Alcohol and Drug Abuse Research Unit
Report
to Parliament 2004: Alcohol and Drug Abuse Research Unit
The Alcohol and Drug Abuse
Research Unit, with SADC/EU
funding has been involved in establishing
surveillance systems throughout the SADC Region since 2001. Findings from
the eight countries from which data are currently available indicate that
while cannabis and alcohol dominate treatment demand and community concern,
there is evidence of substantial use of other drugs such as Mandrax, heroin,
cocaine and amphetamine type stimulants (e.g. Ecstasy) in certain countries
and trafficking of these drugs in many countries.
Recent
findings on drug use trends in SADC countries (SENDU)
- Heroin
use is particularly high in countries in the south and east of the
region, including South Africa, Mozambique, Tanzania and Mauritius.
Between 30 and 40 kg of heroin was seized in these countries in the
first half of 2003. In Mauritius over 50% of the patients seen by
the island's 8 specialist drug treatment centres had heroin
as their primary drug of abuse.
- Treatment
demand and law enforcement indicators for cocaine and Mandrax are
highest in South Africa and Namibia. Cocaine arrests and seizures
were also made in Tanzania.
- Use
of amphetamine type stimulants is growing in South Africa, with police
seizures increasing substantially every 6 months over the past two
years to over a quarter of a million tablets in the first half of
2003.
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In over one quarter (27%)
of intravenous drug users tested for HIV/AIDS in Mauritius in 2003, injection
drug use was indicated as the sole mode of transmission. This increased from
7% in 2001 and 14% in 2002. Also alarming was the dramatic increase in treatment
demand related to methamphetamine use in Cape Town in 2003. Use of this drug
has been linked to violent crime in other countries.
In 2002, census information
on substance abuse treatment facilities in Cape Town was collected. Overall
few treatment facilities reported performing outreach services among under-served
groups, with only 41% offering outreach services in the historically black
township areas. Few treatment facilities reported performing activities to
improve the accessibility of services for under-served groups. Only a quarter
of the facilities employed Xhosa-speaking therapists and under a third employed
translators. While 86% of the facilities indicated employing multilingual
staff, further questioning revealed staff were mainly bilingual in English
and Afrikaans. Although 82% of the treatment facilities offered reduced fees
to clients, the number of free treatment slots offered by facilities per year
ranged from 0 to 80, with a mean of 21.5. Based on these findings a number
of recommendations on how to improve the accessibility of services to under-served
groups were made, including the need to train Xhosa-speaking health care workers
in substance abuse intervention techniques.
As part of a WHO-funded
multi-site study, the Alcohol and Drug Abuse Research Unit conducted a rapid
assessment study on alcohol use and sexual risk behaviour in Gauteng in 2002/2003.
The research used a combination of quantitative and qualitative techniques
and focused mainly on adult samples. The study participants indicated that
heavy drinking increases the risk, for both men and women, of engagement in
risky sexual behaviours. The contexts in which people drink, their attitudes
and cultural beliefs regarding their sexuality, the action of alcohol on their
brain, and intra-personal factors are associated jointly with an increased
propensity for risky sexual actions to occur.
In a mini-survey, which
formed part of the collection of studies for the rapid assessment, it was
found that the percentage of those reporting having had more than three lifetime
sexual partners, more than one sexual partner in the previous three month
period, and having engaged in sex under the influence of alcohol was greatest
for the problem drinkers, followed by the non-problem drinkers, and then the
non-drinkers (Figure 1). A similar pattern of results emerged with respect
to consumption of different quantities of alcohol per occasion. Figure 2 shows
that there was an association between the quantity of alcohol consumed per
occasion and the likelihood of having engaged in each of the sexual risk behaviours
under investigation.
The psychoactive effects of alcohol as well as many aspects of the social
circumstances of those who engage in heavy drinking seem to increase their
involvement in risky sexual behaviour. High-risk sexual actions seem to be
more prevalent among heavy drinkers than light drinkers, and often occur during
episodes of heavy drinking. The potential role of alcohol consumption in HIV
transmission behaviours should be addressed more aggressively by alcohol prevention
and treatment programmes. |
