Reality check: Substance abuse in South Africa

It’s common knowledge that drug and alcohol abuse is rife in South Africa, but how bad are things really? And what is the impact on the well-being of our people and society?

If you’ve had any first-hand experience of addiction or substance abuse, you’ll know how devastating and far-reaching its affects can be.

It’s the SANCA (South African National Council on Alcoholism and Drug Dependence) annual Drug Awareness Week from 20 to 26 June this year. As always, the goal is to shine a light on substance abuse in SA – and with good reason. The Central Drug Authority in SA believes that around 15% of South Africans have a drug problem, and that as a nation we’re among the top 10 narcotics and alcohol abusers in the world.

What is substance abuse?

Substance abuse refers to a pattern of excessive drug use that has a negative impact on individuals, their loved ones and wider society.

Drugs include alcohol, tobacco, prescription medication, marijuana, cocaine, crack (a smokeable type of cocaine), heroin, cat, methamphetamines (like tik and crystal meth), mandrax (also called ‘buttons’) and inhalants (like glue, paint or petrol).

What are the health implications of substance abuse?

Different drugs have different physical and mental effects but in general, long-term substance abuse can lead to cardiovascular disease, cancer, liver disease, hair loss, skin problems, poor oral health, learning and memory issues, behavioural disorders and mental illness.

According to the World Health Organization, alcohol consumption significantly contributes to unintentional and intentional injury – for example, car accidents, violence and suicide. A relationship between harmful drinking and the incidence of infectious diseases like tuberculosis (TB) and HIV has also been found.

Particularly relevant in SA is the effect of alcohol on unborn babies. It’s reported that SA has the world’s highest rate of foetal alcohol syndrome, which causes brain damage and growth problems in children.

What is the impact of substance abuse on society?

Addicts will often go to extreme measures to get their hands on whatever substance they’re addicted to, including stealing money and valuables in order to fund their habit. It’s not uncommon for addicts to be expelled from school, lose their jobs or even become involved in serious crime.

Joblessness has been linked to substance abuse, depression and suicide. With the Covid-19 pandemic having caused an already-high unemployment rate in SA to rise even further (to around 35%), more individuals are turning to drugs and alcohol as a means of escape.

Substance abuse among SA’s youth is particularly alarming. According to a report by the South African Community Epidemiology Network on Drug Use, the average age of drug experimentation in SA is 12 – and getting lower. Marijuana, alcohol and tobacco are reportedly the most commonly abused substances among young people.

We need only to look at the effect of alcohol bans during Covid-19 lockdowns to see how alcohol specifically impacts society. Trauma admissions to hospitals dropped by about 60% during the first 66-day ban. (Although, of course, this figure does not control for factors such as curfew, fewer cars being on the road, and people being restricted to their homes). Violent crime, gender-based violence and car accidents all decreased during that time, and increased once alcohol restrictions were eased.

What are some of the signs of substance abuse?

People who are abusing drugs may come across as sleepy or confused, moody or aggressive, or may act recklessly in social situations. They may regularly be absent from or have performance issues at school, college or work.

Physical signs to look out for include slurred speech, loss of coordination, stained teeth, changes in appetite, needle marks, red eyes and smelling of smoke or alcohol.

Getting help for substance abuse

If you think someone you know is struggling with substance abuse – or if you are concerned about your own drug use – know that help is available and that you’re not alone. Recognising the problem and reaching out are important first steps.


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