Drug policies that promote the rehabilitation rather than criminalisation of drug users protect young people and limit future drug-related harm, says Stellenbosch University (SU) psychiatrist, Dr Abdul Domingo. Substance Abuse Awareness Week is marked from 25 to 30 June.
"A revision of drug policy should aim to minimise harm to those at risk of using substances in a harmful way, and not exacerbate it," says Domingo, a senior lecturer at SU's Faculty of Medicine and Health Sciences and specialist psychiatrist at Stikland Hospital.
Several countries are in the process of re-evaluating the risk of certain illicit substances, such as cannabis, as well as the legislation used to regulate substance use and possession.
"To rely on criminalisation and incarceration as the only form of intervention undermines these individuals' future prospects of education and employment, it fails to offer any form of clinical input and care and ultimately worsens the plight of drug users, their families and communities," says Domingo.
According to him there are harm reduction strategies, such as opioid substitution therapies that reduce the spread of blood-borne viruses, which save lives and improve the health outcomes of drug users.
For many people the cycle of drug addiction starts as an experiment to experience a state of temporary euphoria, says Domingo. "Most individuals who experiment with an illicit substance will not become addicted to it, but some are at higher risk of developing a chronic addiction than others."
Some people are genetically predisposed to addiction, while others may be at higher risk due to environmental factors such as easy access to substances or circumstances that promote the use of substances, for example to regulate emotional discomfort or manage abusive environments.
"Many countries are now trying to assess and implement policies that acknowledge the risks associated with illicit substances, protect young people from having easy access to it, protect communities from drug-related crime as well as offer strategies to rehabilitate rather than incarcerate.
"This growing momentum to relook at drug policy is also a challenge in South Africa, one that should be faced if we wish to protect our young population and limit future drug-related harms," says Domingo.
Ongoing research
The MRC Unit on Anxiety and Stress Disorders at Stellenbosch University and University of Cape Town, are conducting research on 50 women addicted to methamphetamine ("tik") who are undergoing treatment for their addiction.
The overwhelming majority of participants were also abusing other substances, in particular Mandrax, cannabis, alcohol and nicotine.
Many suffered from a history of posttraumatic stress disorder, depression or substance-induced psychosis. Chronic substance abuse has a severely debilitating impact on affected individuals' work, social and family lives.
The large majority (94%) of participants were unemployed, and many reported the damaging effects of substance abuse on the relationships with family members, as well as the guilt and shame they experienced for neglecting their responsibilities at home (such as caring for their children).
As confirmed by previous research in patients with substance use disorders, addiction also impacts the structure and function of the brain. For example, some studies have found differences in the reward centre of the brain in addicted individuals compared to healthy controls. The study is incorporating brain imaging, genetic and neurocognitive components to gain a better understanding of the physiological processes in addiction.
Contact the Mental Health Information Centre Stellenbosch University at 021 938-9229 or email mhic@sun.ac.za.
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