77 research outputs found
Legalising medical use of cannabis in South Africa : is the empirical evidence sufficient to support policy shifts in this direction?
No full textCITATION: Parry, C.D.H. & Myers, B.J. 2014. Legalising medical use of cannabis in South Africa: is the empirical evidence sufficient to support policy shifts in this direction? South African Medical Journal, 104(6):399-400, doi:10.7196/SAMJ.8135.The original publication is available at http://www.samj.org.zaInkatha Freedom Party MP Mario Oriani-Ambrosini’s impassioned plea to legalise the medical use of cannabis must be understood in the context of his own condition as well as legislative changes in at least ten countries. This article argues that any decisions to shift policy must be based on a consideration of the evidence on the risks and benefits associated with the medical use of cannabis for the individual and broader society. It concludes that there are important gaps in the evidence base, particularly in human trials supporting the efficacy of cannabis use for treating and preventing medical conditions and alleviating negative symptoms associated with these conditions. South African researchers should be enabled actively to support development of the necessary evidence base actively by conducting preclinical and clinical research in this area. Human trials to establish the efficacy of the use of cannabis/cannabinoids in addressing AIDS wasting syndrome and other negative sequelae of HIV and AIDS are especially needed.http://www.samj.org.za/index.php/samj/article/view/8135Publisher's versio
Ecstasy use in South Africa: findings from the South African Community Epidemiology Network on Drug Use (SACENDU) project (January 1997-December 2001)
No full textReducing substance use and risky sexual behaviour among drug users in Durban, South Africa : assessing the impact of community-level risk-reduction interventions
No full textCITATION: Parry, C. D. H., Carney, T. & Williams, P. P. 2017. Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa : assessing the impact of community-level risk-reduction interventions. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 14(1):110-117, doi:10.1080/17290376.2017.1381640.The original publication is available at http://www.tandfonline.comAlcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants. There were no decreases in drug use practices such as use of cannabis, heroin, cocaine and Ecstasy after the intervention with drug users; however, there was a significant reduction in alcohol use following the intervention. While there was a substantial increase in the proportion of participants using drugs daily as opposed to more often, the reduction in the frequency of drug use was not statistically significant. Following the intervention, drug users had significantly fewer sexual partners, but there were no significant differences following the intervention with regard to frequency of sex or use of condoms. Substance use in general and during sex was, however, decreased. While the findings were mixed, the study shows that it is possible to provide HIV risk-reduction services to a population of substance users who are less likely to receive services through community outreach, and provide risk-reduction information, condoms and condom demonstration and other services. More intensive interventions might be needed to have a substantial impact on substance use and substance use-related HIV risk behaviours.https://www.tandfonline.com/doi/full/10.1080/17290376.2017.1381640Publisher's versio
The South African community epidemiology network on drug use (SACENDU) project, phases 1-8 - cannabis and mandrax
No full textTo what extent does South African mental health and substance abuse research address priority issues?
No full textArticleThe original publication is available at http://www.samj.org.zaCITATION: Flisher, A.J., Parry, C.D.H., & Stein, D,J. 2000. To what extent does South African mental health and substance abuse research address priority issues? South African Medical Journal, 90(4):378-380.Objective. To investigate the extent to which South African mental health research addresses priority issues. Design. Cross-sectional survey of conference presentations. Setting. The most recent conferences of the following professional societies: the Epidemiological Society of Southern Africa, the Psychological Society of South Africa, the Society of Psychiatrists of South Africa, and the South African Association for Child and Adolescent Psychiatry and Allied Disciplines. Main outcome measures. Whether the presentations addressed priority areas as defined in the list 'Selected priority areas of research' compiled by the Mental Health and Substance Abuse Thrust of the Medical Research Council, and if so which priority areas were addressed. Results. There were 627 presentations, with 267 (43%) on mental health or substance abuse. Seventy-eight papers (29%) reported original research in a priority area identified by the Medical Research Council. Of these, 73 (94%) were on mental health and 5 (6%) were on substance abuse. Of the 73 papers on mental health, 33 (45%) addressed topics in health problem research, 7 (10%) aetiology research, 22 (30%) intervention research, and 11 (15%) operational and health systems research. Conclusion. Much South African mental health research does not address priority issues. There is a particular dearth of research addressing substance abuse research priorities. Funding mechanisms and research capacity development initiatives could help to rectify the situation.Publisher’s versio
Trends in adolescent alcohol and other drug use: findings from three sentinel sites in South Africa (1997-2001)
No full textThis paper aims to provide surveillance information about the extent and consequences of alcohol and other drug (AOD) use by adolescents for three sentinel sites in South Africa (Cape Town, Durban and Gauteng province). From 1997 to 2001, data were gathered from multiple sources, including specialist treatment centres, trauma units, school students, rave party attenders, and arrestees. Since the start of surveillance, an increasing proportion of South African adolescents are using AODs. Surveys point to high levels of alcohol misuse among high school students, with alcohol being the most common substance of abuse. Cannabis is the most frequently reported illicit drug of abuse among adolescents. This is reflected in the large proportion of adolescents receiving treatment for cannabis, cannabis-positive arrestees, and cannabis-positive trauma patients. Cannabis smoked together with methaqualone is the second most common primary drug of abuse in Cape Town. Arrestee data highlights the potentially negative effect of adolescent methaqualone use. Cocaine and heroin are emerging as problem drugs of abuse among
adolescents in large metropolitan centres. Ecstasy (MDMA) use occurs mainly among adolescents who attend rave parties and clubs. The study points to the need for AOD intervention programmes that target young people and the need for continued monitoring of adolescent AOD use in the future.
The South African community epidemiology network on drug use (SACENDU): description, findings (1997-99) and policy implications
No full textOver-the-counter and prescription medicine misuse in Cape Town - findings from specialist treatment centres
No full textObjective. To provide community-level public health surveillance information on over-the-counter (OTC) and prescription medicine misuse.Methods. A retrospective study of OTC and prescription medicine misuse among 9 063 patients from 23 specialist substance abuse treatment centres in Cape Town, South Africa, between 1998 and 2000. Results. OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is evidenced through the constant demand for treatment for OTC/prescription medicine misuse. Benzodiazepines are the class of medicines for which users most often receive treatment, followed by analgesics. Analgesic misuse is most often accounted for by the use of codeine-containing medicines, many of which are available over the counter. Patients using OTC/prescription medicines as their primary drug of abuse are significantly more likely to be female, and aged over 40 years. In contrast, patients using OTC/prescription medicine as an additional drug of abuse tend to be male and over 40 years of age.Conclusions. This study points to the need to develop primary health care protocols for detection, management and referral of patients misusing OTC/prescription drugs and the need to debate the re-scheduling of codeine as a prescription-only substance. The study also points to the need for further community-based research on the nature and extent of OTC/prescription drug misuse among the general population
Alcohol use in South Africa: findings from the South African community epidemiology network on drug use (SACENDU) project
No full textIdentifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa
No full textA performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers' to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development.
Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions.
Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system.
Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented
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