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Substance abuse treatment demand among young people in South Africa

Substance abuse treatment demand among young people in South Africa (based on data from the SACENDU Project) Charles Parry, PhD Andreas Plüddemann, MA EMCDDA TDI Annual Expert Meeting, Lisbon (2006) Funded by the National Departments of Health & Social Development.

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Substance abuse treatment demand among young people in South Africa

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  1. Substance abuse treatment demand among young people in South Africa (based on data from the SACENDU Project) Charles Parry, PhD Andreas Plüddemann, MA EMCDDA TDI Annual Expert Meeting, Lisbon (2006) Funded by the National Departments of Health & Social Development

  2. Overview of methodology used in the South African Community Epidemiology Network on Drug Use (SACENDU) Selected findings and recommendations from Phase 19 (July – December ‘05) particularly as they relate to young people Concluding comments OUTLINE

  3. Develop networks of local role players in the substance abuse area Identify changes in nature/extent of AOD use & emerging problems Identify changes in AOD-related negative consequences Inform policy, planning and advocacy efforts at local & other levels Stimulate research in new/under-researched areas that is likely to provide useful data to inform policy/planning Facilitate SA’s full participation in international fora focusing on epidemiological surveillance of drug abuse SACENDU OBJECTIVES

  4. An alcohol and other drug (AOD) sentinel surveillance system operational in Cape Town, Durban, Port Elizabeth (PE), East London (EL), Gauteng & Mpumalanga operational since July 1996 It monitors trends in AOD use and associated consequences on a 6-monthly basis from multiple sources Establishment of site specific networks & implementation of a “basic” surveillance system in each site with particular emphasis on substance abuse treatment centres Collection of data on 6-monthly basis 6-monthly site report back meetings -> collation & validation of data Multi-pronged approach to disseminate findings Ongoing improvement of data collection systems (training) Funded by WHO, Gauteng Social Services; NDOH & DoSS (currently) Core features of SACENDU

  5. Main data sources (2005b)

  6. Referral source Gender Age Race Suburb Education Employment Marital status Inpatient/outpatient 1st – 4th substance of abuse Mode of use Frequency of use Age of 1st use Prior Rx/# of times Sources of payment

  7. Treatment demand trends: Age <20 years (%)

  8. Primary drug of abuse 2005b (%) – selected drugs

  9. Demographic & other information (under 20s) – 2005b * - partial data

  10. Treatment demand trends: Alcohol (% as primary drug of abuse) - Under 20s

  11. Treatment demand trends: Cannabis (% as primary drug of abuse) - Under 20s

  12. Treatment demand trends: Cannabis + Methaqualone (%as primary drug of abuse) – Under 20s

  13. Treatment demand trends: Cocaine (% as primary drug of abuse) – Under 20s

  14. Proportion (%) of persons in treatment with heroin as their primary drug of abuse – Under 20s (selected sites)

  15. Proportion of heroin patients reporting some injecting: 2005b(selected sites)

  16. Age distribution of patients with methamphetamine as primary substance of abuse vs patients abusing illicit drugs other than methamphetamine (Cape Town, 2005b)

  17. % of patients having methamphetamine (“Tik”) as a primary or secondary drug of abuse in Cape Town

  18. Selected implications for policy: 2005b • Ensure provision of affordable treatment for persons who cannot pay for services & for young people in general. This needs to be at various levels of intensity. • Ensure that there is adequate aftercare (including vocational opportunities and housing) for persons who have gone to drug rehabilitation • Intensify efforts to address methamphetamine use in Cape Town + ensure that other parts of the country are prepared • Intensify efforts to address inhalant abuse by young people in Gauteng and Mpumalanga. • Undertake regular qualitative research among school-going youth to assess changes in drug use practices. • Address the drop in school referrals to drug treatment

  19. Ongoing advocacy is need to highlight increasing Rx demand by young persons & to ensure Rx services are responsive to issues of young people [not just available, but suitable] Urgent steps are needed to address increasing use of methamphetamine by young people in Cape Town [school + community survey] Strategies are needed to complement data coming from Rx centres to ensure a more complete picture of drug abuse situation among young people– e.g. from community surveys & focus group interviews Information collected on patients @ Rx centres should be complimented by collecting information on Rx services [audit in SA based on norms & standards] CONCLUSION www.sahealthinfo.org.sa/admodule/sacendu.htm

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