Substance Abuse in South Africa

Substance Abuse in South Africa

Substance abuse in South Africa is rife. Alcohol, marijuana, cocaine, tik and heroin are the top substances of choice for approximately 15% of South Africans affected by substance abuse and addiction. 


Unfortunately, substance abuse is on the rise in South Africa, as it is globally. Getting a grip on the full extent of this social problem is difficult because no representative surveys are being conducted regularly by a central research body. 


The numbers of substance abusers only begin to show when people are admitted to registered rehabilitation centres and outpatient facilities run by organisations such as the South African National Council on Alcoholism and Drug Dependences (SANCA), Alcoholics Anonymous (AA), and Narcotics Anonymous (NA) which voluntarily submit reports to the Department of Social Development. These figures seldom include the numbers of private patients treated at registered private treatment centres.  


According to Akeso Clinics citing reports from the South African Community Epidemiology Network on Drug Use (SACENDU) project, which surveys nine provinces, there was an increase in the number of people admitted for treatment at 80 treatment centres. In 2016, 8787 people were treated. This jumped to 10 047 in 2017. 


Substance Abuse in South Africa: A Bleak Situation

According to the Department of Social Development (DSD), substance abuse – reportedly double the world norm – challenges the health, safety and well-being of all South Africans.


These are some of the known facts:

  • South Africans use the same psychoactive substances as the rest of the world. Still, alcohol is the most widely used substance countrywide.
  • An estimated six in 10 men (61%) and one in four women (26%) from age 15 upwards drink alcohol. 
  • As a result, the rate of foetal alcohol syndrome is five times higher than the US figures.
  • Alcohol consumption contributes to at least 58 % of all deaths – 80% males – on South African roads.
  • Every year about 5 000 youth under the age of 21 die due to underage drinking. At least 1 900 of those deaths occur in vehicle accidents; 1600 are due to homicide and 300 as a result of suicide, with hundreds more due to drowning and other injuries.
  • Cannabis – a mixture of marijuana and mandrax, is the most popular illicit drug of choice among youth. A report by SACENDU gleaned from 75 rehabilitation centres and 10 936 patients that 32 % – the majority male youths – used cannabis. Alcohol followed at 23%, with males over 20 years being the biggest users.
  • A SA National Youth Risk Behaviour Survey (YRBS) reports that 15% of learners used over-the-counter drugs for a high. In comparison, 11.5% had tried at least one drug from the Tik, heroin, mandrax to sugars, a mixture of cocaine and heroin residues.
  • DSD also reports that adolescents are gravitating increasingly toward using Nyaope/whoonga – a mixture of heroin and cannabis, and methamphetamine (Tik).
  • While crime stats implicate substance abuse in at least 60% of all crimes committed in the country
  • In other parts of the world, at least 2000 South Africans are serving time for drug trafficking offences in foreign prisons. 


DSD also warns that the local drug scene is being flooded with designer drugs/legal highs or New Psychoactive Substances (NPS). These substances disrupt brain function, affecting how nerve cells send, receive and process information. With the use of psychoactive substances such as marijuana and heroin, neurons are activated that reduce the effect of natural neurotransmitters in the brain. Long-term use could completely alter the structure of the brain and inhibit function. 


Warning Signs

Experts say that substance abuse and addiction treatment is available to patients and their families. Still, there is no overnight cure, nor can the condition be cured by taking a magic pill. Being in recovery is life-long.

People are advised to know the signs and seek intervention immediately. Akeso Clinics says these are the physical, psychological and social signs and symptoms to watch out for:

  • Changes in appearances such as weight loss, skin colour and skin outbreaks
  • As the addiction takes hold, intense compulsive urges or cravings.
  • On a psychological level – isolation, depression, anxiety and paranoia
  • Inferior standards and quality in performance, whether in work or study and physical craving due to withdrawal symptoms
  • Forming unhealthy bonds with people who share the same fixations and habits
  • Vast sums of money being spent on drugs or alcohol leading to being broke 
  • Neglectful such as not turning up for work or study or other responsibilities
  • Neglectful when it comes to health, such as engaging in unsafe sex practices and not caring about general hygiene, such as staying clean.


After that, it is a slippery slide of poor judgement in everything from who the addict associates with to engaging in risky behaviours such as stealing from people close to them, lying and cheating to get a fix. The riskiest behaviours lead to life on the street, selling drugs, prostitution or criminal activities and devastatingly, life in prison. 

In conclusion, the cost is high for the families and communities who live in fear of the many social ills that come with living under siege to substance abuse.


There is help for those suffering from substance abuse in South Africa. Many hospitals will guide you to a rehabilitation facility that will assist in getting the proper treatment. There is life after substance abuse. 


If you need immediate assistance from the police or an ambulance in the event of a drug overdose, use the iER App to use on your smart device. There are no in-app purchases or adverts. The app needs mobile data or an internet connection for use.

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