The South African National Council on Alcohol and Drug Dependence (SANCA) Drug Awareness Week takes place from the 24th to the 30th of June. It is an opportunity to look back at the past, examine the present and look to the future in terms of how to effectively address and reduce the impact of substance use disorder.
Substance use disorder is a very serious issue in countries across the world, with approximately 275 million people aged 15-64 years of age having used drugs at least once during 2016 according to the United Nations Office on Drugs and Crime (2016). This source indicates that in this year:
- 192 million people used cannabis
- 21 million people used ecstasy
- 19 million people used opiates
- 34 people used amphetamines and prescription stimulants
- 18 million people used cocaine
Substance use and mental illness can be closely linked in what is known as a dual-diagnosis. According to SANE Australia (2019), if a person has a mental illness, they may stand a greater chance of using drugs as a form of self-medication to improve their symptoms in the short term. In other cases, illicit substances may trigger the onset of a mental health condition. Certain drugs may trigger what is known as drug-induced psychosis. If someone has a predisposition to a psychotic illness, the use of drugs may cause a first episode in an illness that can last a lifetime. Using these substances may also make symptoms of a mental health condition worse or diminish the effectiveness of treatment. On this basis, SANE advises that people with mental health conditions or those who are vulnerable to mental health conditions stay away from all kinds of illicit drugs.
So what is to be done?
First of all, education is key to ensuring that we root out substance use disorder. People who are vulnerable to this disorder and their families must take the initiative to become informed on this issue and must be vigilant about risks in and around their communities. Knowledge is power and it is only in understanding the ramifications of taking drugs that a person can make the decision to stay away from them. Advocacy and self-advocacy within communities is thus key. Also vital, and linked to the need for education, is the need to dispel and eradicate stigma around substance use. There exist beliefs in society that drug use should be punishable. This does not take into account that substance use disorder can be an illness or a product of an illness. This is a form of discrimination that can be addressed through education.
It would not be fair to place the responsibility for eradicating the use of drugs onto the shoulders of society alone. The state is the primary duty-bearer in social and health-related matters. Government must provide adequate prevention and early intervention services, as well as rehabilitation and adequate psychosocial support to those who require such services. Proper dual-diagnosis interventions must be available to those with co-occurring mental health conditions and substance use problems. It is also important to bear in mind that no state department should “own” substance use and that a multi-sectoral and multi-pronged approach is taken in ensuring that members of communities do not make use of drugs. Such a multi-pronged approach must include the provision of the all-important education to communities so as to ensure that such communities are empowered and can begin to manage the issue at home, at work and at schools.