S.A. Drug Crisis Solutions

The Prevention of and Treatment for Substance Abuse Bill

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S.A. Drug Crisis Solutions:

For more information on this publication, contact the writer:
A.A.C. CEO, Mr. Warren Whitfield, at Tel: 0725225325

 

Re : The Prevention of and Treatment for Substance Abuse Bill.

On behalf of the Addiction Action Campaign, its board of directors, and the  many concerned South Africans who support our position, we wish to submit the following points for consideration by the Portfolio Committee on Social Development, on The Prevention of and Treatment for Substance Abuse Bill.

 

Introduction : The focus of the Bill
  1. We believe that Bill, as its name suggests, is too limited in scope andneeds to be reviewed to include addictions other than to substances.
  2. We believe that there are literally millions of undiagnosed addicts in South Africa who are addicted to products, services or behaviours that are not substances. These ‘non-substance’ addictions include:
  3. Sex addiction, love addiction, spending addiction, gambling addiction, internet gambling addiction, work addiction, sleep addiction, pornography addiction, internet addiction,  internet pornography addiction and video gaming addiction.
  4. The Prevention of and Treatment for Substance Abuse Bill needs to be revised, renamed and refocused to consider the needs of South African citizens who have these addictions. It could more appropriately be renamed the ‘The Prevention of and Treatment for Addiction Bill’
  5. With this refocus in mind, ‘The Prevention of and Treatment for Addiction Bill’ should consider the following:
It should begin by being based on adequate information. There has never been a complete survey of all of the addictions in South Africa. The first step to addressing the issue of addiction in S.A effectively is to have at hand all relevant information about on addiction. Any prevention or treatment strategy that is embarked upon without first studying the issue properly is an exercise in futility and will lead to incorrect prioritisation and allocation of funds and effort.

A list of questions must be compiled which asks every question which needs to be asked about the severity of the problem. For instance, on the issue of addiction as a whole in South Africa:

  • How many addictions are there in South Africa?
  • What are the different types of addictions?
  • How many people are addicted to each type of addiction?
  • How old is everyone who is addicted in each addiction?
  • Where do these addicts live?
  • How many are male or female?
  • What is their level of education?
  • What languages do they speak?
  • What income group do they fall into?
  • How many addicts have a dual diagnosis i.e. a psychiatric disorder as well as an addiction?
  • How many addicts have multiple addictions? Etc.
  • How many people die every year because of addiction?
  • How much does addiction cost the country each year in healthcare and lost income?
  • How many skilled workers “brains” are lost each year to addiction, either through death or to poverty?
  • How many minors have an addiction?
  • How many deaths are caused by addiction?
  • How many lives on average are affected financially and emotionally because of each addict?
  • How much fraud is committed each year by addicts?
  • How many marriages are lost each year because of addiction?
  • How many children are left homeless because of addiction?
  • How many children are orphaned each year because of addiction?
  • How many people in prisons are addicts?
  • How many people in prison were incarcerated owing to a crime committed because of addiction?
  • How many people develop a new addiction each year?
  • How many suicides are committed each year owing to addiction?
  • How many accidental overdoses are attended to each year by healthcare professionals?
  • How many people have contracted HIV/AIDS because of being careless whilst under the influence of an addiction?
  • How much money is generated in income by suppliers of addictive services or products?
  • What percentage of the income generated by suppliers of addictive services or products is spent on addiction prevention and treatment programs?
  • How much does the government earn in tax generated by the sale of addictive products or services i.e. from company tax, VAT, and customs and excise duties?
  • What percentage of this tax collected by government is spent on addiction treatment and prevention programmes?
For various addictions additional questions need to be asked: e.g. in gambling or pornography addiction:
  • How does the debt created by all compulsive gamblers affect the repo rate?
  • How many deaths are caused by these addictions?
  • How much does the average compulsive gambler lose to a casino because of his addiction?
  • What is the potential total impact caused by a compulsive gambler because of this addiction?
  • How many children’s educations and futures have been lost because of their parents' addiction to gambling?
  • How many rapes in South Africa can be connected to a sex, love or pornography addiction? Opinions don't help, facts and figures must be established here.
  • How many people are disabled or murdered because of these addictions?
This above list of recommended questions is incomplete. The committee must spend time compiling a list of the essential questions which need to be answered here. The committee must appoint a company or organization such as the AAC to investigate and compile a list of all the questions, facts and statistics which are needed to address the contents of the Bill effectively.

Once a study has been completed which answers all of the questions on all of the addictions, only then can a Bill be compiled which will be effective and comprehensive.

Having said that the said Bill should also consider the following issues:
1) Sin Tax:
The country is addicted to “sin tax” collected from corporates who sell addictive products or services. In other words, we have become dependent on addiction-based incomes to finance areas which are not addiction needs; why are we paying for roads with income derived from alcohol and tobacco? The amount of harm caused by alcohol and tobacco must be calculated and spending aimed at addressing that harm must equal the need. Government must find ways of becoming independent from “sin taxes”. “Sin tax” should be used in the following ways:
  • A national addiction education program included in the school curriculum to present defined and compulsory age-appropriate addiction awareness training to all learners.
  • A national addiction treatment program which provides rehabilitation programmes at low or no cost for the disadvantaged which can be understood by people who cannot read & write, which is in their own language, culture-specific and provides for people with a dual diagnosis; and/or a national addiction treatment assistance fund which assists addicts in paying for their treatment costs at appointed and approved treatment centres.
  • Consistent research programmes which keep addiction statistics relevant and up-to-date.
  • Assist NGOs like the Addiction Action Campaign and other addiction-specific NGOs with yearly financial budgets so that they are funded to carry out their mandates.
  • Identify existing NGOs which are already meeting certain needs effectively and efficiently and replicate them.
2) Advertising
Questions surrounding the continued marketing of products and services such as (but not limited to) alcohol, gambling and pornography must be answered. Studies should be completed and results should determine the desirability of said marketing and/or conditions under which it may take place.

“Underground” or “Guerilla” marketing tactics  should become illegal and punishable with large fines and/or imprisonment.
3) Gambling (including horse racing):
No gambling addict can ever claim to be cured of their addiction. Therefore the existing voluntary exclusion list system must be reviewed as it is flawed. The gaming industry, its companies and any individual profiting from this product or service should be financially accountable for the treatment costs and the costs of reintroduction to society of people who have become addicted. Gaming businesses should also be accountable for preventing people from becoming addicted to their products or services. Early intervention and prevention programmes must be created by these industries. Such research, implementation and running costs of these programmes must be financed by the gaming companies/industries themselves.

For instance, according to National Responsible Gambling Chairman, Dr. Roger Meyer, 5% of gamblers are problem gamblers. Problem gamblers, by definition, will contribute more than the average gambler to the profits of gambling organisations ("Winners know when to stop", but compulsive gamblers will stop only when they have no money left to wager and cannot borrow more).

Therefore, if R13.52 billion in income was generated in one year by the gaming industry, the harm reduction spending should equal the amount contributed, not 5% e.g. if the 5% of all gamblers who are problem gamblers contributed to 35% of the turnover, then 35% should be spent on harm reduction and rehabilitation. It's only fair. Its immoral to accept a bet and exploit someone who cannot control themselves.
4) Pornography:

The availability of pornographic material on physical media should continue to be limited to shops that specialise in these products and existing regulations should continue to be enforced. All cell phones belonging to minors should be barred from accessing pornography. This can be accomplished though linking identity numbers to SIM cards (a function of RICA).

Internet pornography companies who operate in South Africa, must confirm age before any sexually explicit material can be viewed online. International pornography companies who do not comply with this control should not be allowed to access the South African public. The current "honour system" controls are ineffective from preventing access to minors and addicts. The process for viewing pornographic material online needs to be reviewed and the legal age of being able to view pornography should also be reviewed.

The pornography industry must assist people in need of treatment for pornography addiction through sponsored treatment programmes.

5) Tobacco:
Tobacco companies should become financially accountable for the addiction treatment costs / health care costs of people who are addicted to their products. Persons who supply tobacco to minors should receive massive fines as well as the possibility of imprisonment and/or community service.  “Underground” or “Guerilla” marketing tactics should become illegal. The supply of any tobacco product at less than the cost or stipulated selling price should be an offence. The legal age for smoking should be reviewed.
6) Pharmaceuticals:
Pharmaceutical companies should become financially accountable for the addiction treatment / health care costs of people who are addicted to their products. A national online pharmaceutical drug reference system must be started. The system must accomplish the following:
  • An instant record of a visit to a physician or pharmacy.
  • An instant record of the prescription provided by a doctor and when the prescribed drugs were dispensed.
  • All records must be available instantaneously country wide, to stop the sale of over the counter (OTC) drugs to people who are visiting multiple doctors and buying products from multiple suppliers in the same day.
People who obtain prescriptions or purchase drugs on behalf on a person who is addicted to over the counter (OTC) or prescription drugs, should receive a large fine and/or community service or imprisonment. The collection of drugs on someone else’s behalf should be allowed with written consent. The dispensing pharmacist must confirm such request telephonically before drugs can be dispensed on someone else’s behalf.
7) Alcohol:
The legal age for citizens to be able to consume or purchase alcohol should be reviewed. Anyone found selling or supplying alcohol to a minor should receive a massive fine and/or imprisonment. The continuation of alcohol advertising as well as the levels of prevention advertising should be reviewed.
8) The Addiction Treatment Profession Standards:
Government should provide an addiction specialist’s course for individuals wanting to become addiction treatment counselors. It should also sponsor the education costs of people wanting to enter this profession. Government must also regulate all institutions that already provide courses in this field.
9) Faith based addiction treatment facilities:
Any Faith-Based facility providing, accommodation, treatment or life skills programmes, should have at least one trained addiction specialist in their employment. Whilst Faith-Based programmes or facilities should be allowed to continue presenting their programmes, access to conventional treatment methods such as Alcoholics Anonymous or Narcotics Anonymous must be provided for. No facility should be allowed to exclude these programmes, methods or services.

Any facility that accommodates an addict in any phase of recovery, for any reason whatsoever, must employ the services of an addiction treatment professional that has completed the minimum educational requirements, as set out by the bill, for an addiction counselling professional.
10) Anonymity:
People who have addictions have the right to remain anonymous and should never be identified without their explicit permission.
11) Discrimination:
Any person or company found to be discriminating against any citizen because they have an addiction should be punishable by law. Such punishment should include heavy fines and/or compensation for any loss suffered because of discrimination.
12) Diversion treatment programmes:
The Bill should make provision for the establishment of a national diversion treatment program which diverts criminal offenders, who have committed crimes owing to their addiction, from prison into an addiction treatment program. The Bill must make allowances for the costs of financing the offender’s rehabilitation and reintegration. Our prisons hold people who have an addiction problem which is not being treated properly and was the driving force in committing the crime in the first place.
13) Secondary and tertiary services:
Long term care facilities such as 6 month inpatient treatment facilities, half way houses as well as individual places of accommodation and employment programmes, must be considered by the Bill, to make the national addiction recovery programme complete and effective. An ideal country to study this existing model is Brazil which provides a complete addiction recovery programme to the point of reintroduction into society services and employment.
14) Regulation of treatment fees:
The Bill should consider the vast difference in fees which are currently being charged by professionals and non-professionals. Faith-Based organisations and services which charge professional fees should be investigated to ascertain which professional services are being rendered.

These recommendations in no way constitute the AAC’s entire position. We believe that these are the most important issues which must be considered by the committee at this time.

Clinics, Drug Rehabs etc.

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