It is estimated that around 10 million – or 20% – of South Africans are abusing substances. This is according to the South African Society of Psychiatrists. Whether it is alcohol, codeine, dagga, heroin or other drugs it’s a very worrying statistic that costs the private and public healthcare industry millions annually in rehabilitation and recovery.
What makes it an even bigger concern is that it is now widely accepted by medical science that addiction is a medical illness known as – ‘Substance Abuse Disorder’. Doctors say they are seeing patients, from all walks of life, suffering from a combination of substance abuse and mental health problems.
With the help of the Houghton House Addiction Recovery Centre, Bonitas Medical Fund tries to make sense of this dangerous trend gripping the nation and how to manage it. ‘The rise in addiction in South Africa is worrying,’ says Lee Callakoppen, Principal Officer of Bonitas. ‘As part of a Managed Care programme and under the mental health benefit we cover substance and alcohol rehabilitation. The first step on the road to recovery is the addict recognising they have a problem, which is why we are trying to educate South Africans on what constitutes addiction, how to recognise the signs you have a problem and the path to take to overcome your addiction.’
What is addiction?
Addiction is a complex condition but in the most basic terms it is the repetitive use of a substance, or engagement in behaviour, because of the ‘rewards’ message the substance or behaviour sends to the brain. Addicts keep using alcohol or a drug even when they know it will cause problems and despite the negative consequences and impact on their life. No matter how bad it is, you just want more. No, you feel like you have to have more.
At some point, the substance or behaviour dominated the addict’s daily life. And then, it is highly likely that these conditions are accompanied by other mental health conditions, such as anxiety or depression. This can be compounded by a range of factors including socio-economic and political instability.
What causes it?
Oddly enough, science has not been unable to come up with the single cause of addiction, nor can it predict who will become addicted. However, there are risk factors that can be recognised, some of which may be avoidable and some unfortunately not. Genetics, family history and environmental factors play a significant role in determining vulnerability including growing up in a dysfunctional family and exposure to substances or abuse at a young age. Other mental health issues which are present may also contribute to addictive behaviour being realised through an addiction or behaviour. Even physiology may play a role since men seem to be more susceptible to addiction than women.
Common addictions in South Africa
- Alcoholism. Alcohol is one of the oldest addictions known to man. Alcohol contains ethanol, a psychoactive substance that is the active ingredient in drinks such as beer, wine and distilled spirits. Alcoholism is a serious illness, it’s a disease that completely takes hold of its victim, leaving them dependent on the substance for sustenance. Alcoholism is a progressive disease that disrupts the lives of its victim and their loved ones.
- Codeine addiction also known as ‘lean’. Codeine is a prescription pain medication which is used to treat pain. It primarily comes in tablet form and is the main ingredient in prescription-grade cough suppressants. It is an opiate, other well-known opiates include heroin, oxycodone, and morphine. Street names for codeine include cough syrup, schoolboy, coties and t-three’s amongst others. In SA ‘lean’ or ‘double cupping’ is the lingo used that refers to a commonly abused codeine cocktail consisting of different codeine mixes and liquids. This has become a concerning trend between township school learners who are as young as 10 years old are addicted to this drug.
- Dagga or marijuana addiction. Often thought of a ‘gateway drug’ dagga – or weed – is the most commonly abused mind altering substance. Marijuana is smoked through a rolled cigarette (known as a ‘joint’) or a ‘bong’ (pipe) and has a pungent, sweet-sour and easily identifiable smell.
- Nyaope, whoonga or heroin. Heroin is a ‘downer’ and induces a state of euphoria and relaxation, acting on the pleasure centres of the brain. Heroin is an opiate and blocks the ability to feel pain. There is a stigma attached to heroin addiction, many believe it is impossible to come back from such a powerful substance because it is an all-consuming drug. There are numerous ways to come off the drug, be it going ‘cold turkey’ or getting into a medical detox program. Long term treatment is advised for heroin addicts. This powerful drug can be overcome, recovery is possible.
Can you beat addiction?
The answer is a yes. There are a number of effective treatments available and people can recover from addiction and lead normal, productive lives. ‘As mentioned previously, the first step is acknowledging you have a problem and seeking help’ says Dy Williams from Houghton House. ‘A health professional can conduct a formal assessment of symptoms to see if a substance use disorder exists and even if the problem seems severe, most people with a substance use disorder benefit from treatment. However, because addiction affects many aspects of a person’s life, multiple types of treatment are often required. For most, a combination of medication and individual or group therapy is most effective.’
A success recovery
Charles Jones (not his real name), a recovering drug addict, says that his path to recovery, over a period of 14 months, was the most difficult and most rewarding challenge of his entire life. ‘I had battled with different issues throughout my life but by the time I was in my 30s I had thrown away the love of my life, the person I wanted to marry, the company I had for 7 years, my friends and most of all, my identity. I wanted nothing to do with the world anymore and drugs were my way of shutting off from it all.
‘Thanks to my loving parents I was offered a way out, which I accepted. It was the first step in the right direction, for the first time in my life I accepted help and from there my journey to truly discovering myself began.
‘I went into rehab with an open mind, I had no expectations but met the most amazing people who allowed me to grow, learn and connect in a way I never thought possible. I discovered part of me I never knew existed and was able to confront the reasons for my addiction.
‘Under the Houghton House umbrella, I did the 30 day Inpatient Programme, followed by two months at The Gap, which is an extended Inpatient Care and then four months at York Halfway House,’ he says. ‘My road to recovery has not been an easy one but it helped to know that my rehabilitation was covered by Bonitas.’
‘My journey is not over, it continues and I have a long way to go but for the first time I’m starting to like myself and I love where my life is heading.’
Recognising the signs
If one or more of the following conditions seem fairly accurate to your situation or someone you care for, you or they may be an addict. Note “substance” can either mean drug or the behaviour;
- Feeling that you have to use the substance regularly — daily or even several times a day
- Making certain that you maintain a supply of the substance
- Continuing to use the substance even though you know it’s causing problems in your life or causing you physical or psychological harm
- Spending money on the substance, even though you can’t afford it
- Having intense urges for the substance that block out any other thoughts.
- Not meeting obligations at school with family , or cutting back on social or recreational activities because of substance use
- Over time, needing more of the substance to get the same effect
- Taking larger amounts of the substance over a longer period of time than you intended
- Doing things to get the substance that you normally wouldn’t do, such as stealing.
- Driving or engaging in other risky activities when you’re under the influence of the substance
- Spending a good deal of time getting the substance, using the substance or recovering from the effects of the substance
- Failing in your attempts to stop using the substance
- Experiencing withdrawal symptoms when you attempt to stop taking the substance.
As a general rule – if you said yes to 2 or 3 of the above conditions, it may indicate a mild disorder, 4 or 5 could be a moderate disorder and if you have any more than 5, you most likely have a severe disorder.
‘If you suspect you, or a loved one, has a problem get help because you can’t deal with it alone,’ says Callakoppen. ‘There are a variety of treatments available. Speak to your doctor or phone your medical aid call centre and ask to be referred to an organisation that can guide you down the road to recovery. We need to help people beat their addictions so that they can live healthy, productive, happy lives.’