prevention of alcohol and drug abuse.
• Assess community members’ awareness regarding the law.
• Establish from the community members what the government
and others should do to prevent alcohol and drug abuse.
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SURVEY METHOD
• Used triangulation to incorporate both
quantitative and qualitative methods.
• 9 provinces participated with samples from
the selected localities.
• Guidance and ethical issues taken into
account.
• Training offered by CDA members to the
research assistants on request.
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DATA COLLECTION AND
ANALYSIS
• Pilot study conducted in Gauteng June 2010
• Mobilisation campaign launched in Northern Cape in
October 2010.
• Theme: “No place for drugs in my community”.
• Questionnaires administered by trained volunteers
and staff.
• Data from the questionnaires were analysed
quantitatively and qualitatively.
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GENDER OF RESPONDENTS
Male, 35%
Female,
65%
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AGE OF RESPONDENTS
5% 2%
12%
< 15
24%
16-25
26-35
36-45
46-55
17%
56-65
>66
21%
19%
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POPULATION GROUPS
REPRESENTED
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RESIDENTIAL AREAS
7%
42%
33 %
Urban
Peri Urban
Rural
Semi Rural
20%
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EMPLOYMENT STATUS
70
60
50
40
30
20
10
0
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Income
50
45
<R1000
40
R1000-2000
35
30
R2000-5000
25
20
R5000-10000
15
10
>R10000
5
0
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OTHER ISSUES ADDRESSED IN
SNAPSHOT SURVEY AND
SUMMIT
•
•
•
•
•
Role of policy and legislative prescripts
Substance abuse is everyone’s business
South African Harm Reduction perspective
Empowerment is the key to supply reduction
Is substance abuse treatment and aftercare
adequate?
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KNOWLEDGE OF SUBSTANCE
ABUSE
6%
38%
Understood
Not Understood
56%
Not Sure
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USER AT HOME?
35%
Home
65%
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Not at
Home
15
CONCERNS OF COMMUNITY
25
20
15
10
5
0
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Heroin
Tik
Glue
Tobacco
Cocaine
Alcohol
Medication
Mandrax
Dagga
MOST FREQUENTLY USED
DRUGS
25
20
15
10
5
0
17
KNOWLEDGE OF SUPPORT
SERVICES
40%
Yes
No
60%
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SUBSTANCE ABUSE AND
ASSOCIATED SOCIAL ILLS
20
18
16
14
12
10
8
6
4
2
0
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FACTORS INCREASING ABUSE
25
20
15
10
5
0
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12
VIEWS OF COMMUNITY ON
FACTORS TO ADDRESS DRUG
PROBLEM
10
8
6
4
2
0
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THE NATURE OF THE DRUG
PROBLEM IN SA
9
8
7
6
5
4
3
2
1
0
World
SA
Cann
Op
Coke
ATS
% OF POPULATION
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DRUG USERS IN SA IN
MILLIONS
PROBLEM
USERS 235 777
Cannabis 2.2
Opiates 0.079
Cocaine 0.21
ATS 0.21
DIRECT COSTS
R10bn pa
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THE NATURE OF THE ALCOHOL
PROBLEM IN SA
Problem
Drinkers
(1.97 m)
3-5 Standard
Units daily
6%
Risky Drinkers
10%
(3.2 m)
Cost to the
country
Approx
Rbn 78
per year
Low Risk Drinkers
15%
(4.9 m)
Not Currently Drinking
(59%)
19.2
8CDA:
November
Maymillion
2008
2011
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PERCENTAGE AND TYPE OF
RECORDED ALCOHOL
CONSUMED
Beer 43.3
Sorghum 24.7
Wine 12.3
Brandy 6.5
Other Spirits 4.4
Alco Fruit 3.4
Whisky 2.7
Fort Wine 2.4
Spark Wine 0.3
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TOTAL CONSUMPTION OF
ALCOHOL
SA’s 10.1 m drinkers EACH drink per year:
196 six-packs of beer, or
62 bottles of spirits, or
20.1 L of pure
alcohol per head
=
Top Ten in the
World!
220 bottles of wine, or
666 cartons of sorghum beer
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THE DRUG PROBLEM:
ADULTS UP CLOSE AND PERSONAL
THINK ABOUT:
•Binge Drinkers: 37% plus
•Monday drivers: 10% drunk
•DUI: 7000 deaths per annum
•Drug dealers of 18: R100k per day turnover
•Dependent of 24: R5000 per day
•Link between drug use, HIV/AIDS, TB, violence and
crime
•Co-dependents: Bankrupt and destitute
•Heroin dependents: 2% recovery
success
•All dependents: 47% plus bipolar
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ALCOHOL CONSUMPTION
AMONGST ADOLESCENTS
70
60
50
40
Lifetime
Past Year
Past Month
30
20
10
0
Boys Gr 8
Boys Gr 11
Girls Gr 8
Girls Gr 11
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THE NATURE OF THE ALCOHOL PROBLEM IN
SCHOOLS
9 TOTS/1 L WINE/2L
BEER
DAILY/WEEKENDS
DEPENDENT DRINKERS
?
RISKY DRINKERS
9-35%
?
?
LOW RISK DRINKERS
31%
COST TO
COUNTRY?
ABSTAINERS
40%
(After Parry)
THE DRINKERS’ PYRAMID
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LIFETIME SUBSTANCE USE BY LEARNERS
25
20
15
Males
Females
10
5
0
Cann
Mand
Coke
Heroin
Youth Risk Behaviour 2002
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YOUNG SUBSTANCE USERS AND
POTENTIAL HARM
•Crime and violence
•Accidents and injuries
•Risky sexual behaviour/unplanned pregnancies/STI’s/HIV
and AIDS
•Learning problems
•Mental and physical health problems
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PERCENTAGE OF USER AND NON-USER
LEARNERS REPORTING BEING STABBED
16
14
12
10
Users
Non-users
8
6
4
2
0
Alc
Smokers
Cann
Youth Risk Behaviour 2002
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PERCENTAGE OF USERS AND NON-USERS
REPORTING SEXUAL INTERCOURSE
45
40
35
30
25
User
Non-user
20
15
10
5
0
Alc
Smokers
Cann
Youth Risk Behaviour 2002
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PERCENTAGE OF USERS AND NONUSERS REPORTING EXPULSION
45
40
35
30
25
Users
Non-users
20
15
10
5
0
Alc
Smokers
Cann
Youth Risk Behaviour 2002
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THE DRUG PROBLEM:
THE YOUTH UP CLOSE AND MORE
PERSONAL
THINK ABOUT SCHOOLS & YOUNG OFFENDERS:
•Age of Dependence: 12 years and reducing.
•School children: 1 in 2 experimented
•Drug dealers in schools: Target schools
•Increase in injection drug use (IDU)
•HIV/AIDS in prisons linked to IDU
•Tik :42% to 98% level in Cape treatment centres
•SACENDU and ISS: Positive link between drugs and
violence
•Drug Disguises: Peanuts; tattoos; sweets; cakes;
lollipops
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Women’s substance abuse –The Basics
•
•
•
•
•
Women’s substance abuse is different
Addiction occurs more rapidly for women
Frequently involves more than one mood-altering substance
Produces serious medical consequences over a briefer period of time
Women are more likely to have co-morbid psychiatric disorders
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What we know
We know that
• Women respond differently to treatment than men, particularly to
programmes designed initially for men (like the 12 steps)
We know that
• Women abuse substances at different rates, and for different
motivations than men
We know that
• Women use different substances and for different reasons than men
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Women’s substance abuse –The Basics
•
•
•
•
•
Women’s substance abuse is different
Women are more likely to be victims of violence, physical abuse,
domestic violence and rape
According to Mondanaro et al. (1982) 46% of all drug-dependent
women have been victims of rape
28% to 44% have been victims of incest
Studies indicate these percentages are significantly higher for
incarcerated women. (80% have experienced some form of abuse)
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What we know
We know that:
• Gender responsiveness requires programmes specifically geared to
meet the needs of women, who experience substance abuse differently
than men on many levels
We know that:
• These programmes must also be culturally sensitive
• Intersection of gender expectations within culture are important to
consider when adapting treatment programme to different populations
• We know that
• Programme must take into account family and children
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What we know
We know that:
• There are many risk factors and co-occurring disorders (e.g. a history
of traumatic exposure) and consequences (interference with parenting)
of substance abuse that are unique for women, giving rise to special
treatment needs of substance-abusing women with children
We know that:
• Service barriers exist for women differently than for men. Substance
abusing mothers also experience unique barriers to receiving the
services they need to recover, such as absence of child care and lack
of gender-specific treatment in their communities
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CDA STRATEGIES FOR COMBATING
ADDICTION
DEMAND REDUCTION
SUPPLY REDUCTION
HARM REDUCTION
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DEMAND REDUCTION OUTCOMES
POVERTY
REDUCDUCTION
ADVOCACY
DEMAND
REDUCTION
RESULTS
SOCIAL
POLICY
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November
JUNE 2011
2011
COMMUNITY DEV.
ED.
&
COMM.
42
SUPPLY REDUCTION OUTCOMES
TRENDS
LEGAL
ACTION
PRODUCTION
SUPPLY
REDUCTION
RESULTS
CONTROL
TRAFFICKING
PRICES
PURITY
CONSUMPTION
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November
JUNE 2011
2011
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HARM REDUCTION OUTCOMES
DETOX
&
REHAB
LIMITING
SPREAD OF
IDU
DISEASES
AFTERCARE
&
REINTEGRATION
HARM
REDUCTION
RESULTS
CONTROL OF
DISTRIBUTION
AND
ACCESS
SUBSTITUTION
THERAPY
MEDICAL
TREATMENT
EDUCATION
&
COMMUNICATION
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November
JUNE 2011
2011
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SUBSTANCE USE AND ABUSE IN SOUTH AFRICA
•
•
•
•
The drug problem in South Africa is
extremely serious, with drug usage at twice
the world norm, and
alcohol consumption among the Top 10.
The socio-economic consequences of this
cost the country more than Rbn 130 per
year.
The CDA integrated strategy is incorporated
in the National Drug Master Plan.
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ANTI-SUBSTANCE ABUSE RESOLUTIONS
AND THE COMMUNITY NEEDS
•There are 34 resolutions: remembering
them all is a monumental task
•There are presently 12 factors/needs
expressed by the communities
•For ease in remembering and reporting a
grouping of resolutions into common
factors is desirable.
•People remember alliterative terms more
easily or terms that make a word that has
meaning to them.
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COMMUNITY NEEDS IN ORDER OF PRIORITY
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SOME COMMUNITY NEEDS GROUPED IN TERMS
OF COMMONALITIES
FACTOR
COMMONALITY GROUP
Parenting
Family Education
Re-education
Spirituality
Faith education
Re-education
Knowledge
Substance/abuse
Education
Re-education
Influence
Life skills
education
Re-education
Healthy mind
Life skills
education
Re-education
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GROUPED COMMUNITY NEEDS AND
INTEGRATED NDMP STRATEGY
NEEDS
Re-education
Recreation
EQUALS
SUPPLY
REDUCTION
Reduction
Re-enforcement
Rehabilitation
DEMAND
REDUCTION
HARM
REDUCTION
Re-employment
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EXAMPLE: SOME SUMMIT RESOLUTIONS
GROUPED
RES
No.
CONTENT
POTENTIAL
GROUP
1
Laws & policies on alcohol
Re-enforcement
2
Structure and mandate of CDA
Re-enforcement
3
Reducing accessibility of alcohol
Reduction
4
Reductions on sales of alcohol
Reduction
5
Reduce liquor outlets
Reduction
6
Control of home brews and
concoctions
Reduction
7
Raising duties and taxes on
alcohol
Reduction
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DEMAND REDUCTION OUTCOMES
POVERTY
REDUCDUCTION
ADVOCACY
DEMAND
REDUCTION
RESULTS
SOCIAL
POLICY
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COMMUNITY DEV.
ED.
&
COMM.
51
SUPPLY REDUCTION OUTCOMES
TRENDS
LEGAL
ACTION
PRODUCTION
SUPPLY
REDUCTION
RESULTS
CONTROL
TRAFFICKING
PRICES
PURITY
CONSUMPTION
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HARM REDUCTION OUTCOMES
DETOX
&
REHAB
LIMITING
SPREAD OF
IDU
DISEASES
AFTERCARE
&
REINTEGRATION
HARM
REDUCTION
RESULTS
CONTROL OF
DISTRIBUTION
AND
ACCESS
SUBSTITUTION
THERAPY
MEDICAL
TREATMENT
EDUCATION
&
COMMUNICATION
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IN CONCLUSION:
SUBSTANCE USE AND CONTROL IN SOUTH
AFRICA
Snapshot survey conducted to determine community
needs on dependence-forming substances 2010-2011:12
key needs identified
2nd Biennial Anti-substance Abuse Summit developed 34
resolutions
CDA mandated to review and revise NDMP to meet new
requirements including community needs and resolutions to
combat substance use, abuse and dependence
Integrated and balanced strategy of demand-, supply- and
harm reduction developed.
 Draft NDMP 2012-2016 drafted and now under review by
stakeholders.
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