Alcohol and Drug Abuse Research Unit

Report to Parliament 2009: Alcohol and Drug Abuse Research Unit
Selected Research Highlights 2010-11

A prospective study investigated the association between life-time methamphetamine and other drug use and school non-attendance in a sample of 1535 high school students in Cape Town. Forty-three percent of the students surveyed at baseline did not complete a follow-up questionnaire after 12 months. Life-time methamphetamine use in addition to other substances was significantly associated with non-attendance. It was concluded that early identification of students with methamphetamine and other substance use problems, and a supportive rather than punitive school policy, may be valuable in improving high school completion and student retention rates.

Surveys of substance abuse treatment services in Gauteng, KwaZulu-Natal, Northern Cape, Free State, North West, Limpopo and Mpumalanga were conducted between 2006 and 2008. Less than half of the facilities surveyed provide HIV counselling and testing (HCT) services to clients or test clients for co-occurring infectious diseases. Less than one-third conduct harm-reduction interventions among injection drug users, and opioid substitution treatment (OST) is largely unavailable. Few substance abuse services routinely monitor client outcomes. Recommendations to address gaps in availability of HIV risk-reduction services include providing HCT to all patients attending drug treatment services, rolling out the provision of OST to selected heroin users, and piloting harm reduction services for injection drug users. Furthermore, it is recommended that a national minimum dataset of indicators for measuring intervention outcomes is developed and pilot-tested.

Another project has the aim of designing and implementing an intervention to enhance health care providers’ capacity to reduce alcohol use-related non-adherence to antiretroviral therapy (ART). Almost all of the 313 ART recipients interviewed at two sites in the Tshwane municipality felt that there was a need for additional interventions focusing on alcohol use and ART adherence. They stressed that interventions should also include an emphasis on cigarettes and dagga, should consist of two group sessions of an hour each, and take place at HIV clinics.

A further project was initiated in the Tshwane municipality to determine whether implementation of an HIV prevention intervention in bars is feasible and acceptable to bar clients, and if so, the extent to which the HIV prevention services are utilised. A programme was designed that had on-site trained servers to encourage responsible drinking and sexual risk reduction among bar patrons; trained bar patrons to serve as peer educators/leaders; and on-site professional counsellors to provide education, counselling, and referrals to outside counselling and treatment services. Magazines, booklets with prevention messages and information, and condoms were also provided. The counsellor sub-component of the intervention was found to be acceptable and feasible, and levels of uptake over the six months were higher than expected. Owners and managers were also supportive of the intervention, however, the server intervention sub-component was not taken up fully by the bar staff, due to their lack of time and interest. The peer sub-component of the programme was also successfully implemented.