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Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Karl Peltzer, kpeltzer hsrc. Illicit drug use is a growing public health problem. The aim of the study was to assess the prevalence of drug use and the sociodemographic and health characteristics that influence it among young and adult South Africans. Data based on the South African national population-based survey in for 26 individuals Bivariate and multivariable logistic regression was conducted to assess the association between sociodemographic factors, health variables and any past 3-month drug use. Overall, any past 3-month drug use was 4. The proportion of past 3-month cannabis use was 4. Among the nine South African provinces, any past 3-month drug use was the highest in the Western Cape 7. In adjusted, multivariable, logistic regression analysis among both men and women, younger age, being mixed race and hazardous or harmful alcohol use were associated with any past 3-month drug use. In addition, having been a victim of violent crime and sexual risk behaviour among men and having psychological distress among women were associated with any past 3-month drug use. An increase of any past 3-month drug use from 3. Prevention and intervention activities targeting drug use, in particular in identified risk groups, need to be strengthened in South Africa. The estimated global prevalence of illicit drug use including amphetamines, cannabis, cocaine, opioids, etc. In a US population-based survey conducted among individuals aged 12 years and older in , past 1-month any illicit drug use was Previous investigations in South Africa and other countries found that specific sociodemographic factors were associated with drug use, including male gender, 5 , 6 younger age, 5 specific population groups mixed race and white people , 5 , 6 lower income or not employed 5 and geolocality such as urban areas. In order to update planning on drug use programming, more recent national population-based prevalence data on illicit drug use among adolescents and adults in South Africa are needed. Therefore, the purpose of this secondary analysis was to make more recent estimates on the frequency and type of drug use among women and men 15 years and older available using a nationally representative household survey in All individuals within a household were eligible to participate. Trained and supervised field workers interview-administered a questionnaire. Informed consent was attained prior to the conduct of the interview. The detailed survey methods are described elsewhere. Any drug use in the past 3 months was coded as 1 and never as 0. All items were added together to indicate the prevalence of any illicit drug use in the past 3 months. Demographic measures included age, educational level, race African black people or other races , geolocality, province and employment status. These scores were added up, with higher total scores indicating higher psychological distress. Sexual risk behaviour was assessed with two questions. Descriptive statistics were used to summarise drug use prevalence, sociodemographic factors and health variables. Associations between the outcome variable of any past 3-month drug use cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens or opiates including Whoonga , sociodemographic and health risk-independent variables were examined by calculating odds ratios. Unconditional multivariable logistic regression was utilised to assess the impact of explanatory variables for the outcome of past 3-month drug use prevalence, for women and men separately. In the article, weighted percentages are presented. All statistical analyses were performed by using Stata software version 12 Stata Corp. This analysis is based on data on individuals aged 15 years and older who participated in the survey. Response rates for the interview was More than half of the participants A large proportion of the participants Overall, the past 3-month of any drug use was 4. The proportion of the past 3-month cannabis use was 4. The prevalence of past 3-month drug by injection was 0. In adjusted, multivariable, logistic regression analysis among men, younger age, being mixed race, not living in a rural informal area, hazardous or harmful alcohol use, having been victim of a violent crime and having two or more sexual partners in the past 12 months were associated with any past 3-month drug use. In adjusted, multivariable, logistic regression analysis among women, younger age, being white people or of mixed race, not unemployed looking for job , psychological distress and hazardous or harmful alcohol use were associated with any past 3-month drug use see Table 2. In this very large national population-based study of among individuals 15 years or older found that any past 3-month drug use was 4. This seems to show that the increase in any drug use is mainly attributed to an increase in cannabis use and a decrease in poly drug use two or more drugs from 0. The increase in the prevalence of cannabis use may be attributed to lower costs and better accessibility than the other drugs. One review 18 indicates a global increase in substance use, including illicit drug use, in particular among young people, emphasising the importance of interventions. The use of Whoonga does not seem to be insignificant. In a qualitative study:. The use of amphetamine-type stimulants including tik and others had been as high as 2. As found in previous studies, 5 , 6 , 7 , 22 including in South Africa, the prevalence of drug use was significantly higher among men than women. Further, in agreement with some previous studies, 5 , 6 this study found that younger age and being from the mixed race population group were associated with drug use. Unemployment was among men in bivariate analysis associated with drug use, as found in some previous studies. In agreement with previous reviews, 8 , 9 , 10 , 11 , 12 this study found that hazardous or harmful or probable dependent alcohol use among both men and women, having had more than one sexual partner in the past 12 months among men, having been victim of violent crime among men and psychological distress anxiety and depression among women were associated with drug use. Drug use prevention and intervention have to include co-morbidity factors such as common mental disorders, alcohol use disorders and sexual risk behaviour. This study was cross-sectional and no causative conclusions between independent variables and drug use can be drawn. The data on drug use were collected by self-report and may underreport the true consumption rate. Possible reasons for this may be that alcohol and tobacco use were not assessed as part of the ASSIST and an additional item Whoonga use had been added. An increase of any illicit drug use prevalence rates was observed from to in South Africa. Prevention and intervention activities targeting illicit drug use, in particular in identified risk groups, need to be strengthened in South Africa. The work used data from the Human Sciences Research Council. Version 1. The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article. All authors read and approved the final article. Drug use among youth and adults in a population-based survey in South Africa. S Afr J Psychiat. As a library, NLM provides access to scientific literature. S Afr J Psychiatr. Find articles by Karl Peltzer. Find articles by Nancy Phaswana-Mafuya. Received Jun 5; Accepted Sep 12; Collection date Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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Evidence gathered by police in Durban in a July raid that demonstrates the assembly-line production approach and sheer scale of producing heroin capsules. Durban is home to one of the oldest, largest and most deeply entrenched heroin markets in South Africa. As the market has grown in sophistication, a unique method of processing and distributing heroin has come to be widely used in the Durban area: that of packaging the drug in pharmaceutical-style capsules. This unique method sheds light on the structure of the heroin market in and around Durban, yet also raises questions as to why Durban-based drug networks are operating differently to their counterparts elsewhere. This evolution has taken place in a volatile context. Drug dealers in key Durban suburbs are deeply entrenched in their communities, employing a mix of charitable giving to secure community favour , violence and links to corrupt police officers. The capsules were part of a haul that also included thousands of tablets of Mandrax and methaqualone a precursor for manufacturing Mandrax , as well as other large volumes of heroin. This raid was one of the largest hauls of heroin capsules in KwaZulu-Natal province. One such raid in Springfield Park in Durban in March revealed capsule-pressing machinery and thousands of empty capsules, with police estimating that they believed 10 capsules containing heroin were being manufactured per day. Since January , over individual capsules containing heroin have been seized in South Africa, according to our analysis of drug seizures reported by the South African Police Service. However, the data is useful in illustrating the geo-graphical concentration of these capsules. During this analysis, no reports were noted of heroin capsules being seized in South Africa outside of KwaZulu-Natal province, and seizures have been overwhelmingly concentrated in Durban. Other seizures were made in surrounding towns near Durban such as Pietermaritzburg — all along major roads leading out of the city within a kilometre radius. Figure 1 The number of heroin capsule seizures in KwaZulu-Natal has risen sharply since Note: Seizures of these capsules are highly concentrated in and around Durban, and no seizures have been reported outside of the province. Source: South African Police Service. Metrics measured included a comparison of the retail packaging of heroin samples, with capsulized heroin reported only in Durban and Pietermaritzburg. Examples of heroin in capsule form are also rare outside of South Africa: our research team is aware of only two other examples. During our research in , capsules were reported by people who use drugs PWUD in Busia, a border town that straddles the Uganda—Kenya boundary. In interviews, sex workers and PWUD in Busia reported that the capsules were mainly provided by truck drivers. It is possible that the easily disguised pharmaceutical packaging may be an advantage for these drivers when travelling across borders. In both cases, the capsules containing heroin do not appear similar to those being produced in KwaZulu-Natal, with the drug being re-sealed into pharmaceutical-style blister packs in order to resemble regular medical products. By contrast, the capsules sold in Durban are stored as loose capsules. Capsules of heroin in Busia, on the Uganda—Kenya border. Unlike the capsules found in Durban, these are re-sealed into medical-style blister packs so as to look like regular pharmaceuticals. Seizure data supports this narrative, as the number of capsules seized has increased exponentially from fewer than 50 annually before to over in and The shift towards capsules has brought about a revolution in efficiency, creating an assembly-line style of production that outstrips other methods. In addition, studying the retail packaging can provide interesting information about forms of drug consumption and supply routes. For example, the fact that no samples have been reported in our South Africa pricing surveys outside of KwaZulu-Natal — either by police or by PWUD — may suggest that the distribution networks that actually transfer the heroin from bulk into capsules cater only to a local consumer population. However, there is a possibility that examples of capsule heroin may be being overlooked. After all, in capsule form the drug can more easily be disguised as an innocuous medicine, passing under the radar of police and researchers alike. In an interview, one Durban police officer argued that dealers had shifted to capsules because consumption in the area had increased: capsules allow dealers to produce a larger quantity more efficiently. Why has the technical expertise seemingly not been passed to networks in other cities, especially when links between Durban drug gangs and those in Cape Town have been previously documented? The concentration around Durban raises many questions for future analysis. Samples of heroin from different locations in South Africa. The central image shows a heroin capsule, pictured in Durban. The left and right images, collected in Cape Town and Port Elizabeth, respectively, show plastic-wrapped heroin. This is how heroin is generally packaged for consumption in South Africa: capsules are a phenomenon that is unique to Durban. Figure 2 Distribution flows of heroin in South Africa. Following in-depth GI-TOC fieldwork re-searching the political economy of urban drug markets, 13 there are a few key factors to understanding the drugs landscape in Durban. All these factors are exemplified in the story of Teddy Mafia real name Yaganathan Pillay , a well-known local drug kingpin whose assassination on 4 January this year — and the subsequent mob lynching of his killers — rocked Durban. Drug dealers in Durban often operate with a very high public profile, enabled by a climate of impunity that derives from police corruption. He was arrested in January alongside his son after a police raid at their home. Note: The above timeline shows the assassinations and attempted assassinations that have been publicly reported as being linked to the drug market in Durban. Despite these multiple major incidents and the invest-ment of police resources, Teddy Mafia was never convicted of a drug-related offence. Sources say that this was thanks to law-enforcement officers on his payroll. One police officer in a leadership role argued that Durban would not be home to powerful and well-known dealers without police tip-offs and corrupt support. We knew their pawn shops. We knew the names of the cops who arrived to collect tax. And we supplied that information to the relevant bodies in law enforcement, but there was no will to shut them down. Some of them do get arrested, but there are no convictions. They anoint their communities with false charity while they inject those very communities with poisonous drugs that get these youngsters hooked and destroys their lives. As we drove past, men in nearby hostels blew whistles, which community activists said is a system used to alert drug dealers to a potential police raid. These two key trends — rising violent competition and community support for drug kingpins — came together around the events of 4 January, when Pillay was shot in his home in Chatsworth. According to a source working in crime intelligence in Durban, the alleged purpose of the meeting was to sell unlicensed firearms to Pillay. However, the source went on, it was in reality an assassination ordered by a rival dealer in Chatsworth, against whom Pillay had been waging war. The men shot Pillay and fled, only to be caught by a mob that had assembled outside the house. They were then reportedly shot, and footage shared widely on social media shows the bodies being beheaded and then burned in view of an assembled crowd of hundreds. As shown by the career of Teddy Mafia, the phe-nomenon of heroin capsules — the development of a resource-intensive, more efficient mode of drug distribution — has taken place under a certain set of circumstances where police are highly compromised, drug networks can operate confidently with impunity and often with community support and the rising value of the drugs market thanks to growing con-sumption is spurring violence as groups compete for control. But how to interpret this phenomenon is still a very open debate. On one hand, it could be argued that investments in laboratory-style equipment to improve heroin production efficiency demonstrate that drug networks in Durban have been emboldened, and are not concerned that sourcing pharmaceutical equipment could raise suspicion. On the other, in a context where corruption is rife and drugs networks are well protected, what is the advantage of concealing heroin in capsule form? Further investigation into the unique characteristics of the Durban drugs market may seek to answer these questions. According to our analysis of drug seizures reported by the South African Police Service, there have been 13 seizure incidents in KwaZulu-Natal since January , each of which have led to the seizure of over 10 capsules. In the largest such incident, an estimated capsules and 59 kilograms of heroin powder were mysteriously reported stolen while being transported by police after it was seized in a raid in May Note: this research paper illustrates a sample from Durban where capsules were used. In the research underlying the same paper, capsules were also reported in Pietermaritzburg. Interview with a law-enforcement officer in a narcotics-focused unit, Durban, 10 April Interview with high-ranking investigative police officer stationed in Phoenix, Durban, May Community activists and police officers working in key suburbs said that dealers pay bills for community members and provide loans, have invested in local sports facilities and host celebrations. In return, they may expect support from the community they have patronized. He later died in hospital. Risk Bulletins. Tap or select text, and then tap the bookmark icon to save a bookmark. Bookmarks are saved in your browser cache. Clearing your cache will remove them. Your last visit. The last time you visited, you stopped reading here. Heroin capsules: a Durban-specific phenomenon? How the Central Firearms Registry has been left open to manipulation. About Risk Bulletins.

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