Stigma against cocaine users in South Africa

Cocaine use and dependence have grown dramatically in South Africa over the last five years according to latest data. The past five years has see use increase by 55% and abuse dependence by 70%. And the demographics of cocaine use have evolved as well. Before, cocaine was less prevalent and more specific to marginalized individuals in low-income areas and inner cities of South Africa like Johannesburg, Durban, Cape Town among others. However, currently the use and dependence have increased among all demographic groups. Cocaine use has also doubled among those who have historically had low rates of use, women and wealthy individuals.The epidemic has the potential to affect anyone. I know this firsthand from the death of my South African friend brother, who died two years ago from acute intoxication involving cocaine. As cocaine use and dependence have become more prevalent, the chances that each of an average South African knows someone dependent on cocaine have climbed. A friend, family member, neighbor, work mate, or significant other may be struggling with a cocaine problem. The stigma toward drug users, especially those who use cocaine, is very strong in South Africa. And this stigma can make it that much harder for people to come forward and get the help and support they need.The cocaine epidemic has many causes, but it is now closely linked to many other drug epidemics. Between 2012 and 2016, hospital visits related to cocaine use nearly tripled in South Africa according to the data and cocaine-related deaths nearly doubled in those two countries. Many South Africans have been caught up in the prescription cocaine epidemic that is sweeping through South Africa. Many South Africans who are hooked on cocaine are moving onto other drugs because they are cheaper and more easily available alternative. In fact, the data in my possession found that 67% of recent cocaine initiates first used other drugs like marijuana. Many of them are part of this changing demographic and are getting hooked on drugs and feel they had no other alternative than to move on to cocaine. Most of South African population disapprove of cocaine use, and many of them stigmatize users. While disapproval is minimal for other drugs such as marijuana, 99% of adults in South Africa disapprove of someone trying cocaine.

Even frequent users of drugs such as marijuana tend to stigmatize cocaine use.Although much of the public is uninformed about drugs, this disapproval is still understandable, as data shows that cocaine appears to be associated with a higher level of dependence and physical and social harm than any other drug. Overall, disapproval toward use is understandable regardless of the reasons that someone started using. However, stigmatizing users does not appear to help improve their condition, especially when the users are our friends or family. Cocaine addicts are already at odds with much of society, and many are at risk for losing life resources, such as a job. They may need to depend most on friends and family to help pull them through.The data shows that those South Africans who stigmatize drug users are less likely to use themselves, societal stigma against drug use does not necessarily reduce risk of use.Stigmatizing attitudes toward cocaine use might help prevent a lot of South Africans from initiating use, but such attitudes appear to be less than helpful or even harmful when it comes to individuals who have become dependent. These attitudes encourage users to be more discreet about use, and makes them hesitant to seek treatment due to stereotypes. Knowing drug users tends to be associated with decreased stigma. Interestingly, data have shown that health care professionals tend to hold negative attitudes toward individuals with drug use disorders. Many South Africans have been taught to stigmatize drug users through anti-drug programs in school and communities settings. And since cocaine use is illegal, many South Africans stigmatize use and addiction and perhaps feel that it is wrong. It is already difficult enough for someone to get treatment, it is very expensive with or without health insurance and it can be hard to tell an employer that you need time off to go to rehabilitation. So further marginalizing those who are dependent does not seem to help the situation. If South African users aren’t willing to be open about use and seek help, their drug problem will likely only get worse. If family, friends and even medical professionals stigmatize users, then there is little motivation for those with drug problems to seek help.