Monday, July 22, 2013

Cape addicts wait months for treatment

Cape Town - Drug addicts in the province who cannot afford private in-patient treatment and rely on the state usually have to wait between three and four months as the centres are always full, says the social development ministry.

The South African National Council on Alcoholism and Drug Dependence (Sanca) in the Western Cape says while there are enough in-patient treatment facilities in the province, only a few addicts and their families can afford the treatment, even if state-subsidised.

However, Social Development MEC Albert Fritz’s spokeswoman, Melany Kühn, says that in-patient treatment “is not the be all and end all of treatment” and that outpatient facilities, the cheaper alternative, can be a better option.

In-patient treatment involves specialised residential treatment provided at a centre, while outpatient treatment involves people remaining in their communities while being treated.

According to a progress report from the province’s Substance Abuse Forum, set up to tackle the drug problem:

* There are six state-subsidised in-patient facilities in the Western Cape that cater for 807 people a year.

* The Social Development Department funds 17 community-based outpatient treatment centres that cater for 3 095 people a year.

* This is aside from three state-owned facilities that can cater for 1 480 people.

This means the centres collectively cater for at least 5 382 people.

According to a South African Community Epidemiology Network on Drug Use (Sacendu) report, in the second half of last year, 3 178 people were admitted for treatment at 26 centres in the province.

Kühn said the in-patient centres were “always at full capacity”.

“However, there seems to be a perception that in-patient treatment is somehow a better option.

“Depending on the screening and assessment of the client, they can be referred to either one of the options,” she said.

Bronwyn Myers, a chief specialist scientist in the Medical Research Council’s alcohol and drug abuse unit, said in-patient and outpatient facilities should not be compared, as each targeted a different set of problems.

She said it was difficult to assess if there were sufficient state-funded in-patient facilities in the province because better statistics were needed to look into, among other things, the need for drug treatment and the effectiveness of it.

However, Sanca Western Cape’s corporate services director Tertius Cronje said there were “certainly not enough” free in-patient facilities in the province.

“The fact is simply that the largest proportion of Sanca Western Cape tik patients are unemployed, which means that no employer loans are available and their families cannot afford even a substantially reduced cost.

“Unlike outpatient services, in-patient treatment is costly,” he said.

Ashley Potts, director at the Cape Town Drug Counselling Centre, also said there were too few in-patient facilities.

“Matched to the number of service users, we most certainly do not have sufficient facilities to assist for the demand for services,” he said.

Potts said people often thought in-patient treatment was better, but outpatient treatment could be preferable.

“We have seen greater success with outpatient treatment services and advocate for it,” he said.

Potts said outpatient treatment involved a client’s family more and allowed a client to manage his or her daily life and “triggers” that came with it.

He said in-patient treatment was the best for heroin addicts, who struggled the most “to stay clean”.

“In-patient treatment is also appropriate for those who are struggling as outpatients,” Potts said.

Tik: the drug of choice in the Cape

Cape Town - Most drug and alcohol users who have been admitted for treatment in the province have primarily used tik, says a report on substance abuse trends.

According to a South African Community Epidemiology Network on Drug Use (Sacendu) report, in the second half of last year, 3 178 people were admitted for treatment at 26 centres in the province.

Of these, tik was the primary drug of abuse for 33 percent of them, followed by 22 percent primarily using alcohol and another 22 percent primarily using cannabis.

“(Tik) remained the most common primary drug reported by patients in the (Western Cape),” the report said.

The Sacendu report said treatment admissions for heroin as a primary drug of use had decreased in the Western Cape. But when it came to “club drugs”, including ecstasy and tik, treatment admissions for these substances was low except in this province.

The report said “the abuse of over-the-counter and prescription medicines such as slimming tablets” was an issue “across sites”.

Treatment admissions for over-the-counter or prescription medicines as a primary or secondary drug of choice stood at 1 percent in the Western Cape.

Bronwyn Myers, a chief specialist scientist in the Medical Research Council’s alcohol and drug abuse unit, said while the primary drug for those seeking treatment was tik, the primary substance of abuse within communities in the province was alcohol, followed by cannabis and then tik.

The average drug user in the Western Cape is:

* Male

* Unemployed

* Not married

* 25-29 years old

* Primarily uses tik

Based on data from the SA Community Epidemiology Network on Drug Use report (Jul-Dec 2012)