Introduction Thefollowing paper is an essay based on the National Drug Master Plan in SouthAfrica between the years of 2012 and 2016. The purpose of this essay is tostate the extent to which evidence-based research has influenced the policywith regard to the most effective ways of reducing illicit drug abuse in the country.It will also explain the ideological and/or discursive considerations that areassociated with the chosen policy.
BackgroundIllicit drug abuse in South Africa Accordingto Thomson (2013), illegal drug consumption in South Africa is double the worldnorm. Some of the illicit drugs most commonly used in South Africa includeCannabis, Heroine, Cocaine, Methamphetamine, Mandrax and Ecstasy (Pelzer,Ramlagan, Johnson & Mafuya, 2010). The major contributing factors to theabuse of these drugs are primarily poverty, reduced mental health, poorpersonal and social competence, unemployment, lack of education and peerpressure (United Nations Office on Drugs and Crime, 2004).
Sadly, abusingillicit drugs does not only result fromthe above-mentioned factors, but can actually lead to many of those factors as well. In addition to this, theSouth African Police Services (2014) have reported that up to 60% of all crimesnationally are related to substance abuse. With South Africa being named one ofthe drug capitals of the world (Christian Drug Support, 2014), there is a direneed for interventions at policy level, to assist in curbing the alarminglyhigh rate of illicit drug use in the country. National Drug Master Plan 2012-2016 The word policy, can be defined as “a set of ideas or a plan of what to do in particular situations that has been agreed on officially by a group of people, a business organisation, a government, or a political party” (Cambridge Dictionaries,2014). This being said, the National Drug Master Plan is a policy as it is a countrywideplan drawn up by the Central Drug Authority (CDA), approved by the parliamentand supported by President Jacob Zuma.
It is a set of guidelines that has beendeveloped to serve as a basis for cost-effective and holistic strategies to bringabout a reduction in the supply and demand of illicit drugs as well as reducethe harms associated with these drugs (CDA, 2012). The stakeholders involved inthe policy include up to 12 different government departments, as well as manymore research institutions and supporting companies, some of which include theSouth African Revenue Service and the National Youth Development Agency. Evidence-Based Research in Policy, and its Affects Onthe Health and Lives of Users The NationalDrug Master Plan is a policy that was not simply drawn up based on assumption,but rather rigorous research across all aspects of illicit drug use in SouthAfrica. This began at community level, where needs assessments were carried outin various communities hard hit with the problem.
This allowed the CDA to drawup a comprehensive list of community needs in order to tackle the problem ofillicit drug abuse, based on what the community members said themselves. Thislist will further be described in the paper under the section of ideas andideals. The NDMP was also developed using notions from previous policies thathave been effective. From these past policies, it was observed that whencombatting illicit drug use, a multidisciplinary approach works best. Thismeans that the policy should not be based on a single strategy, but manyintegrated strategies to tackle the problem. With this in mind, the CDAformulated the policy on a 3-approach basis, namely demand reduction of illicitdrugs, supply reduction of illicit drugs and harm reduction of illicit drugs,focusing on methods to limit the damage caused to users. Within thecommunities researched, not only did the CDA learn about what the communitiesneed, but also where they stand in terms of employment, age, populationdistribution, gender, social gradient, the types of drugs most used and thedemand for treatment etc.
This gave the CDA a clear and holistic look at howsome of the specific community factors affect drug abuse and what people arewilling to do to stop. This will also be elaborated on further under theideological considerations section further down in this paper. Before writingup the NDMP, the CDA, together with other stakeholders conducted research onpast policies tackling the same issue to determine exactly what worked and whatdid not. Other policies and their effects are listed within the NDMP.
Some ofthe knowledge gained from this included:1) There is no single effective drug policy- due to thefact that there is no single drug problem; there is no single miracle that willeffectively tackle drug abuse.2) Prevention programmes have modest impact- whether itbe amongst family, school or community, merely prevention programmes don’tserve to give the most satisfying impact unless done in conjunction with otherstrategies.3) Increased punishment yields little benefit- being imprisonedfor illegal drug consumption has shown no real decrease in drug use.4) Crop destruction does not result in a decrease insupply- destroying drug-producing plants has not shown a reduction in theaverage supply of drugs. The NDMP statesthat all policies can and should be grounded on evidence-based research toincrease efficacy and effectiveness of the policy.
It goes on to say thatscientific research carried out for policy development is crucial as it servesas proof or verification of what has worked, what has not and what can bealtered. The NDMP categorised the scientific research conducted by the CDA intothree main categories. Firstly, efficacystudies, this can also be called evaluation studies as it measures the naturalchanges due to the intervention over time. Some of the efficacy studiesreviewed for the development of the NDMP include peer help/social supportinterventions, which would fall under behavior change.
Numerous studies usingthis intervention as part of an integrated approach depicted a reduction in notjust drug use, but crime and infections too. Secondly, there are naturalexperiments, which monitor the changes in environment with regard to the way itaffects drug use. Last, but not least, there are effectiveness researches,which serve to observe how effective an intervention is and why. All threetypes of scientific research were used in the development of the NDMP to ensurethe quality and value of the policy. Monitoring and evaluation of theprevious NDMP used between the years of 2006-2011 was also done to improve andfurther adapt the policy for 2012-2016. This can also be called evidence-basedresearch, as it is the process of finding out what is significant and what isnot. For the past two-years the CDA hasbeen involved in a pilot project, looking at Injecting Drug Use (IDU) and itsrelation to the increasing numbers of disease infections, namely HIV/AIDS.
TheNDMP has been developed also with this issue in mind, and the CDA haveresearched previous policy formulations on IDU, concluding that addressing IDUeffectively reduces the spread of HIV/AIDS and other infections, even much morethan originally assumed. This is the reason why the NDMP has focus on IDU, asit will improve the health of users not just from a drug point of view, butbeyond. Last, but not least, evidence-basedresearch has shown that policy addressing employment has a substantial impacton the health of communities. This is because, when employment status isincreased and income is generated, people have more control over their lives interms of making healthy, rational decisions and even seeking care or treatment.
Having a steady income also allows an individual to be more mentally,personally and socially stable, resulting in less people seeking drugs toalleviate their psychological pain. Employment reduces poverty, which as saidin the beginning of this paper, is one of the biggest contributors to drugabuse. After researching this in detail, the CDA have included addressingpoverty and unemployment in the NDMP.
(Central DrugAuthority, 2012) Ideological and Discursive Considerations Within theNDMP Accordingto the Oxford Dictionary (2014), the term ideology can be defined as “a system of ideas and ideals,especially one that forms the basis of economic or political theory and policy”.Some of its synonyms include beliefs, principles, ethics, theory andphilosophy. Ideas Surrounding the NDMP 1) The idea of moving from a top-down approachto a bottom-up approach: the bottom-up approach is an idea that differsdrastically from the ‘one-size fits all’ conventional national policy approach.By utilising this method, the NDMP aims to put primary emphasis on thecommunity itself to develop different solutions to address specific needs. Inaddition to this, the NDMP has adopted a continuous monitoring and evaluation tactic,not just on policy activities, but still focusing on the needs of thecommunity.
This allows for constant improvement and measure of achievement bylooking at indicators, outcomes, targets etc. 2) The idea of the term ‘drugs’: for purposesof the NDMP, the term drugs is derived from the Drug-Trafficking Act (Act No.140 of 1992), which include commonly abused licit drugs like OTC drugs, toalcohol, tobacco and other volatile solvents, as well as other undefined andillicit substances which may cause harm and are dependence-forming. The NDMP isa policy that addresses all of the above drugs. 3) The idea that rural areas need lessattention compared to urban areas: due to the fact that urban areas hold themajority of the drug user population at 43%, many past policies have put theirfocus there. The CDA observed that up to 33% of the drug user population lieswithin rural areas, although less than urban, it is fast increasing, and sohave made addressing rural communities just as much a priority area as urban. (CDA, 2012). Ideals Surrounding the NDMP The ideals of the NDMPare basically the principles of the policy and what is needed to be done tomake the policy intervention a successful one, and is focused on addressingwhat the community needs to combat illicit drug use.
1) Better parenting: due to the fact thatparents and family are the primary contacts and caregivers of children, theneed for the development and application of parental skills and competencieswill enable people from a young age to deal with the issues surroundingsubstance abuse.2) Increase in recreational facilities: this providesopportunities, especially directed at the youth to pass time in a fun and safemanner, time that could otherwise be used to take drugs.3) Emphasis on spirituality: the provision offacilities that enhance spirituality and religious observance will mean anincrease in people identifying their value believing they can do better thandrugs, and following a different, healthier and happier path of life.4) Law enforcement: by applying protocols,laws, policies and practices to those who do not abide by the law, will reducethe threat of substance abuse if done in conjunction with other strategies. 5) Rehabilitation: this gives existing usersa chance to turn their lives around for themselves and their loved ones. Thisincludes detoxification, aftercare and reintegration into society. (CDA, 2012).Ethical Considerations Surrounding the NDMP The NDMP being a national policy plan means that ithas been implemented across South Africa, in both rural and urban environments.
This being said, it is of utmost importance to facilitate interventions thatare successful- brining about overall benefit, but to also be culturallysensitive. This includes sensitivity to both language and practices so that noone is offended in the process. Data collected in the needs assessment andthroughout application of the policy will also include personal and sensitiveinformation regarding topics such as drug use, disease status etc. This is whyit is important to not just get informed consent to receive this information,but to also keep it confidential. No harm is to be done in any way, before,during and even after the policy implementation. Theoretical Support of the NDMP There are twomain theories supporting the NDMP; namely the Biological Theory, as well as theTheory of Behavior Change. 1) The Biological Theory: With regard to illicit drugabuse, this theory focuses on the effects of drugs on the biological physiologyof the user.
According the National Health Service (2014), Cannabis is acalming drug, but can have serious effects on the body. This includes changingchemical balances in the brain resulting in poor mental health, and when smoked,increases a person’s risk of developing asthma, lung cancer and cardiovasculardisease. Cocaine and Heroin causes a short-lived intense ‘high’ (Drug FreeWorld, 2014). It has many side effects such as loss of appetite, nausea,hallucinations, vomiting, paranoia, damaged blood vessels, malnutrition anddepression to name a few.
There are hundreds of other drugs that have theability to cause havoc in the body. Drug addiction leads to serious damage inevery aspect and can easily result in death. 2) Theory of Behavior Change: This is the predominanttheory surrounding drug abuse. This is because no matter what intervention isin place, it will always come to the decision of the user to stop and make achange. One of the models within this theory, known as the Health Belief Modelwould be apt in this policy as all the strategies in the policy will lead theindividual to make a decision based on their perceived susceptibility, severityand benefits as well as determine their cues to action and be able to maintaintheir decision of giving up their addiction (University of Twente, 2014).
Conclusions TheNational Drug Master Plan 2012-2016 has the ability to be highly effective ifall the stakeholders involved are able to pull their weight. Being developed onthe highest forms of evidence-based research means it is a comprehensive andvery strategic plan, aimed for success. The parliament, minister of social developmentand the president have all pledged their support for the policy, and it willsurely reduce the high rate of illicit drug use in South Africa by decreasingthe supply, demand and harms of the drugs. A large part of the NDMP is basedaround ideological theories that have proved to be worth the effort. From here,we must allow the policy to be implemented correctly to bring about the desiredoutcomes for the overall benefit of the country now, and in the years to come.