NATIONAL DRUG MASTER PLAN 2013 – 2017 FOREWORD BY THE MINISTER OF SOCIAL DEVELOPMENT The impact of alcohol and substance abuse continues to ravage families, communities and society. The youth of South Africa are particularly hard hit due to increases in the harmful use of alcohol and the use and abuse of illicit drugs. The use of alcohol and illicit drugs impact negatively on the users, their families and communities. Alcohol and drugs damage the health of users and are linked to rises in non-communicable diseases including HIV and AIDS, cancer, heart disease and psychological disorders. Users are also exposed to violent crime, either as perpetrators or victims and are also at risk of long-term unemployment due to school dropout and foetal alcohol syndrome, being in conflict with law and loss of employment. The social costs for users are exacerbated due to being ostracised from families and their communities. In acute cases users are at risk of premature deaths due ill health, people involved in accidents as well as innocent drivers, violent crime and suicide. The harmful use of alcohol and drugs exposes non-users to injury and death due to people driving under the influence of alcohol and drugs and through being victims of violent crime. Socially, the families of addicts are placed under significant financial pressures due to the costs associated with theft from the family, legal fees for users and the high costs of treatment. The emotional and psychological impacts on families and the high levels of crime and other social ills have left many communities under siege by the scale of alcohol and drug abuse. The revised National Drug Master Plan 2013 – 2017 and the work done by the Inter- Ministerial Committee on Alcohol and Substance Abuse seek to address these challenges. The Inter-Ministerial Committee has worked on policies, laws and strategies that seek to reduce the supply and demand for alcohol and illicit drugs. Extensive work is also being done to improve treatment for addicts and other harm reduction modalities The National Drug Master Plan complements the work of the Inter- Ministerial Committee on Alcohol and Drug Abuse by guiding and monitoring the actions of the government departments to reduce the demand for and supply of drugs and the harm associated with their use and abuse. The Government further displayed its commitment through the leadership of the President when intervening in the challenges faced by the community of Eldorado Park. A special intervention plan was developed in line with the pillars prescribed in the National Drug Master Plan 2013-2017. Page 2 The interventions in Eldorado Park are going to help us implement the consolidated programme throughout the country. The plan is intended to help realise the vision of a society free of substance abuse so that more attention can be focused on raising the quality of life of the poor and vulnerable and of developing the people to achieve their true potential. In comparison with the National Drug Master Plan 2006 – 2011, the revised plan focuses more on the delivery of evidence based strategies that are designed to meet the defined needs of communities. It also strengthens prevention which is the most important leg of this programme. MS BATHABILE DLAMINI, MP MINISTER OF SOCIAL DEVELOPMENT EXECUTIVE SUMMARY Page 3 The National Drug Master Plan (NDMP) 2013 – 2017 of South Africa was formulated by the Central Drug Authority in terms of the Prevention and Treatment of Drug Dependency Act (20 of 1992), as amended, as well as the Prevention of and Treatment for Substance Abuse Act (70 of 2008), as amended, and approved by Parliament to meet the requirements of the international bodies concerned and at the same time the specific needs of South African communities, which sometimes differ from those of other countries. At the 2nd Biennial Anti-Substance Abuse Summit in Durban, President Jacob Zuma pledged his support and the support of Parliament and national and provincial authorities to combating substance abuse in South Africa. The NDMP sets out the contribution and role of various government departments at national and provincial level in fighting the scourge of substance abuse. It also recognises the need for a significant contribution to be made by other stakeholders in the country. In reviewing the NDMP 2006 – 2011, the CDA identified several challenges and impediments that need to be addressed and incorporated with the NDMP 2013 – 2017. It is generally accepted that a single approach such as criminalising or decriminalising substances or abusers will not solve the problem. Instead, a number of strategies should be applied in an integrated way. The commonly recognised strategies applied in the NDMP 2013 – 2017 are: demand reduction, supply reduction and a localised version of harm reduction. The key specific outcomes derived from a review of the NDMP 2006 – 2011 are described in the NDMP 2013 – 2017 in terms of the basic concepts of monitoring and evaluation (Public Service Commission of South Africa, 2008). These outcomes are listed below. 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 Page 4 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 7. Creation of job opportunities in the field of combating substance abuse In a national rapid participatory assessment (RPA), community respondents indicated that alcohol and cannabis were the two main substances of abuse. Their opinion is supported by data gathered from other sources such as the findings of the South African Community Epidemiology Network on Drug Use (SACENDU) (Dada, Plüddemann, Parry, Bhana, Vawda, Perreira, Nel, Mncwabe, Pelser & Weimann, 2012). The predominant strategy for dealing with the drug problem had for years been that of supply reduction. However, the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization (WHO) recently advocated a shift to primary prevention, i.e. a strategy based on the need to prevent the risk of substance abuse/dependence. The review of the NDMP 2006 – 2011 made it clear that the new NDMP would have to be changed in the following key respects: Devising solutions from the bottom up rather than from the top down; Shifting from a national to a community approach to devising strategy (from one size fits all to a community-specific solution); Shifting from supply reduction to primary prevention in an integrated strategy; Developing and applying evidence-based solutions wherever possible; Introducing a monitoring and evaluation (M&E) approach to the formulation of the results to be achieved, i.e. impact, outcomes, outputs and targets; Aligning the NDMP and national and provincial department drug master plans with an M&E approach; Applying research and development to meet the predicted needs and future changes in the field of substance abuse; Reporting in terms of M&E needs instead of activities carried out; and Page 5 Extending the reporting base beyond the CDA and its supporting infrastructure by including non-CDA sources and linked databases. In analysing the substance abuse challenges facing South Africa, the CDA identified a country free of substance abuse as the ultimate goal. The delegates at the 2nd Biennial Anti-Substance Abuse Summit adopted this goal as the vision for NDMP 2013 – 2017. This vision was also endorsed by all the high-level political figures attending the summit. The mission of the CDA, or that which it must do in order to achieve the vision, is to direct, guide, co-ordinate, monitor and evaluate the initiatives and efforts of all relevant government departments at a national and provincial level, the provincial substance abuse forums (PSAFs) and other stakeholders in their implementation of the NDMP 2013 – 2017 and its goal of a country free of substance abuse. The NDMP provides the means for harnessing existing resources to achieve the key outcomes of the NDMP. The NDMP requires national and provincial government departments to plan for and deal with substance abuse problems as part of their normal planning and budgeting. Their drug master plans (DMPs) must be submitted to the CDA at the beginning of each financial year. The CDA must monitor and evaluate the implementation of these plans continuously as described in the CDA's mission. Designated members of the CDA must attend the monthly and quarterly meetings of the PSAFs to carry out the monitoring and evaluation as required, and also the meetings of the local drug action committees (LDACs) if necessary. Monitoring is to be based on the requirements of a standardised reporting tool, the quick analysis of substance abuse reports (QuASARs). These reports are to be submitted by the last day of June, September, December and March of each year. Designated members of the PSAFs must attend the quarterly general meetings of the CDA and submit their reports for discussion at those meetings. Departmental representatives on the CDA must also attend these meetings and submit their departmental reports based on the QuASAR for discussion at those meetings. In terms of legislation, the CDA must submit an annual report to the Minister of Social Development for onward transmission to Parliament by the end of September each year.