Abstract Objective Methamphetamine use has become a growing problem in a number of countries over the past two decades, but has only recently emerged in South Africa. This study investigated the ...prevalence of methamphetamine use among high-school students in Cape Town and whether students reporting methamphetamine use were more likely to be at risk for mental health and aggressive behavior problems. Methods A cross-sectional survey of 15 randomly selected high schools in Cape Town, of 1561 males and females grade 8–10 students (mean age 14.9), was conducted using the Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI). Results Findings indicated that 9% of the students had tried methamphetamine at least once. Ordinal logistic regression analyses showed that methamphetamine use in the past year was significantly associated with higher aggressive behavior scores (OR = 1.81, 95% CI: 1.04–3.15, p < 0.05), mental health risk scores (OR = 2.04, 95% CI: 1.26–3.31, p < 0.01) and depression scores (OR = 2.65, 95% CI: 1.64–4.28, p < 0.001). Conclusions Methamphetamine use has become a serious problem in Cape Town, particularly among adolescents. Screening adolescents in school settings for methamphetamine use and behavior problems may be useful in identifying youth at risk for substance misuse, providing an opportunity for early intervention. These findings have implications for other parts of the world where methamphetamine use may be occurring at younger ages and highlight the importance of looking at co-morbid issues related to methamphetamine use.
ABSTRACT
The Alcohol and Drug Abuse Research Unit (ADARU) was established at the South African Medical Research Council (MRC) at the beginning of 2001, although its origins lie in the activities of ...the Centre for Epidemiological Research in Southern Africa and other MRC entities. Initial challenges included attracting external funding, recruiting new staff, developing the skills of junior staff, publishing in international journals and building national and international collaborative networks. ADARU currently comprises a core staff of 33 members who work on 22 projects spanning substance use epidemiology and associated consequences, intervention studies with at‐risk populations and services research. A large component of this portfolio focuses on the link between alcohol and other drug use and human immunodeficiency virus (HIV) risk behaviour, with funding from the US Centers for Disease Control and Prevention. Junior staff members are encouraged to develop independent research interests and pursue PhD studies. Research outputs, such as the 20 papers that were published in 2010 and the 35 conference presentations from that year, form an important part of the unit's research translation activities. We engage actively with policy processes at the local, provincial, national and international levels, and have given particular attention to alcohol policy in recent years. The paper includes an analysis of major challenges currently facing the unit and how we are attempting to address them. It ends with some thoughts on what the unit intends doing to enhance the quality of its research, the capacity of its staff and its international standing.
To make quantitative estimates of the burden of disease attributable to alcohol use by sex and age group in South Africa in 2000.
The analysis follows the World Health Organization comparative risk ...assessment (CRA) methodology. Population-attributable fractions (PAFs) calculated from modelled prevalence estimates and relative risks based on the global review were applied to the burden of disease estimates from the revised South African National Burden of Disease study for 2000. The alcohol-attributable fractions for injuries were directly determined from blood alcohol concentrations (BAC > 0.05 g/100 ml) at the time of injury. Monte Carlo simulation-modelling techniques were used to quantify uncertainty in the estimates.
South Africa.
Adults >or= 15 years.
Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, stroke, hypertensive disease, diabetes, certain cancers, liver cirrhosis, epilepsy, alcohol use disorder, depression and intentional and unintentional injuries as well as burden from fetal alcohol syndrome (FAS) and low birth weight.
Alcohol harm accounted for an estimated 7.1% (95% uncertainty interval 6.6 - 7.5%) of all deaths and 7.0% (95% uncertainty interval 6.6 - 7.4%) of total DALYs in 2000. Injuries and cardiovascular incidents ranked first and second in terms of attributable deaths. Top rankings for overall attributable burden were interpersonal violence (39.0%), neuropsychiatric conditions (18.4%) and road traffic injuries (14.3%). Interpersonal violence accounted for 42.8% of the injury DALYs attributed to alcohol in males and 25.9% in females. In terms of alcohol-attributable disability, alcohol use disorders ranked first (44.6%), interpersonal violence second (23.2%), and FAS third (18.1%).
Particular attention needs to be given to preventing and reducing the burden of alcohol-related homicide and violence, alcohol-related road traffic accidents, alcohol use disorders, and FAS. Multilevel interventions are required to target high-risk drinkers, in addition to creating awareness in the general population of the problems associated with alcohol abuse.
This study investigated involvement in substance use and sexual activities among adolescents in Cape Town, and specifically the associations between methampethamine use and sexual risk behaviours. ...Data were collected from 15 randomly selected and 15 matched schools in Cape Town via quantitative questionnaires. Students used hand-held computers (PDAs) to answer the questions. A total of 4605 grade 9 students were sampled. Male and female students were almost equally likely to have used methamphetamine at least once (13% versus 12%). Students who had used methamphetamine in the past 30 days were significantly more likely to have had vaginal, anal or oral sex than students who had never used it, to have been pregnant been responsible for a pregnancy and to have been diagnosed with a sexually transmitted infection. Logistic regression analysis indicated significant associations between methamphetamine use in the past 12 months and engaging in vaginal and anal sex. Drug abuse and sexually transmitted infections (STI) prevention services should incorporate the link between drugs and STI into their prevention and education strategies, especially those aimed at school-going adolescents.
Introduction and Aims. In the past decade, methamphetamine has become increasingly a drug of concern globally. The purpose of this study is to describe the changing trends in treatment admissions for ...methamphetamine abuse in Cape Town, South Africa and to highlight the implications of these changes for policy, practice and research. Design and Methods. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug treatment centres and programmes in Cape Town every 6 months as part of the South African Community Epidemiology Network on Drug Use (SACENDU). A one-page form was completed by treatment centre personnel to obtain demographic data, the patients' primary and secondary substances of abuse, the mode, frequency and age of first use of substance and information on prior treatment. Results. The results indicate that between 2004 and 2006 a dramatic increase in treatment admissions for methamphetamine abuse occurred, a large proportion of the methamphetamine patients are adolescents and that the drug is almost exclusively smoked. Discussion and Conclusions. The rapid increase in admissions for methamphetamine abuse is of great concern, particularly as the drug has a number of serious, often chronic, side effects and that a large proportion of the patients are adolescents. The implications for public health are discussed. Surge in treatment admissions related to methamphetamine use in Cape Town, South Africa: implications for public health. Drug Alcohol Rev 2008;27:185-189
This 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 aim of this article is to describe the prevalence of risk for developing mental health problems in a large survey of high school students in the Western Cape Province in South Africa. The study ...population comprised students in Grades 8, 9, and 10 attending public schools in the Western Cape Province. Schools were randomly sampled proportional to total school size (all grades). A total of 227 schools and a total of 20,855 students completed the survey. Overall, 14.9% of students were categorised as 'high risk' for mental health problems. A significantly higher proportion of female participants were in the 'high-risk' category (18.5%; confidence interval = 17.2, 19.8) than male participants (10.1%; confidence interval = 9.3, 10.8). Female students who reported more days absent from school in the previous school quarter were more likely to be in the 'high-risk' category for mental health problems. Findings highlight the need for screening for mental health problems among adolescents attending high school in South Africa, and the need to develop intervention programmes for students at risk of mental health problems.
Amphetamine-group substances and HIV Colfax, Grant, Dr; Santos, Glenn-Milo, MPH; Chu, Priscilla, DrPH ...
The Lancet (British edition),
2010-Aug-07, Volume:
376, Issue:
9739
Journal Article
Peer reviewed
Summary Amphetamine-group substances are used worldwide and are more prevalent than either cocaine or opioids. We reviewed published reports about amphetamine-group substances and did a meta-analysis ...of randomised controlled trials of behavioural interventions for their use. Most research was done in developed countries. Many, but not all, studies show an association between amphetamine-group substance use and risk of HIV infection. Much use of amphetamine-group substances is non-injection and is associated with increased HIV risk, particularly in men who have sex with men. The structural, social, interpersonal, and personal factors that link to amphetamine-group substance use and HIV risk are poorly understood. 13 studies, with a cumulative sample size of 1997 individuals, qualified for the meta-analysis. Overall, high-intensity behavioural interventions were moderately effective in reducing use of amphetamine-group substances (effect size 0·28, 95% CI 0·13–0·44). We did not find conclusive evidence that behavioural interventions as a group are more effective than are passive or minium treatment for reduction of amphetamine-group substance use or sexual risk behaviours. The search for effective, scalable, and sustainable interventions for amphetamine-group substance use, including pharmacotherapies, should be supported and encouraged.
Objective: To investigate whether methamphetamine use is associated with sexual risk behavior among adolescents. Method: A cross-sectional survey of 1,561 male and female high school students in Cape ...Town (mean age 14.9 years) was conducted using items from the Problem Oriented Screening Instrument for Teenagers (POSIT) HIV Risk Scale. Results: Nine percent of the students had tried methamphetamine and 30% of male and 17% of female students reported sexual debut. Multinomial logistic regression analyses showed that methamphetamine use in the past year was significantly associated with being in a higher HIV/STI risk category (RRR = 2.1, 95% CI: 1.10-4.03, p < 0.05). Conclusions: Methamphetamine use, coupled with a high HIV prevalence in South Africa, raises serious cause for concern about the potential for methamphetamine to further exacerbate the prevalence and spread of HIV in Cape Town.
U Nreports point to a steady increase in heroin use in a number of African countries, including South Africa. South Africa also has one of the highest HIV infection prevalence rates in the world. ...Given the link between intravenous heroin use and HIV transmission, this study aimed to investigate HIV-related risk behaviors among heroin users in the city. A snowballing or chain referral sampling technique was used to find 239 heroin users in Cape Town who were interviewed using a structured questionnaire. Overall, 24% of all the participants reported that they had injected heroin in the past 30 days and 89% of these had shared a needle at least once during that period. Condom use was irregular among the survey participants. Three percent stated that they were HIV positive. Heroin use has become a major concern in Cape Town and may still be increasing. While injecting use still appears to be fairly limited, this has the potential to change. Further debate is required regarding the introduction of harm reduction approaches that have been found to be effective elsewhere.
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