As South Africans, we need to roll-up our sleeves and support efforts at various levels that are designed to turn the tide against illicit drugs abuse in our beloved country, writes Dr Fundile Nyati.
The UNDP, which is the lead agency of the United Nations, serially produces an annual report titled, ‘Annual Human Development Report’, wherein they rate all the UN member countries on their human development index. A look at South Africa’s Human Development index over the past five years reveals that our country has been unable to score in the top 100 Human Development Index scores, ranking #114 in 2019 and 2020; #109 in 2021; #106 in 2023 and 2024.
The Human Development Index is a composite index that is based on three dimensions of human development, namely Life Expectancy (Population Health); Education (expected years of schooling and mean years of schooling); and Income and Standard of Living (GNI per capita).
Despite trailing fellow African countries like Seychelles (undisputed #1 HDI Africa), which is in the category of very high development index, South Africa still performs relatively modestly in the high development index category, with its Human Development Index actual number marginally increasing year on year, however the global ranking reducing over time.
Whilst SA is amongst the top performers on the Human Development Index in Africa, the sobering reality is that other African countries (e.g. Namibia, Botswana, Gabon, etc.) are developing at a higher pace, albeit the fact that their economies are growing from a much lower base than South Africa. So, with the modest progress on the successive HDI scores, our country has to pick up pace from a Human Development Index point of view.
The historical and ongoing investment in education and training as part of the various macro-economic policies has ensured that more black people (A, I, C) qualify with matric certification and university diplomas and degrees. Unfortunately, after qualifying, many of them suddenly realise that the economy cannot absorb them and they are unable to obtain jobs, despite their educational qualifications.
The issue of record unemployment of the youth in South Africa is a serious indictment of the failed serial macro-economic strategies that were created to deliver on the jobs promises of serial election manifestos of many political parties, especially the ANC which campaigned aggressively on the tip of jobs and a better life for all since 1994.
In the first quarter of 2025, South Africa’s youth unemployment rate specifically for individuals aged 15-24, reached 62.4%, a significant increase from 59.6% in the previous quarter, and some political parties are now considering this as a national emergency. The broader youth unemployment encompassing those aged 15-34 also remains high at 46.1% according to Stats SA, this figure represents a substantial increase from 36.9% a decade prior.
The impact of the very high unemployment will likely lead to social and economic strain wherein it may lead to social unrest, increased poverty, and a significant strain on social services. Also, there is lost potential to the country’s economy because it means that there is a significant loss of human capital and potential for economic growth.
Published research by various economics researchers has demonstrated that young people who experience unemployment early in life face greater challenges in finding and maintaining employment later, so the negative impact of early life unemployment can be long term.
Of specific interest for this article on the epidemic of substance abuse in South Africa, is the fact that it has already been proven by several researchers that amongst the key drivers of increasing substance abuse in the country, unemployment and poverty key drivers that boost the demand for narcotics.
Further, many studies by HSRC population-based surveys, are showing that unemployed people were more likely to have used illicit drugs in the recent past than those who currently work. Herin below, I will then zoom in deeper on the national crisis relating to drugs abuse in South Africa, as a way of demonstrating that the we have a grave problem and to turn it around, we must all work together to defeat the scourge that threatens the future of our kids and the nation as a whole.
On the 28th of June, as I was going through recently published literature in preparation for my regular Saturday morning Health Feature on the Weekend Breakfast on 702FM, with the topic of discussion being on the Annual Drugs Awareness Week (24th-30th June), I came across a research paper entitled, ‘Trends and factors associated with illicit drugs use in South Africa: findings from multiple national population-based surveys, 2002-2017’.
The above shocking yet enlightening article revealed sobering and very worrying trends about the exponential rise of the scourge of illicit drugs abuse in our country. Globally, in the annual health calendar, the 26th of June is designated International Day Against Drugs Abuse and Illicit Trafficking. The global theme this year was ‘Evidence is clear: Invest in Prevention’, and it highlighted the need for urgent, evidence-based preventative measures to address the world’s drug problem.
So, back to SA current situation, various research papers inform us that 10.3% of the South African adult population (15 years and older) are estimated to consume alcohol at harmful levels (16.5% of men and 4.6% of women), and 8.6% (13.3% of men and 4.1% of women) are estimated to use illicit drugs. Further, we are informed that 11% of South Africans have addiction problems, and the drugs of choice in South Africa are Alcohol and Dagga.
So, what is substance abuse? Substance abuse refers to a pattern of using alcohol or drugs in a way that causes significant personal or social problems and or distress. This is a recognised medical brain disorder that includes the misuse of illegal substances like marijuana, heroin, cocaine or methamphetamines. The above substance above definition also includes abuse of legal substances like alcohol, nicotine, over the counter or prescription medicines.
Back to the research paper, the following were some of the key trends and findings:
Proportion of South Africans consuming Marijuana, Cocaine, and Heroin has risen substantially since early 2000s.
In Y2000, less than 2% surveyed South Africans had taken illicit drugs like marijuana, cocaine, amphetamine, inhalants, sedatives or hallucinogens.
15 years later, in Y2017, the percentage climbed to 10%, (*and obviously that percentage has increased further in 2025, which is 8 years later)
Marijuana makes up overwhelming bulk of illicit drugs consumption in South Africa (*remember it was decriminalised in 2018 in SA, and it is often a gateway drug to other harder illicit drugs in South Africa).
Recent cocaine use was 88 times in Y2017, compared to Y2002.
Recent opioids use was 161-fold increase in Y2017 compared to Y2017 (group of drugs that include heroin and pain relief medications).
Overall, when one looks at abuse of Cannabis, Opioids, Cocaine and Amphetamines, the percentage increased from 1.5% in Y2002 to 10% in 2017.
The increasing illicit substances abuse trend was ubiquitous across race and class, although some population subgroups were more affected than others.
Gender wise, being young (25 to 34years) and male one was strongly associated with drugs use or abuse.
Urban based young people were more likely to use illicit drugs than rural based youth (*however this picture is rapidly changing due to establishment of new drugs distribution channels that make use of night clubs as distributors, and musicians, artists, celebrities of influencers as active promoters).
Further statistics that came from SA Medical Research Council study revealed that in the five-year period from Y2012 to Y2017, an increasing share of people who were coming to drugs rehabilitation centres were largely due to opioids addiction, especially heroin. Also, recently the SAPS has supported the picture of increasing abuse of opioids in South Africa by reporting that in the number of SAPS drugs involving heroin, the annual numbers have risen steadily between Y2002 and Y2018.
So, what are the reasons that are advanced as key drivers for the rising prevalence of substance abuse of illicit drugs in South Africa?
- Rise in the illicit drugs that are trafficked through porous SA borders, as part of international supply routes, that were previously less used during apartheid and sanctions period, which have now been exploited in the democratic era. The rise in illicit drugs availability has also made them to be less expensive because of supply and demand economics.
- SA is becoming a key heroin smuggling route for Heroin as a Southern Supply Route, an alternative to previous Northern Supply Route from Afghanistan to Europe then to various continents. (Enact 2018 Research paper)
- Socio-Economic Factors: South Africa’s sustained unemployment and poverty are boosting demand for narcotics (Enact 2018 Research paper)
- South Africa’s suboptimal implementation of its own drugs prevention policies has prevented it from effectively tackling the drugs abuse problem in the country.
- The country had a National Drugs Master Plan (2019-2024) that was released by the Department of Social Development, but Central Drugs Authority implementers have been disempowered and under resourced.
- As you can see on the key drivers of the rising epidemic of illicit drugs abuse, the socio-economic drivers from our underperforming or even moribund economy, the scourge of substance abuse epidemic in the country is getting out of hand, and if left unchecked, from a macro-economic point of view, we are all going to suffer.
- The rapid rise in the levels of Major Mental Illness (Depression, Anxiety, Bipolar Mood Disorder, Substance Abuse and Psychosis) amongst both working and unemployed adult South Africans, especially post COVID-19 pandemic, is a ticking time bomb, which is slowly reversing quite a few gains that have been made from our macro-economic point of view.
As more and more young people lose hope due to their daily realities of unemployment and poverty, many are using a destructive coping mechanism of Escapism as their way out, and increasingly, we are seeing a rapid rise of suicide, especially amongst males, as well as the problems of GBVF and other violent crimes, some of which are driven by substance abuse in society.
The substance abuse by the unemployed under 25 year olds, is likely to result in permanent damage of their underdeveloped prefrontal cortex of the brain, which may make their prognosis of recovery and rehabilitation from substance abuse a all order, and may reduce their ability to contribute positively in the job market, in the increasingly unlikely even that they secure employment, or even manage to get into entrepreneurship.
In closing, as South Africans, let us all reflect on the situation I have shared above, roll-up our sleeves, support efforts at various levels that are designed to turn the tide against illicit drugs abuse in our beloved country.
As a South African people, we have faced many serious national challenged before, for example the impact of HIV and AIDS, for which we now have the biggest Anti-Retroviral Treatment program in the world, that pandemic is no longer having a disproportionate impact with regards to annual morbidity and mortality as reported by Stats SA. Even this current challenge of illicit and legal drugs abuse epidemic in our country can be contained, and reversed, All hands-on deck!
