NDMP vs Alcohol and Drugs in South Africa

There are many criticisms that have occurred regarding the NDMP and the Treatment of Substance Abuse Act, one of the main criticisms of the NDMP and the Prevention and Treatment of Substance Abuse Act No 70 of 2008 is that there is policy confusion around harm reduction. Some other provinces tend to fail in implementing the programme due to lack of resources or strategy or knowledge about certain substances that are used highly and cause most effect. And basically in South Africa there are not enough programs or projects that are implemented to make the people aware of the effect.

Individuals in the community should be educated with regarding the effects of substance use. Some provinces do have programs but they are not finalised due to lack of clarity as to funding and the local action plans. As a result there are insufficient funding activities (Pasche and Myers, 2012:340).

The current NDMP aims to reduce the supply and demand for alcohol and illegal drugs, and it also states that the interventions that are implemented in Eldorado Park are going to help the government to implement the combined programme throughout the country (NDMP,2013-2017:35) .

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It does not state what those interventions are, if they were really effective in Eldorado they should be indicated in the policy that others cities or provinces can also try those specific programmes. The NMDP is a broad policy that acknowledges that substance use problems cut across the different spheres of government and different considerations and it requires a multi-level policy approaches.

And it identifies and aims to implement holistic and cost effective strategies that can be followed and used to reduce the supply and consumption of drugs and the harms that are associated with the substance use in the country.

The NDMP strategic approach expected outcome was improved quality of life individuals, families and community through the implementation of integrated and provincial drug master plans and reports. The government should target the cause of abuse before targeting the main problems that should focus on the roots. The cause of substance abuse are unemployment, low self-esteem, and domestic violence. In this way they can see how they get to the main problem and they will have an idea of how to solve the problem. The NDMP covers the three pillars of harm reduction, demand reduction and supply reduction. However there is policy confusion around harm reduction, with law enforcement criminalising users and addicts and thereby working against the public health approach of restorative justice. The NDMP is not effectively directing implementation. Partly this is because the NDMP does not provide implementation details and it is assumed that policy and direction set at a national level will filter down to the provinces, however each provincial department defines its own strategies and produces its own legislation (NDMP,2013-2017:48).

Substance use policy is often conceptualised as falling under three broad categories which are as follows:

1. attempts to reduce the demand for the relevant substances,
2. attempts to reduce its supply, and
3. attempts to reduce the impact or harm of its use.

These concepts are or can be described as:

• Demand reduction, or reducing the need for substances through prevention that includes educating potential users, making the use of substances culturally undesirable and imposing restrictions on the use of substances for example by increasing the age at which alcohol may be used legally ;
• Supply reduction, or reducing the quantity of the substance available on the market by, for example, destroying cannabis crops in the field or controlling the trade conditions of legal substances;
• and Harm reduction, or limiting or reducing the damage caused to individuals or communities who have already yielded to the temptation of substance abuse (Pasche and Myers, 2012:440).

This can be achieved, for example, by treatment, aftercare and reintegration of substance abusers/dependents with society.The war on drug is based on the following: elimination of illicit compounds through destruction of raw materials, the interdiction of drugs being shipped in the country, legal sanctions against those who engage in the use of the substances deemed illegal by the government and treatment for those addicted to these compounds (Doweiko, 2012:505). According to the NDMP (2013-2017:50) the targeted outcomes of the NDMP are intended as:

1. Reduction of the bio-psycho-social and economic impact of substance abuse and related illnesses on the South African population,
2. Ability of all people in South Africa to deal with problems related to substance abuse within communities,
3. Recreational facilities and diversion programmes that prevent vulnerable populations from becoming substance abusers/dependents,
4. Reduced availability of dependence forming substances/drugs, including alcoholic beverages,
5. Development and implementation of multi-disciplinary and multi-modal protocols and practices for integrated diagnosis and treatment of substance dependence and co-occurring disorders and for funding such diagnosis and treatment,
6. Harmonisation and enforcement of laws and policies to facilitate effective governance of the supply chain with regard to alcohol and other drugs, and
7. Creation of job opportunities in the field of combating substance abuse.Awareness raising, and even the NDMP shows that the efficacy of these prevention programmes is questionable.

There are not enough evidence-based programmes targeted specifically to at-risk groups and communities. High-risk groups that need more attention are people who inject drugs, prison populations, and sex workers, specifically in the light of the spread of HIV and AIDS amongst drug users. In terms of harm reduction, there has been insufficient buy-in from the Provincial Departments of Health to finance drug-related medical care, and there are insufficient skills and in-hospital facilities to confirm that harm reduction is being applied (NDMP,2013-2017:52). The results show that in terms of the continuum of care there are fewer services for early intervention and for after care. However, for prevention to be effective, early intervention services must be available and accessible, and the same applies to treatment and aftercare. For integration to work, the Departments need to work together and encourage integrated planning and shared resourcing of programmes