FRAMEWORK FOR A

NATIONAL DRUG MASTER PLAN

DRUG ADVISORY BOARD

SOUTH AFRICA

OCTOBER 1997

CONTENTS

PREAMBLE

1. AN EVALUATION OF THE MERITS AND AIM OF A DRUG MASTER PLAN SITUATION ANALYSIS

2.1 Introduction
2.2 The broader socio-economic and demographic context in South Africa
2.3 Population distribution
2.4 The nature and extent of drug abuse in South Africa

3. SURVEY OF CURRENT MEASURES APPLIED TO ADDRESS DRUG ABUSE AND TRAFFICKING IN SOUTH AFRICA

3.1 Policy initiatives, legislation and international co-operation
3.2 Supply reduction initiatives
3.3 Demand reduction initiatives

4. RESEARCH / INFORMATION SYSTEMS

4.1. Historical appraisal of drug-related research and information bases in South Africa
4.2 Research needs
4.3 Research Institutions
4.4 Governmental Information Systems
4.5 Networks Facilitating Research

5. A NATIONAL PLAN OF ACTION

5.1 Vision
5.2 Mission
5.3 National goals
5.4 Principles
5.5 An agenda for action

6. INSTITUTIONAL ARRANGEMENTS

7. MECHANISM FOR IMPLEMENTING A DRUG MASTER PLAN

8. MANAGEMENT OF A SOUTH AFRICAN NATIONAL DRUG AUTHORITY

8.1 Options to be considered
8.2 Proposed structure of the central drug authority
8.3 Proposed central drug authority

9. GLOSSARY

10. REFERENCES

The Secretary
Drug Advisory Board
Department of Welfare
P/Bag X901
PRETORIA
0001

Telephone: 012 312 7568 (Ms Joan Groenewald)
Facsimilee: 012 324 2648
e-Mail: wels040@welspta.pwv.gov.za

Members of the Master Plan Committee of the Drug Advisory Board were:

Dr S Rataemane(convener) SAAPSA
Mr T Stander (facilitator) Department of Welfare
Dr S de Miranda Alcohol and Drug Studies, Johannesburg
Dr EW Harvey Department of Welfare
Mr L McCarthy (drafter) Attorney General Office, Cape Town
Mr J Welch Department of Justice, Pretoria
Ms O Maphai Department of Health
Ms I van Vuuren Department of Health [Medicines Control Board]
Supt K van Aarde South African Narcotic Bureau[SANAB]
Capt E Kadwa South African Narcotic Bureau [SANAB]
Mr M Lourens South African Revenue Services
Mr S Mathe South African National Council on Alcoholism and Drug Dependency [SANCA]
Mr A Seckle Department of Education
Mr P Viviers Department of Welfare
Ms S Brewis Department of Welfare
Ms J Groenewald (Secretary) Department of Welfare
Dr Y Vawda Department of Correctional Services
Mr V van Aswegen Department of Correctional Services
Ms L Rocha Silva Human Science Research Council
Dr C Parry Medical Research Council
Ms E Van Niekerk Council for Scientific and Industrial Research

FRAMEWORK FOR A DRUG MASTER PLAN

PREAMBLE

This framework should be viewed against the background of a prevailing concern among national policy makers and service providers with preventing an expected increase in drug-related health and social problems in South Africa. This concern is supported by evidence throughout the world that:

• an increase in the general level of drug intake and, consequently, in the level of drug-related problems often occur in countries undergoing major socio-economic change.
• the general level of drug intake in a country is positively related to the general prevalence of various chronic diseases (e.g. HIV/AIDS) and socio-economic impairment (such as crime, impoverishment, reduced worker productivity and unemployment) in that country; and

A comprehensive review of relevant South African research, as well as the experience of service providers and law enforcement agents, point towards a general increase in the prevalence of drug-related problems in South Africa.

Although efforts have been made over the past fifteen years to mobilize concerted action against drug-related problems in South Africa, these efforts have not been successful, mainly because of deeply ingrained fragmentation. An innovative plan is needed to mobilize and sustain comprehensive and integrated policy. A paradigm shift from traditional undimensional to multidimensional thinking and action in the field of combatting drug-related problems, will have to be made. The envisaged paradigm or approach would require an overarching framework within which multiple, possibly conflicting, facets can link in a mutually satisfactory manner, each being complemented or strengthened rather than weakened or eliminated by the other.

Hence and in line with international practice and in order to effectively deal with the increase in drug-related problems in this country, the South African Drug Advisory Board has initiated the formulation of a draft Drug Master Plan for submission to Cabinet.

The Drug Master Plan will set out the Government’s vision on how departments, agencies, communities and other role players, can mount a collective effort to reduce drug-related problems and, indeed, substance abuse and illicit drug trafficking in South Africa.

The proposed Drug Master Plan will comprise of the following:

• General aims
• A broad overview of
• the broader socio-economic and demographic context in South Africa,
• research findings on the nature and extent of drug trafficking, areas of risk with respect to the development of drug-related problems as well as the general prevalence of such problems, and
• -the legislative, service provision and research context in South Africa with regard to combatting/preventing drug-related problems.
• Specific objectives for combatting and preventing drug-related problems, based on the reviewed research findings and infra structural context.
• Propose a time schedule and ways for implementing the proposed objectives.

The intention is to set out parameters for a comprehensive and integrated national strategy to combat drug-related problems and especially illicit drug trafficking, specifically as part of the Government's broader socio-economic reconstruction and development initiatives e.g. Growth and Development Strategy (GDS), National Crime Prevention Strategy (NCPS) and government departments, non-government agencies and civil society, generally collaborating closely. In fact, this framework will form the basis for the development of a five-year strategic plan of action.

It should be noted that the focus of the Master Plan is on alcohol, tobacco, illicit drugs and the misuse of over - the - counter and prescription medications.

1. AN EVALUATION OF THE MERITS AND AIM OF A DRUG MASTER PLAN

The Minister for Welfare and Population Development requested the Drug Advisory Board (established in terms of Act 20 of 1992) to develop a Drug Master Plan for South Africa under the auspices of the Chairperson, Mr F Kahn, Attorney- General of the Western Cape Province.

In this respect it is also important to note that in terms of Section 3(b)(e) of the Prevention and Treatment of Drug Dependency Act, 1992 (Act 20 of 1992) the Drug Advisory Board is entitled to initiate, co-ordinate and promote measures to prevent and combat the abuse of drugs.

Further more, the United Nations Commission on Narcotic Drugs called upon States to formulate and implement a National Drug Master Plan. The United Nations Drug Control Programme has also been invited to increase its assistance to States in adopting Master Plans and to give higher priority to combatting drug abuse and psychotropic substances.

Indeed, the international community has called upon South Africa to adopt a national anti-drug strategy. The vital importance of (a) co-ordinating at national level (in a way that transcends inter-departmental and territorial encumbrance), and (b) firm and authoritative leadership at political level has been stressed.

Note also needs to be taken, that the Southern African Development Communities (SADC) protocol on combatting illicit drug trafficking, to which South Africa is a party, reads as follows:

"A joint concerted effort can only be effected through the implementation of coordinated, comprehensive and integrated drug control and prevention programmes, that address both supply and demand."

Against the above background, the Drug Master Plan, a Government document, constitutes an operational manual for the planning, management and implementation of comprehensive and integrated national and local drug control measures, whilst simultaneously serving as a barometer of the commitment and performance of Government.

Overall, the aim of the Drug Master Plan is:

• To promote a community, free of drug abuse, through effective control over the availability of dependence-producing and related substances, through law enforcement, with regard to drug-related offences, and through the reduction of the demand for drugs, specifically by means of
• Establishing a comprehensive and integrated framework for policy and action that facilitates.
• a common understanding and, thus, a common vision and general support regarding the prevention of illicit drug use and reduction of licit drug use in South Africa
• links with the general socio-economic programmes of the Government (e.g. GDS and NCPS)
• recognition of the wider African and international context
• accountability through ongoing monitoring and evaluation and, thus, research-based policy and action
• a public health understanding of the nature, development, prevention and containment of drug-related problems and, consequently a balanced attention to the acceptability (demand) and the availability (supply) of drugs, giving attention to multi-levelled initiatives, i.e.
1. primary initiatives (environmental and individual-orientated "engineering" to forestall and/or minimize the negative impact of drug-related problems), secondary initiatives (early identification and intervention) and tertiary initiatives (rehabilitation), as well as
2. ) national, provincial and local initiatives
• broad-brush and, thus, co-ordinate community-based and community-led initiatives.

The following chapter will deal with the drug scene in South Africa which will include the nature and extent of drug abuse and the current measures applied to address drug-abuse and trafficking. This chapter will form the basis for the next chapter which will deal with the way forward.

2. SITUATION ANALYSIS

2.1 INTRODUCTION

Since 1994 the first democratically elected government of South Africa faced enormous challenges in the field of safety, security and socio-economic stability.

Illicit use of and traffic in drugs in particular, pose a serious threat to the health and welfare of the people of South Africa and adversely affect the economic, cultural and political foundations of society.

Drugs and alcohol abuse affect South Africans from every social, ethnic, racial and economic background. It blights individual lives, undermines families, damages whole communities and hampers economic and democratic progress.

It is therefore of crucial importance that South Africans mobilize a collective effort to reduce illegal drug use and its devastating consequences in this country - to manageable proportions, at least.

2.2 THE BROADER SOCIO-ECONOMIC AND DEMOGRAPHIC CONTEXT IN SOUTH AFRICA

2.3 POPULATION DISTRIBUTION

South Africa's population consists of at least 37,9 million people grouped in 8,8 million households situated in 9 provinces and spread over 1 219 090 km². The country’s constitutional development has culminated in the Constitution of the Republic through Act 108 of 1996. South Africans are in the process of building a united and democratic South Africa, able to take its rightful place as a sovereign state in the family of nations.

2.4 THE NATURE AND EXTENT OF DRUG ABUSE IN SOUTH AFRICA

2.4.1 DRUG TRAFFICKING

In a recent paper delivered by the Superintendent of the South African Narcotics Bureau (SANAB) on the nature and extent of drug trafficking in South Africa he stated the following (South African Police Service, SANAB 1996:1):

"A survey of current public opinion leads unequivocally to the perception that the war against narcotics trafficking has been lost by law enforcement agencies. Everyday one can find news articles on previously unheard of quantities of all types of drugs being found or seized. These seizures represent only the tip of the iceberg in terms of the actual volume of illegal drugs which are being produced and sold, but which evade the attention of police authorities. It can be safely concluded that the drug menace is a more significant threat to civilized societies than ever before. This situation exists in spite of increased efforts on the part of law enforcement authorities world-wide to stem the tide.

Since South Africa has emerged from international isolation, it has increasingly become a transit point as well as a consumer market for many different types of drugs."

The document concludes with the following warning (South African Police Service, SANAB 1996:22):

"The drug trafficking issue could not only impact negatively on interstate relations in the African region, but also on the political and economic stability (in South Africa), especially as far as the successful implementation of the Recon-struction and Development Programme in South Africa is concerned. The dimensions of the problem require a comprehensive and integrated counter-strategy that attempts to reduce the supply of and diminish the demand for drugs."

2.4.2 NATURE AND EXTENT OF DRUG USE

Alcohol remains the most popularly abused drug, and alcoholic beverages are growing in popularity, especially in informal settlements and rural areas. The abuse of over-the-counter medication and prescription drugs are increasing. Regarding other drugs, the South African market is dominated by Dagga, Mandrax, Cocaine, and to some extent Ecstasy. The simultaneous use of Dagga and Mandrax is widespread in South Africa. Glue sniffing is also prevalent. The increase in liquor outlets (shebeens in particular) and drug smuggling and selling as a means of income, is a grave concern.

Generically, high-risk groups include the youth, commercial sex workers and pregnant women. There are indications that the abuse of drugs are increasing.

For the period 1992 - 1996, South African Narcotics Bureau (SANAB) figures (excluding those from other policing units and the 13,5 million kilograms of Dagga that have been destroyed), show that 1 812 297 kg of dagga, 12 940 241 Mandrax tablets, 420 kg Cocaine, 30 kg of Heroine and 6 750 Ecstasy tablets have been confiscated. This translates into drugs worth a street value of R22 billion or for that matter, to at least R220 billion for the period 1992 - 1996.

3. SURVEY OF CURRENT MEASURES APPLIED TO ADDRESS DRUG-ABUSE AND TRAFFICKING IN SA

3.1 POLICY INITIATIVES, LEGISLATION AND INTER - NATIONAL COOPERATION

South Africa is a signatory to the 1971 Convention on Psychotropic Substances and the 1961 Single Convention on Narcotic Drugs and its 1972 Protocol. The control of licit substances, as prescribed by these Conventions is conducted under the Medicines and Related Substances Control Act 101 of 1965. Based on scientific information the Medicines Control Council evaluates the safety of drugs with an abuse potential and advises the Minister of Health on appropriate scheduling for these substances in the interest of public health.

A legislative package, including laws on asset forfeiture, extradition and international cooperation in criminal matters, approved by Parliament during November 1996, should enable South Africa to finally accede to the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

In addition, South Africa has entered into a number of formal and informal agreements with the United States of America, Great Britain, Brazil, some Eastern countries and agencies such as the Drug Enforcement Agency (DEA) and INTERPOL, with regard to mutual legal assistance, intelligence-sharing, co-operation in anti-drug efforts and training.

Although South Africa has entered into a number of agreements with other countries, limited emphasis is placed on the sharing of knowledge and experience on demand reduction initiatives.

South Africa has placed itself at the centre of regional counter-narcotics efforts by facilitating the Protocol on Combatting Illicit Drug-Trafficking in the South African Development Community (SADC) Region, signed by 12 Southern African countries. This protocol needs to be ratified.

What also needs to be noted is that the Drug Advisory Board is a statutory body appointed by the Minister for Welfare and Population Development facilitating implementation of the above agreements on a multi-central level. It has representatives from the nine provinces and Departments of Health, Education, Labour, Justice, Police Service, Correctional Services, Welfare, the National Defence Force and Foreign Affairs as well as experts in the field of substance abuse.

Prevention of drug-abuse and treatment of drug dependence are being dealt with under the Prevention and Treatment of Drug Dependency Act, 1992 (Act 20 of 1992).

3.2 SUPPLY REDUCTION INITIATIVES

The Department of Safety and Security’s Police Plan unveiled in 1996, identifies narcotic related offences as one of the National Crime priorities. Its key objective with regard to narcotics is stated as follows:

"To implement effective counter-narcotic strategies in conjunction with enhanced investigative capacity and skills, supported by related intelligence, education and awareness programmes. The control and policing of ports of entry must augment such capacity.

To tackle all aspects of drug-trafficking, whether the production, distribution importation, exportation or sale."

Amidst the restructuring of the police, which is still underway, the South African Narcotics Bureau (SANAB) is recognised as the most effective drug law enforcement agency in the region. The National Organised Crime Division is currently investigating the operations of a myriad of drug-smuggling syndicates.

The Government established a new border control and policing unit consisting of 1 600 officers, to patrol land, sea and air points of entry. The role of the 1,500 officials of South African Customs and Excise bureaus in narcotics interdiction should be extended. Comprehensive changes to customs legislation are aimed at addressing inefficiencies in Customs and Excise as well as Revenue Services. These relate to measures to streamline South Africa’s ports in a bid to stem the influx of drugs, to expose customs fraud and smuggling, and to enhance skills and training levels.

Prosecutions of illicit substances are conducted under the Drugs and Drug-Trafficking Act, 1992 (Act 140 of 1992). Specialisation involving prosecutors, police and other agencies, takes place on an ad hoc basis.

Finally, in order to facilitate the integration of drug control measures into the broader national social and economic plans of our country, the Strategy should be adapted to meet the needs of, amongst others:

• the Government’s macro-economic plan (GEAR) and the RDP.
• the National Crime Prevention Strategy.
• the Department of Justice’s Vision 2000.
• the Social Welfare Action Plan of the Department of Social Welfare.
• the Mental Health and Substance Abuse Plan and the National Drug Policy of the Department of Health.
• the Department of Education’s transformation initiative, through Curriculum 2005, the Campaign on the Culture of Learning and Teaching, and the Codes of Conduct in the SA Schools Act (1996).

3.3 DEMAND REDUCTION INITIATIVES

3.3.1 PREVENTION

Although recognition is given to the importance of addressing drug-related problems on a multi-sectoral and multi-levelled manner, various factors complicate matters.

Furthermore, preventive agents have prioritised programmes related to the youth, to "the disentangling" of drug-crime connections, the reduction of the level of drug use among offenders and the prevention or curbing of drug-related HIV infection. Initiatives in this regard should be strength-ened.

Most importantly, accessible and acceptable specialised treatment to those who are experiencing comparatively severe drug-related biopsychosocial impairment is imperative. Existing initiatives need to be expanded to meet increased demand. The multifaceted and complex nature of drug use underscores the need for optimally locating preventive services within the broader context of service delivery in South Africa. In fact, the implementation of a community-based preventive strategy seems essential. In this respect, available data remind preventive agents that, as shown throughout the world, drug-related problems (e.g. drug-crime connections) emerge and are sustained within, inter alia, a context of differential social and economic opportunity.

In this respect cognizance needs to be taken of contribution towards increased literacy to creative critical-thinking among young people.

For example the initiatives include:

• Through the adoption of a code of conduct for pupils at schools, the South African Schools Act (1996) aims to establish a disciplined and purposeful environment at schools which will be conducive to the improvement and maintenance of quality learning.
• The "Culture of Teaching and Learning Campaign", initiated by President Nelson Mandela in February 1997, inter alia address crime and substance abuse within the context of schools.
• Curriculum 2005 also emphasizes the importance of the development of values and attitudes conducive to a healthy and balanced lifestyle.

It should be noted that there are many other useful prevention strategies such as the development of recreation facilities for young people, decreasing the accessibility to alcohol through establishing a more coherent liquor outlet policy, prevention of the purchasing of alcohol by under-aged youth, and through establishing workplace intervention programmes, etc.

The Department of Health is positioning itself towards strengthening substance abuse prevention. Amongst others, the Department has restructured the Mental Health Directorate to include substance abuse explicitly. It has further established an expert committee to guide its activities in this area. The need for addressing substance abuse explicitly within primary health care, needs to be attended to.

During the second quarter of 1995 the Department of Welfare also completed a lengthy series of consultative meetings and released its second draft entitled "National Substance Abuse Strategy", as a contribution to the White Paper on Social Welfare. Specific goals and activities were identified for four areas of need namely: prevention, treatment and rehabilitation, information and research. Apart from these current initiatives the Department of Welfare is the leading department in SA with regard to substance abuse prevention and treatment.

Primary intervention initiatives include awareness, skills training information and education programmes, targeting various sections in the general public. The focus of secondary prevention initiatives is on high-risk groups (e.g employers, youth, women) providing specific education programmes.

Tertiary prevention initiatives focus on holistic community-based treatment programmes, with the aim of re-integrating the person into society and preventing the recurrence of abuse. Strategies are devised to curb the demand for abusive substances, at the same time linking up with supply reduction strategies.

Readers have to be reminded that apart from indications that existing treatment/prevention services are inadequate in terms of the proportion of people in need in the most populated areas and specifically the African community in South Africa. It is clear that existing facilities are fairly costly, for example, the total cost of welfare authorities in the provinces for services and facilities related to substance abuse, amounts to R44 million in the 1997/98 financial year.

In conclusion, note needs to be taken that various preventive initiatives exist on primary, secondary and tertiary level.

3.3.2 TREATMENT AND REHABILITATION

Treatment should be viewed as a process aimed at the promotion of the quality of life of the drug dependant and his/her family (husband/wife, family members and significant other persons in his/her life) with help of a multi-professional team.

Co-responsibility for the prevention and treatment of drug dependency rests with the individual, the family, civil society, schools, employers, businesses, religious organisations and the Government.

Community-based treatment and development should be promoted, particularly in under serviced areas. Community development programmes in disadvantaged communities will promote empowerment and self-help strategies.

Interprofessional treatment and after-care programmes (rehabilitation) will ensure the effective reintegration of the dependant into the community.

Services to under serviced communities should be expanded through community-based strategies. Existing residential facilities which are not fully being utilised, need to become more efficient and effective in meeting needs. Residential facilities will only be expanded after rigorous assessment of needs. Consultations need to be held about the provision of detoxification and medical care services at all provincial hospitals.

Services in the overcrowded townships, informal settlements and rural areas, are grossly inadequate, compared with those in urban areas. Detoxification services, at hospitals in particular, are often inadequate. Community-based services as well as treatment programmes and services for high risk groups, are very limited. Insufficient funds and personnel, threaten existing services and their further development. After-care services providing for the reintegration of patients into the community, are inadequate.

4. RESEARCH/INFORMATION SYSTEMS

4.1 HISTORICAL APPRAISAL OF DRUG-RELATED RESEARCH AND INFORMATION BASES IN SOUTH AFRICA

Historically, the importance of driving the prevention/combatting of drug-related problems through research, seems to have been regularly advocated from various platforms and frequently formally acknowledged in (non) government policy or strategic documents. Traditionally South African policy makers and service providers in the field of prevention/combatting drug-related problems, have fairly consistently tried to take cognisance of research, especially in terms of accounting for their concerns.

A 1992 review of drug-related research in South Africa, over the period 1960-1990, showed that research was generally not part and parcel of drug-related preventive initiatives. Researchers and policy makers/service providers, tended to operate in isolation, with investments in preventive initiatives not simultaneously accompanying investments in research. A general tendency to research/gather information, without explicitly grounding the work within a comprehensive conceptual framework, impeded the development and sustainment of a solid information base of national scope, essential for rational and cost-effective national preventive policy/action.

However, notwithstanding the above-mentioned fragmentation, the 1992 review showed that South Africa, in comparison with other African countries at least, had fairly substantial and sophisticated research capacity in terms of timeously and appropriately informing policy makers/service providers in the field concerned.

Since more or less the beginning of the 1990s various "external" pressures came to facilitate the development of close partnerships between researchers and between researchers and policy makers/ service providers. These include (a) an explicit multidimensional emphasis in policy/strategic documents (e.g. White Paper for Social Welfare 1997 and the National Crime Prevention Strategy 1996), (b) a "tighten-the-belt" economic climate, an expected increase in the general level of drug use and consequently in the level of related problems, and (d) statutory measures (e.g. the White Paper on Science and Technology 1996) to ensure research collaboration. In fact, since the beginning of the 1990s various collaborative networks among stakeholder agents have evolved.

Assuming that current high-level national and international interest in drug-related issues, and especially research findings in South Africa continues, an unprecedented demand for drug-related research (particularly on a contractual (profit-making basis) can be expected.

4.2 RESEARCH NEEDS

In the light of (a) historical developments with respect to drug-related research in South Africa, (b) available information on the nature, extent and development of drug use and related problems, as well as the prevalence of such problems, and the overall aim of the Master Plan, it seems advisable to an overarching "framework" for stimulating, initiating and comprehensively integrating, drug-related research in South Africa.

The relevant framework needs to be:

• explicitly geared at promoting the prevention/combatting of drug-related problems
• premised on a multidimensional conception of research
• explicitly geared at facilitating transparency and accountability
• emphasising conceptual grounding (e.g. a public health conceptual framework).
• geared at facilitating indigenous research capacity and perspectives
• geared at linking with research capacity and perspectives in other African and overseas countries

Specifically, attention should be given to focusing on the monitoring of the nature, extent and development of drug use and related problems, as well as the prevalence of such problems; the monitoring (including auditing) and evaluation of preventive policy/action (including structures related to sustaining the Master Plan). Furthermore, facilitation should be undertaken with regard to the establishment/sustainment of a comprehensive and integrated national drug-related information base, tapping primary and secondary sources and doing so quantitatively as well as qualitatively. Finally, attention should be given to facilitating the drafting and implementation of a national drug-related research code of ethics.

Decriminalisation of drugs is another issue that needs to be investigated.

4.3 RESEARCH INSTITUTIONS

4.3.1 SCIENCE COUNCILS

4.3.1.1 Council for Scientific and Industrial Research (CSIR)

This research body concentrates mainly on industrial and scientific research aspects. In the field of substance abuse its research has mainly concentrated on alcohol and drug related traffic infringements.

Note needs to be taken that various other Science Councils also contribute to research.

4.3.1.2 Human Sciences Research Council (HSRC)

This research institute, specialising in sociological research does research pertaining to all aspects of substance abuse, through a well established division "The Centre for Alcohol/Drug Related Research". Its research includes major surveys targeting specific population groups and national surveys and expert analysis of valid statistical data. Its findings are utilised both nationally and internationally.

4.3.1.3 Medical Research Council (MRC)

"This institution is primarily engaged in epidemiological research into the nature and extent of alcohol and other drug use, and in measuring the health impact of the misuse of alcohol and other drugs. Another key focus of the MRC is in the area of formulating local and national policy. Three divisions are directly involved in conducting research in the substance abuse area:

1. The National Trauma Research Programme, which among others, has studied the impact of alcohol and other drug use on various forms of trauma.
2. The Health Consulting Office, which has been involved in longitudinal research into the role of alcohol in non-natural deaths.
3. The Mental Health and Substance Abuse Division, which has been extensively involved in the alcohol policy area, in conducting research into binge drinking among adolescents, and in running the South African Community Epidemiology Network on Drug Use (SACENDU), an ongoing system for monitoring alcohol and other drug trends (use and consequences) in various sentinel sites around South Africa. This division also oversees the MRC's extramural research in the substance abuse area."

4.3.1.4 Universities

South African universities are playing an active role in substance abuse related research, specifically Cape Town, University, Stellenbosch and Durban-Westville. NGOs such as SANCA, SABRI, and the Centre for Alcohol & Drug Studies have also been active in substance abuse research.

4.4 GOVERNMENTAL INFORMATION SYSTEMS

4.4.1 NATIONAL INFORMATION SYSTEM FOR SOCIAL WELFARE (NISWEL)

The national Department of Welfare, in collaboration with all stakeholders, will develop a National Information System for Social Welfare in order to inform policy formulation, planning and monitoring. A national data-base (also regarding substance abuse) will be developed in conjunction with role players.

4.4.2 SOUTH AFRICAN POLICE SERVICE (SAPS)

The South African Police Service collect, analyse and assimilate crime and intelligence data of practical and strategic value.

 4.5 NETWORKS FACILITATING RESEARCH

4.5.1 SOUTH AFRICAN ALLIANCE FOR THE PREVENTION OF SUBSTANCE ABUSE (SAAPSA)

The South African Alliance for the Prevention of Substance Abuse (SAAPSA) was established in 1995 to facilitate networking amongst organisations, government, non-governmental and civil society, concerned with substance abuse in South Africa - with a view to optimise co-operation in the prevention and treatment of alcohol and other drug abuse.

4.5.2 SOUTH AFRICAN RESEARCH-PRACTITIONER ASSOCIATION (SARPA)

The South African Research-Practitioner Association (SARPA) comprises various sections and levels of government as well as private institutions and a strong grassroots (community based) contingent. One of its major initiatives is the sustainment of an ongoing, rational, cost-effective, comprehensive and integrated needs assessment, regarding the prevention of alcohol, tobacco and other drug-related problems in South Africa.

SARPA’s vision is: sustaining an inclusive multi sectoral forum of researchers and practitioners that facilitates community-driven research based policy formation and service provision regarding drug-related prevention and treatment in South Africa.

The Association’s mission reads as follows: To inspire researchers and service providers at all levels to effect co-operatively community-driven research-based policy and services in the relevant field.

4.5.3 SOUTH AFRICAN COMMUNITY EPIDEMIOLOGY NETWORK ON DRUG USE (SACENDU)

The Medical Research Council has initiated the SACENDU project in 1996 for the following purposes:

• Develop a network of stakeholders;
• To identify changes in the nature and extent of alcohol and other drug use;
• To identify changes in alcohol and other drug negative consequences;
• To monitor the nature and extent of initiatives and resources;
• To inform policy, planning and advocacy efforts at all levels; and
• To monitor the broad impact of public health and other substance abuse interventions.

The SACENDU project currently comprises three port cities, Cape Town, Durban, and Port Elizabeth. Steps are under way to expand the surveillance system to include Gauteng. Information is presented on a six-monthly basis and comprises secondary data from specialist treatment centres, psychiatric facilities, local police stations (including SANAB data), and mortuaries, as well as primary research from school surveys, emergency room surveys, and qualitative research amongst sex workers and street children. On a six-monthly basis, workshops are being held to allow discussions around the validity of the data, to identify trends that may be emerging, further research that may be required, and local action that may be warranted. Such in-depth local data can complement national surveillance systems.

5. A NATIONAL PLAN OF ACTION

In the light of the Master Plan's general aims as well as the reviewed research findings and infra structural context in South Africa, the following specific focuses, goals and objectives for preventing/combatting drug-related problems seem essential. However, these focuses, goals and objectives need to be supplemented with specific tasks, a time schedule, as well as monitoring and evaluation mechanisms.

A national plan of action for the next five years will be developed by the national and provincial authorities, in consultation with all stakeholders, including Government departments, to facilitate the shift towards a comprehensive, integrated, equitable, multidisciplinary and developmental approach in the field of substance abuse.

The Drug Master Plan will be used as a basis for the development of such a plan of action.

A Master Plan is conceived as a comprehensive, multidisciplinary, multifacted and joint effort towards a plan of action on substance abuse at a macro level.

5.1 VISION

A well informed and equipped South African society free from drug abuse and drug trafficking.

5.2 MISSION

Promote actions to decrease the demand for licit and illicit drugs and the supply of illicit drugs.

5.3 NATIONAL GOALS

• To promote a community free of drug abuse through effective control over the availability of dependence-producing and related substances and through law enforcement with regard to drug-related offences.
• To promote the development and utilisation of appropriate information, education, prevention and life skills programmes needed for a healthy lifestyle, free of drug abuse.
• To promote the development and utilisation of multidimensional and multi professional programmes for identification, assessment, treatment and continuous development (after-care) and thereby achieve the effective reintegration of the dependent person into the community.
• To promote the development of appropriate programmes in the field of combatting drug abuse through research and the introduction, dissemination and implementation of relevant research results.
• To promote programmes which could ultimately reduce the cost and destructive impact of substance abuse.
• To promote networking in the field of substance abuse between all stakeholders.

5.4 PRINCIPLES

• In order to address the drug problem effectively there should be a balance between actions which bring about a decrease in the availability of drugs (control and law enforcement) and the demand for drugs (prevention and rehabilitation).
• Alcohol and other drugs are considered to be potentially dangerous substances
• The abuse of legal substances and the use of illegal drugs are discouraged.
• Multi -sectoral partnerships, networking and co-operation between all relevant role players at all levels, including internationally, to combat drug abuse.
• Communities have the right to information and education re substance abuse and to receive quality care and service, contributing financially where possible.
• Community based prevention treatment and development should be promoted, especially in under-served areas.
• Co-responsibility for prevention and treatment of substance abuse rest with the individual, the family, civil society, community organisations and the State.
• Programmes should be aimed at all the dimensions of man’s life (the physical, psychological, social and spiritual) and promote a healthy life style free from drug abuse.
• Special emphasis should be placed on helping high-risk groups, particularly youth.
• Affordable and accessible services for all.
• A multi-disciplinary and comprehensive approach is needed in the treatment of drug dependencies.
• Programmes should be initiated which could contribute to the optimal development of individuals, families and communities.

It should be noted that the vision, mission, national goals and principles, set out the broad outlines for action on the medium and long term. However, it is necessary to identify specific areas of action on a shorter term on the basis of what is needed to make an immediate difference in the fight against illicit trafficking and substance abuse. These areas will thus form an agenda for action which will be discussed here after.

5.5 AN AGENDA FOR ACTION

The focus of the new Master Plan should be, amongst others, on three areas, namely: drug-related crime; young people and promotion of community health.

These elements are interdependent and of relatively equal importance. They share a common purpose of breaking the cycle of addiction and reducing illegal drug circulation in South Africa. This does not detract from other efforts to enhance coordination in the three traditional programme areas: prevention; treatment and rehabilitation; and law enforcement and control.

There appears to be a special focus worldwide (and particularly in countries such as America, Britain, Canada, Thailand and Singapore) on the following: crime and safety; motivating and investing in the youth; and reducing the expenditure on health, welfare and crime resulting from illegal drug use.

Our Statement of Purpose will therefore be the following:

To take effective action by vigorous law-enforcement, accessible treatment and a new emphasis on education and prevention to:

• increase the safety of South African communities by substantially reducing drug-related crime.
• motivate our youth to reject illegal drug use and substance abuse by preventive education and by reducing acceptability and availability of drugs to young people.
• ultimately reduce cost of health and welfare services, police, justice and other sectors resulting from drug abuse.

5.5.1 INCREASING COMMUNITY SAFETY FROM DRUG-RELATED CRIME

The Government wishes to see carefully targeted and effective action to reduce the incidence of drug-related crime, which will help to make communities safer and reassure the public of the Government’s commitment.

Drug-related crime encompasses any criminal activity which is committed either to fund or as a consequence of drug misuse. This includes:

• all offences under the Drugs and Drug-Trafficking Act 140 of 1992;
• offences under the Medicine’s Control Act 101 of 1965;
• criminal and irresponsible acts by persons' acting as a consequence of drug misuse;
• acquisitive crime (such as theft, burglary and fraud);
• the laundering of the proceeds of drug trafficking, either to fund further trafficking and/or to allow unrestricted use of assets;
• violent crime carried out in the course of drug trafficking, including violence between dealers, gangs or against innocent parties.

The Government aims to have in place, effective, co-ordinate control, investigation and prosecution arrangements, to prevent and combat trafficking.

5.5.1.1. Increased Community safety from drug-related crime can be achieved by focussing on the following objectives:

• increasing the effectiveness of policing by ensuring that law enforcement agencies are adequately researched and skilled;
• effectively co-ordinating law enforcement under a leading agency which will be responsible for the development and implementation of the drug enforcement strategy;
• improving the efficiency of drug law enforcement, investigation and intelligence to apprehend drug traffickers, seize drugs, counter laundering of money and secure forfeiture of assets derived from, traceable to, or intended to be used for illicit drug-trafficking;
• *creating multi-disciplinary drug prosecution teams to secure the effective prosecution and dismantling of trafficking organizations;
• stemming the influx of drugs by safeguarding the 7000 km long border through effective control at various border posts, increasing interdiction capacity by upgrading customs control at all airports and by limiting the number of border posts and airports utilized for commercial traffic;
• reducing domestic cannabis production through crop eradication and substitution;
• targeting those who import and/or illegally divert pharmaceuticals and precursor chemicals used in the clandestine manufacture of drugs;
• developing partnership between police and communities through inter alia, visible, and assertive community policing and by involving criminal justice agencies in preventive strategies;
• breaking the cycle of drug abuse and crime by integrating drug testing, treatment and after-care, prison rehabilitation and education, and supervised transition to the community - as an effective means of controlling drug use and recidivism to criminal behaviour; and
• *strengthening international co-operation to reduce drug flows and create a hostile environment for drug trafficking.

5.5.2 MOTIVATION OF YOUNG PEOPLE TO REJECT ILLEGAL DRUG USE AND SUBSTANCE ABUSE

Against the background of rising trends in drug abuse and experimentation amongst young people, the Government wants to encourage a range of actions to enable young people to resist taking drugs. Preventive health education in schools and more widely, can raise young people’s awareness of the facts about drug abuse and the associated risks, emphasise the benefits of healthy lifestyles and develop the skills needed to make informed and responsible decisions to resist drug abuse.

As they grow older, children are open to an increasingly wide range of influences and sources of information. Drug abuse among young people is an issue in rural as well as urban areas. It extends across socio-economic boundaries and different communities. There is no single reason why young people choose to experiment with drugs and no single action which will prevent them from doing so. A co-ordinate range of preventive actions are required.

Information and skills to resist abusing drugs are best provided before experimentation is likely. Younger children are likely to benefit from unambiguous messages and from being helped to develop a range of responses to resist pressure or encouragement to abuse drugs.

An effective programme of drug education in schools can be an important step in helping young people to resist drugs. But schools alone cannot "solve" the drug problem. Young people are also influenced by their parents, caregivers, the media, other professionals and their peers. It is therefore important that all those involved with young people, both in formal and informal settings, should have accurate information about drugs and are helped to develop the confidence to deliver effective and consistent drug prevention messages. More positive role models are needed, especially in local communities.

Activities which provide recreation and opportunities to develop a variety of skills are also important in helping young people to resist drugs. The role of statutory and voluntary children and youth services is significant in this respect. They can offer educational programmes and individual counselling and can also help to raise awareness of the damaging impact of drugs and encourage positive lifestyles among young people. Through youth work, group work or special projects they can target their approaches to those most at risk.

Local social welfare and education authorities should provide support services to families and schools, to counter drug abuse among young people.

The Government places a very strong emphasis on preventing children and youth from abusing drugs in the first place. But there will still be some who choose to experiment even if they have both the knowledge of the risks and the skills to resist peer pressure. Efforts should therefore also be made to protect those who are at risk by a range of responsible measures, often expressed as "harm minimisation" or "harm reduction".

In addition young people at an early stage of drug-taking could benefit from the provision of early intervention services to help them stop. The majority of young people who experiment do not become dependent upon drugs, but a significant minority do go on to develop serious problems and they also need specialist help and advice. It is therefore important to ensure that a range of services are available and accessible to children and youth across the spectrum of drug abuse from experimentation to dependency, including early intervention services, advice, counselling and treatment.

5.5.2.1 Objectives:

The objectives in these areas are:

• to allow for full participation - particularly from young people - in the decision-making process in issues directly related to them;
• to discourage young people from taking drugs and to minimize the proportion of children and youth who experiment with drugs;
• to ensure that schools offer effective programmes of drug education, giving pupils the facts, warning them of the risks and helping them to develop the skills and attitudes to resist drug abuse;
• to raise awareness among school staff and parents of the issues associated with drug abuse and young people;
• to offer schools guidance on how to deal effectively and consistently with drug-related incidents on their premises, including ensuring that children and youth have access to relevant advice, counselling and, where appropriate, treatment;
• to encourage youth services and other agencies in contact with children and youth to play a part in alerting them to the dangers of drugs, and advising those who may already be experimenting of the services available, to help them stop;
• to encourage institutions of further and higher education to provide appropriate prevention, counselling and support services to their students;
• to raise public awareness by developing effective national and local public education strategies focussing particularly on shaping the attitudes of our nation’s youth;
• to ensure that young people have access to a range of appropriate advice, counselling, treatment, rehabilitation and after-care services.

(under all the above objectives, specific tasks and ongoing monitoring and evaluation mechanisms should be dealt with)

5.5.3 REDUCTION OF COSTS OF HEALTH, WELFARE, JUSTICE AND OTHER SECTORS RESULTING FROM SUBSTANCE ABUSE

Research (International and National) has revealed that the societal costs of untreated addiction - e.g. violence, crime, poor health and family break-up - far exceeds the costs of providing treatment. While rehabilitation of a drug offender is a long-term process, it is a logical investment because they will eventually be returned to our communities.

In addition, absenteeism, accidents, health care and low productivity in the workplace have an insidious, long-term, negative effect on the economy of the country.

Abstinence from substance abuse should be the ultimate goal of drug related services, whether that means primary, secondary, or tertiary prevention.

For treatment to be considered effective it should produce one or more of the following results: abstinence from substance abuse; reduction in the level of drug abuse; reduction in risk behaviour; improved physical and mental health; improvement in social functioning and life context and a reduction in criminal activity.

A fundamental need is to shift the country’s primary focus from drugs to people and the families and communities that nurture them. Strong people, strong families and strong communities are the keys to winning the battle against drug-abuse.

It is important to ensure that all sections of society have access to affordable and equitable services.

It is also important to ensure that staff working in different agencies receive training to equip them with the necessary knowledge and to develop their confidence to provide advice and support to drug abusers and their families.

Communities need accurate information about the health risks associated with drug abuse and how to obtain help and advice. A range of different methods should be further developed including national and local publicity campaigns, Help lines and community based initiatives such as outreach work.

5.5.3.1 The objectives in this area are:

• to increase treatment, efficiency and effectiveness;
• to use effective outreach, referral and case management efforts to facilitate early access to treatment;
• to protect communities from the health risks and other damages associated with drug abuse, including the spreading of communicable diseases;
• to discourage people from abusing drugs and to enable those who do so, to quit;
• to ensure that communities have access to accurate information about the risks of substance abuse;
• to ensure that individual drug abusers have access to a range of appropriate advice, counselling, treatment, rehabilitation and after-care services;
• to reduce the health and social damage that individual drug abusers inflict upon themselves;
• to ensure that families of drug abusers have access to appropriate advice, counselling and support services; and
• to expand and enhance drug education and prevention strategies in the workplace.

(under all the mentioned objectives, specific tasks, monitoring and evaluation mechanisms should be drafted.)

6. INSTITUTIONAL ARRANGEMENTS

The diversity of stakeholders in the field of substance abuse, contributes to a wealth of knowledge, skills and resources, which should be harnessed by the Government and its partners in a restructured substance abuse structure.

A network of specialist organisations, render specific services regarding substance abuse in all the provinces. Other organisations and support groups are visible in most urban areas. A number of bodies exist which provide research services to inform policy and programme development. Guidance classes can serve as a corrective resource but can also be utilised for broader preventative programmes such as alcohol safety schools.

Inequity, fragmentation, the duplication of services, a lack of capacity and infra-structure and inadequate inter sectoral collaboration and communication are typical problems encountered in the field.

It is thus of importance that the development of an inclusive and effective partnership with all stakeholders on the basis of set goals, be facilitated. However, the resources and the unique characteristics of each of the partners will be harnessed optimally. A genuine partnership will have a common purpose and be structurally efficient.

Effective and appropriate mechanisms will be developed to facilitate the participation and consultation in policy development, planning and the evaluation of programmes, inter sectoral collaboration, the development of criteria for the financing of programmes and services and development of appropriate regulations, norms and standards.

Government will address needs which are not being met by its partners in civil society. In this regard, Government will also play an enabling and pro-active role to ensure that services are provided in under-serviced areas. Government will provide an enabling environment for the delivery of services.

A representative structure made up of Government and civil society will be established in accordance with the goals, principles and actions. The terms of reference of the authority will be defined in consultation with the stakeholders.

The involvement of community based and non-governmental organisations in prevention and treatment programmes, underscores the need for co-operation between government and civil society.

7. MECHANISM FOR IMPLEMENTING OF THE DRUG MASTER PLAN

A comprehensive service delivery and operational network within supply and demand reduction needs to be promoted on national, provincial and community level.

Besides law enforcement measures and drug treatment, provision should be made for preventative activities covering the whole spectrum of licit and illicit drugs.

Each department concerned should within its own line function and area of responsibility develop a business plan covering all levels, national, provincial and local, ensuring co-operation on cross-cutting issues. Collective functions need to be identified and strengthened. These business plans should be developed in close collaboration with civil society.

In their business plans, departments need to prioritise actions, determine gaps in their capacity and resources, as well as the financial implications of their programmes.

Taking into account the devastating effect of drug abuse in the country it could be argued that services in this focus area is underfunded. The Government and civil society have to reprioritise in an attempt to make a bigger financial contribution in order to make a difference.

The Government will finance statutory programmes, including related services and facilities. Appropriate and affordable criteria, norms and standards for the delivery and funding of statuary services will be developed and set.

The financing of programmes will be based on approved business plans and will reflect the priorities of the Government. Each sector will be responsible to negotiate for funding in order to operationalism their set business plans related to the combatting of substance abuse in South Africa.

The various Government departments will be encouraged to develop complementary financing policies in order to achieve shared goals.

FORMAT FOR THE DEVELOPMENT OF SECTORAL BUSINESS PLANS

A format which could serve as a guide for the development of sectoral business plans is attached as annexure I.

7.1 KEY DEPARTMENTS AND STAKEHOLDERS

The following are key departments and stakeholders which should develop their own business plans aligned with the Master Plan.

NATIONAL LEVEL

Directly involved

  Indirectly involved

SCHEMATIC ILLUSTRATION OF ROLE PLAYERS IN THE ALCOHOL AND DRUG FIELD IN SOUTH AFRICA

PROVINCIAL LEVEL

 Directly involved

  Indirectly involved

8. MANAGEMENT OF A SOUTH AFRICAN NATIONAL DRUG AUTHORITY

It is important to:

• develop a National Drug Control Authority with an appropriate budget, resource and management infrastructure, to provide a co-ordinating umbrella for all initiatives and programmes in the drug field and at the same time to make the most effective use of existing human, financial and organisation resources;
• provide a framework for research, data and baseline information systems to inform policy, planning and advocacy efforts;
• introduce performance indicators whereby effectiveness and progress of anti-drug abuse action can be monitored and evaluated.

A crucial decision for the Government, all agencies and the citizens of the country is the kind of organisation and related mechanisms needed to implement the National Drug Control Strategy.

8.1 OPTIONS TO BE CONSIDERED

The following options are to be considered:

• extending the scope, functions and powers of the existing Drug Advisory Board and to provide for mechanisms of control. The lead department responsible for formulating effective policies and sustaining the Strategy nationally and locally, will be the Department of Welfare.
• establishing a Ministerial Sub-Committee of the Cabinet on "Drug control" chaired by for instance, the Speaker, who is supported in her/his coordinating role by a "Central Drugs Coordination Unit".
• creating an Office for a National Drug Control Strategy with executive powers under the leadership of the President or Deputy President who will drive the Strategy as a priority of Government.

8.2 PROPOSED STRUCTURE OF THE CENTRAL DRUG AUTHORITY

Ultimately the proposed Drug Authority will report to the President or a person being nominated by the President via the Cabinet.

The President will appoint the Chairperson to the DRUG AUTHORITY.

THE DRUG SECRETARIAT will be accountable to the DRUG AUTHORITY, which is located in an executive office of the President or Deputy President.

The SECRETARIAT will compose of staff seconded from:

• Justice
• SAPS
• Health
• Welfare
• Education
• Research

Staff from other departments can be co-opted to serve on the Secretariat, which will perform specific tasks on an operational level.

Departments concerned will contribute to the budget. The Drug Authority should be given executive powers in terms of legislation and will execute functions and objectives set out in the Master Plan. The Drug Authority will meet according to the need.

8.3 PROPOSED CENTRAL DRUG AUTHORITY

The Central Drug Authority should be independent and autonomous from any existing government department. A mechanism must be created in which the central drug authority becomes directly accountable to the country’s executive cabinet.

8.3.1 MANDATE

The final mandate to establish The Central Drug Authority should be in the nature of a Cabinet recommendation to Parliament in the form of appropriate legislation.

8.3.2 DUTIES

• Establish national objectives and targets for both drug control and drug demand reduction (preventive).
• Oversee the implementation of the above.
• To identify legislative issues and make recommendations as to changes, when and where required.
• Review and advise on international developments and co-operation in the interest of South Africa.
• Produce annual reports to the nation, reporting overall achievements and/or shortcomings in the implementation of the national objectives, and the nature and extent of alcohol and other drug use and consequences of the Drug Master Plan.

8.3.3 POWERS AND AUTHORITY

• Allocate resources and monitor their effective use for the successful implementation of the Drug Master Plan.
• Monitor and evaluate standards of treatment and preventative programmes.
• Initiate a "licencing/diploma" board to develop adequate standards of skills training in the various aspects of "addictive management".

8.3.4 DELEGATIONS

• Establishment of effective delegations to provincial authorities.
• Establishment of specialised committees to examine specific problem areas.

8.3.5 The following essentials should be accommodated within the above structure:

Once the National Drug Authority has been established, it should have the capacity, resources and the responsibility to:

• Act as an authoritative source of advice to Government on policies and programmes in the field of drug-abuse and trafficking.
• Review and provide informed comment on drug-related policies and programmes.
• Act as an umbrella organisation to evaluate and coordinate programmes and establish standards for programmes of action directed at demand and supply reduction.
• Establish, maintain and operate information systems and initiate, promote, assist and evaluate research in order to monitor the efficacy of initiatives and utilization of resources directed at addressing the drug problem.
• Liaise at international, national, regional and provincial level on drug related matters.

In order to effectively deliver a workable strategy at community level there should be a significant emphasis on a participating approach in which the establishment of local forums will provide an avenue through which communities could cooperate in realizing the goals of the Drug Master Plan. Such a forum should comprise of representatives from health, welfare, education and criminal justice agencies, community organizations, the private sector and local experts. The purpose of such teams must be, to drive the Master Plan effectively in the light of local needs, conditions and priorities.

At the provincial level it is essential to pool resources in focussed areas, for example, interdiction and law enforcement, treatment, prevention, policy, and community/school-based programmes. Provincial forums could also play a key role in supporting the development of community-based initiatives which will in turn impact on national policy-making.

At the national operational level, the Master Plan should be driven by a Secretariat of full-time coordinators (in the fields of demand reduction, supply reduction, research and policy making), who would be accountable to the Drug Authority.

The issue of an adequate budget is a very real one, as a National Drug Master Plan would have to be well-funded in order to operate effectively.

9. GLOSSARY

ABUSE
The persistent or sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice.

CHEMICAL PRECURSORS
Substances frequently used in the illicit manufacturing of narcotic drugs or psychotropic substances as defined in Article 12 of the 1988 UN Convention Against Illicit Drugs and Psychotropic Substances mentioned in Table I and Table II annexed to the said Convention.

COMMUNITY-BASED TREATMENT
Community-based treatment refers to programmes or initiatives that arise out of the needs of a particular community, (through a needs assessment) and by identifying and utilising existing infra-structures in order to provide for these needs.

DEMAND REDUCTION
A general term used to describe policies or programmes directed at reducing the consumer demand for psychoactive drugs. It is applied primarily to illicit drugs, particularly with reference to education, treatment and rehabilitation strategies, as opposed to law enforcement strategies that aim to interdict the production and distribution of drugs.

DEPENDENCE
A person is dependent on a drug or alcohol when it becomes very difficult or even impossible for him/her to refrain from taking the drug/alcohol without help, after having taken it regularly for a period of time. The dependence may be physical or psychological or both.

DESIGNER DRUG
A novel chemical substance with psychoactive properties, synthesized specifically to be sold on the illicit market and to circumvent regulations on controlled substances. These regulations now commonly cover novel and possible analogues of existing psychoactive substance.

DRUG
A term of varied usage. In medicine, it refers to any substance with the potential to prevent or cure disease or enhance physical or mental welfare, and in pharmacology to any chemical agent that alters the biochemical or physiological processes of tissues or organisms. In common usage, the term often refers specifically to psychoactive drugs, and often, even more specifically, to illicit drugs, of which there is non-medical use in addition to medical use.

DRUG CONTROL
The regulation, by a system of laws and agencies, of the production, distribution, sale and use of specific psychoactive drugs (controlled substances) locally, nationally, or internationally. Alternatively as an equivalent to drug policy in the context of psychoactive drugs, the aggregate of policies designed to affect the supply and/or the demand for illicit drugs, locally or nationally, including education, treatment, control and other programmes and policies.

DRUG MASTER PLAN
A Master Plan is a single document, adopted by Government, outlining all national concerns in Drug concerns.

DRUGS OR SUBSTANCE ABUSE
Entail drug, alcohol, chemical substances, or psychoactive substances

DRUG TESTING
The analysis of body fluids, (such as blood, urine, or saliva) hair, or other tissue for the presence of one or more psychoactive substances.

EARLY INTERVENTION
A therapeutic strategy that combines early detection of hazardous or harmful substance use and treatment of those involved. Treatment is offered or provided prior to patients presenting of their own volition and in many cases before they become aware that their substance use may cause problems. It is directed particularly at individuals who have not developed a physical dependency or major psycho-social complications.

HARM REDUCTION
A harm-reduction philosophy emphasises the development of policies and programmes that focus directly on reducing the social, economic and health-related harm, resulting from the use of alcohol or drugs.

ILLICIT DRUG
A psychoactive substance, the production, sale or use, of which is prohibited.

ILICIT DRUG
A drug that is legally available by medical prescription in the jurisdiction in question, or, sometimes a drug legally available without medical prescription.

MONEY-LAUNDERING
Engaging directly or indirectly in a transaction that involves money or property which is proceeds of crime, or receiving, processing, conceiving, disguising, transforming, converting, disposing of, removing from, bringing into any territory, money or property which is the proceeds of crime.

PREVENTION
Prevention is a proactive process that empowers individuals and systems to meet the challenges of life’s events and transitions by creating and reinforcing conditions that promote healthy behaviours and lifestyles. It generally requires three levels of action: Primary prevention (focuses on altering the individual and the environment in such a way as to reduce the initial risk of developing substance abuse), secondary prevention (focuses on early identification of persons who are at risk of developing substance abuse and intervening in such a way as to arrest progress); and tertiary prevention (focuses on treatment of the person who has developed a drug dependency).

SUBSTANCE ABUSE
The term substance abuse includes the misuse and abuse of legal substances such as nicotine, alcohol, over-the counter drugs, prescribed drugs, alcohol concoctions, indigenous plants, solvents, inhalants, as well as the use of illicit drugs.

SUPPLY REDUCTION
A general term used to refer to policies or programmes aiming to interdict the production and distribution of drugs, particularly law enforcement strategies for reducing the supply of illicit drugs.

TREATMENT
Treatment is a process aimed at promoting the quality of life of the drug dependant and his/her system (husband/wife, family members and significant other important persons in his/her life) with the help of a multi-professional team.

YOUTH
Young people refer to both child and youth and this could go up to 30 years of age.

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