The week of 24-30 June 2019 marks SANCA Drug Awareness Week. An increasing number of people were admitted for treatment in 2017, from 8 787 in 2016 to 10 047 across 80 centres, as reported by the South African Community Epidemiology Network on Drug Use (SACENDU) project.

The statistics from this project show:

• an estimated 60% of crimes committed involve the use of substances
• the rate of foetal alcohol syndrome in South Africa is 5x that of the USA
• 80% of male youth deaths are alcohol-related
• drug consumption in SA is estimated to be 2x the world norm
• cannabis and alcohol are the substances most likely to be abused
• males over the age of 20 are the biggest abusers of alcohol
• male youths are the main abusers of cannabis

These statistics are frightening and the US National Institute on Drug Abuse (NIDA) explains that a child's family environment is very important and may contribute to their substance abuse, especially if they have a family member who also has a problem with addiction. Other factors include family background and genetics, mental health issues, work stress, financial pressure and relationship problems. Peer pressure plays a significant role, particularly when substance use is a norm; boredom, and the feeling of not having a sense of purpose can also be contributing factors. Adolescents are 'biologically wired' to seek new experiences and take risks, as well as to carve out their own identity. Trying drugs may fulfill all of these normal developmental drives, but in an unhealthy way that can have very serious long-term consequences.

What long-term effects does substance abuse have?

Use of substances can lead to impulsive behaviour and poor judgement. Alcohol abuse contributes to risky sexual behaviour, increasing the chances of contracting HIV and other sexually transmitted diseases, as well as neurological disorders and chronic memory disorders. Opioids, such as morphine and heroin, can result in accidental overdose. And sometimes, drug abuse can actually increase a user's risk of developing a mental disorder.

Several studies have linked marijuana use to increased risk for psychiatric disorders, including schizophrenia, depression, anxiety, and substance use disorders. On top of all these possible outcomes, sustained cannabis use can also have a negative impact on interpersonal relationships, work performance, financial management, and more.

Increased tolerance to drugs is dangerous, as it causes the individual to use more and more of a drug to achieve the desired euphoric or stimulated state. This increases the person's risk for overdose and even death.

How can I identify if someone is using drugs?

Drug users may exhibit some or all of the following physical, psychological and social signs and symptoms:

• Weight loss
• Skin colour change or skin outbreaks
• Intense urges or cravings as the addiction develops
• Withdrawal symptoms leading to suboptimal performance and physical craving
• Isolation, depression, anxiety and paranoia
• Unhealthy friendships with people who have similar habits
• Financial difficulties due to large amounts of money being spent on drugs or alcohol
• Neglecting responsibilities, such as work or personal obligations
• Poor judgement, including risky behaviours such as stealing, lying, engaging in unsafe sex, selling drugs, etc.