Western Cape's progress in reducing drug and alcohol-related harms

Introduction

The recent spike of gang violence in hotspot areas of the Cape Flats has once again highlighted the urgent and critical need for interventions to tackle endemic substance abuse in affected communities.

Competition over turf in the drug trade is a major contributor to gang wars in the affected communities. But in addition, substance abuse is destroying countless young lives, trapping people in permanent poverty, rendering them unemployable, driving school drop-outs and teenage pregnancies. The children of women who abuse drugs can be permanently damaged from birth, continuing the devastation in the next generation.

Most violent crimes, particularly domestic violence, as well as many motor vehicle crashes are linked to substance abuse, creating tragedy in countless lives and costing society billions of Rands.

For these reasons, reducing drug and alcohol abuse and the related harms in the province remains a priority for the Western Cape Government.

Our commitment in this regard has led to a doubling of our annual budget for interventions to address substance abuse over the last four years, from just R42 million when we came into office in 2009, to R87 million this year. This amount enables us to provide services to over 13 515 individuals in need of residential facilities and community-based outpatient treatment across the Province. To offer more treatment opportunities, we have increased the number of drug rehabilitation facilities from 8 in 2008 (5 of them residential) to 25 in 2013 (9 of them residential). The remainder of these are NGO-run out-patient treatment programmes that we support financially.

This budget also includes increased allocation for public information provision and early intervention services to help prevent the onset of drug and alcohol abuse. In addition, we are increasing our provision for youth treatment and early interventions, and for Foetal Alcohol Syndrome prevention programmes, especially in rural areas. 

We will be investing half a billion rand in these services over the next 5 years should the DA remain in office.

Below is an outline of the educational and treatment opportunities that the Western Cape Government, through the Department of Social Department (DSD), provides directly or supports financially in our quest to reduce drug and alcohol-related harms across the Western Cape: 

Interventions 

1. Education and Awareness 

A dedicated website (http://druginfo.westerncape.gov.za) was launched in 2011 and is constantly updated with information on where and how to access treatment and other services for drug and alcohol related harms. A hard copy of the substance abuse directory has recently also been updated and is being distributed to schools, magistrates, police stations, NGOs and libraries.

Drug education has been mainstreamed into the Life Orientation teaching material for grade 11 since the beginning of the 2013 academic year. This year we are targeting grades 7 and 9. 

Foetal Alcohol Syndrome remains a critical challenge that we address through ongoing public education about the dangers and risks of alcohol consumption by pregnant mothers. The Western Cape Department of Social Development, with the Department of Agriculture, reaches 4 250 educators and youth per year with programmes aimed at preventing Foetal Alcohol Syndrome, primarily run in rural areas and on farms.

2. Early/Brief Interventions 

The Department of Social Development has funded 31 NGOs to render services in early intervention, targeting 4 380 individuals and families during the past financial year. One of the new exciting initiatives on this level, is the expansion of early interventions services linked to schools, targeting 320 learners identified with risky substance abuse behaviour. These services will continue to be expanded, targeting hotspots identified in a comprehensive Youth Risk Survey conducted by the Western Cape Government, UNODC and Medical Research Council (which researched 20 000 learners across the province). 

As from this year, early intervention and short term counselling programmes are also being introduced at DSD local offices in Athlone, Gugulethu, Wynberg and Mitchell's Plain. These programmes utilise departmental social workers who have undergone specialised postgraduate training in substance abuse treatment at the Universities of Cape Town and Stellenbosch (courses which were initiated and funded by the Western Cape Department of Social Development). 

The Western Cape Education Department (WCED) is rolling out the drug testing policy to identified high risk schools. There will be continued collaboration between WCED and DSD on the identification of learners with substance abuse-related risky behaviour in order to link them with early intervention programmes. It is absolutely essential that we identify at-risk young people while their vulnerability to slip into destructive cycles of social dysfunction can still be contained and when their anti-social behaviour is in its formative stages and can be reversed.

 2. Treatment services

The Western Cape Department of Social Development runs three public residential treatment centres with a joint treatment capacity for 1200 adults and 280 youth between ages 12 and 18 years. In addition, the department also funds six NGO-run residential treatment centres with a joint treatment capacity of 657 adults and 150 youth per year. 

Furthermore, the department funds 16 community-based treatment programmes with a treatment capacity of 3095 persons per annum. 

We have already seen positive results with our pilot outpatient projects for school children in Eerste River, Mitchell's Plain and Khayelitsha, and we are now looking at extending these services to Lavender Hill and Hout Bay.

The Western Cape Department of Health has a dedicated heroin detoxification unit at Stikland Hospital and there is a close working relationship between the detoxification unit and various inpatient and community-based treatment facilities. 

We are also engaging with the Department of Health and the Sultan Bahu treatment centre in Mitchell's Plain with a view to establishing South Africa's first outpatient opiate replacement programme. This initiative is aimed at addressing the harms associated with shifting trends toward heroin abuse in the province.

Up until now, opiate detox and replacement therapy had been exclusively offered by in-patient facilities, however research by the United Nations Office on Drugs and Crime (UNODC) has shown that these programmes can be very effective, and offer a wider reach, if rendered on an outpatient basis.

3. Aftercare 

For the first time ever, post-treatment aftercare services are available in the Western Cape. We want to ensure that every person who receives treatment has access to aftercare services. DSD renders aftercare and reintegration services through its 35 service delivery offices situated throughout province and we have also concluded 21 service contracts with NGOs from all over the province to render aftercare services, with a total of 2290 beneficiaries accessing from these services so far. The risk of relapse by patients who complete a treatment course means that every effort to ensure maximum outcome for treatment services. 

Conclusion 

Demand often outweighs supply as we strive to implement these different interventions. We have however made great strides in reducing drug and alcohol-related harms over the past four years and are already looking at ways to increase capacity for treatment at some of our facilities. 

The Western Cape is further ahead than any other province in terms of the accessibility and quality of services and treatment models available to the public. 

As part of our commitment to the people of the Western Cape, we will continue to make additional funds available wherever we can make savings, so that NGOs are also further capacitated to increase their services to people in communities where they are most needed.

Joint statement issued by Western Cape Premier Helen Zille and Western Cape Minister of Social Development Albert Fritz, August 19 2013

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