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18 January 2012

Tik: hidden risks

The Western Cape in particular has an alarming number of tik users. This has led to an increase in STDs, crime and the spread of HIV/Aids. Why is this and what can be done?

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The ripple effect of tik goes way beyond the obvious. It is being blamed for an increase in the number of sexually transmitted infections, including the spread of HIV/Aids, and an increase in crime. Why? And what is being done to curb this growing problem?

Tik (methamphetamine) use tends to be associated with aggression/violence, high-risk sexual risk behaviour and crime, and the use of tik has become a major concern," confirmed Andreas Plüddemann, Senior Scientist at the Alcohol and Drug Abuse Research Unit at the Medical Research Council (MRC). The Western Cape is particularly severely affected.

In a report compiled by Plüddemann for the MRC a while ago, a sharp increase was noted in the number of patients seeking treatment for methamphetamine-related problems during the study period (2002 – 2006).

The average age of patients who reported methamphetamine as the primary substance of abuse was 22. Of these, 72% were men; and 37% of the total group were under the age of 20.

Risky sex, tik linked
According to Plüddemann, the common thread in many studies, is the strong link between methamphetamine use and sexual behaviour, with many users reporting that tik use enhanced sexual experiences and vice versa.

“A number of users report experiencing highly positive aspects of sexuality whilst under the influence of methamphetamine, more so than any other substance-dependent group,” he said.

This, he added, also often led to a higher level of sexual risk behaviour, including multiple partners, risky partner types (e.g. anonymous sex partners), and high rates of unprotected sex among users.

“The link between tik use and risky sexual behaviour is a great concern, given the epidemic of tik use in the Western Cape and the area's high HIV stats.

“The use of methamphetamines can further fuel HIV infection rates, compounding what is already a health crisis,” he said.

Fight back
In a fact sheet prepared by Plüddemann and his colleagues this year, three strategies were named to combat this problem. These include:

1. Prevention strategies: Raising awareness and providing accurate information about the dangers and availability of methamphetamine, and introducing scientific prevention programmes. There's a particular focus on schools, where drug policies should be developed and promoted.

2. Treatment strategies: There should be adequate and effective treatment available and it should be accessible to all who need it. Hospitals and other care facilities need tik treatment protocols, including eductation for the staff on screening and interventions. The effects of methamphetamine can include, for instance, psychosis, anxiety and withdrawal.

Additionally, community resources should be ntroduced to scientific models of substance-abuse treatment; and the criminal justice approach should become more systematic around substance-abusing offenders.

 

3. Prohibiting strategies: The introduction of laws governing the sale of substances used to manufacture methamphetamine, and a clamp down on companies which distribute chemicals these.

Community policing should be expanded to encourage the public’s involvement, which in turn will put pressure on drug-related organised crime.

What the government is doing
The City of Cape Town has put forward a Draft Alcohol and Drug Strategy for the period 2007 – 2010 with the aim of “reducing the burden of alcohol and other drugs (AOD) use on the city, its residents, businesses and visitors through the provision of targeted supply and demand reduction interventions”.

In this, it is again highlighted that drug use often leads to risky sexual behaviour and increased HIV/Aids, TB, hepatitis B and C risk and infection. It mentions the link between drug use leading to criminal and violent behaviour.

It also speaks of a “dramatic increase in the use of methamphetamines” in Cape Town. Tik is often produced in home laboratories, which leads to easy availability, but also leads to constant variation in the strength and type of drugs produced.

The report stated that in the second half of 2006, of the 761 patients under the age of 20 admitted to substance abuse treatment centres, a shocking 72 percent of them had methamphetamine as a primary or secondary substance of abuse.

With regard to crime, the strategy declared that in the year 2000 six out of every 10 people arrested tested positive for drugs.

Facts on methamphetamines

  • Methamphetamine is highly addictive and is a stimulant
  • It affects several areas of the central nervous system
  • It can be smoked, snorted, orally ingested or injected intravenously
  • In SA it is commonly smoked by placing the powder/crystal in a light blub and the fumes are smoked
  • It triggers the release of epinephrine, norepinephrine and dopamine in the sympathetic nervous system
  • Common effects are euphoria, increased energy, insomnia, irritability, heightened sexuality and tremors
  • An overdose is characterised by dehydration, hyperthermia, convulsions, renal failure, stroke and myocardial infarction
  • Prolonged use leads to weight loss/anorexia, severe dermatological problems, and risk of seizures, uncontrollable rage and violent behaviour.

Sources: Andreas Plüddemann, Senior Scientist at the Alcohol and Drug Abuse Research Unit at the Medical Research Council.

Draft Operational Alcohol and Drug Strategy: 2007-2010; City of Cape Town.

(Amy Henderson, Health24, updated January 2011)

 
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