by Donna Johnson JD, CAS, ICADC, ICCJP, ICCDP, LADC
When you travel across South Africa you can’t help but be in awe of the vastness of the land, and the complexities and beauty of this country. From the city of Johannesburg with its big city feel and technology that competes with anywhere in the world, to the coastal area of Cape Town filled with a breathtaking view of the city from Table Mountain, and the magnificence of nature that surrounds it. South Africa is indeed a country that displays a knowledge and understanding of its past, that brings with it a strength and passion for its bright future.
During the past several years, I have had the honor of working in South Africa to provide training, consulting, and education on addiction. I am amazed not only by the beautiful people of South Africa and their resilience, but by the determination and dedication of a group of professionals and individuals who understand the impact addiction has, not only on those affected, but on the families and communities who also suffer.
With all of its beauty and offerings, South Africa like most other countries has not been able to escape the devastation of addiction. Substance use in South Africa, as in the rest of the world reaches across racial, social, cultural and religious barriers and places an immense health burden on South African society. South Africa represents a wide variety of cultures. With over 11 languages spoken, addiction impacts all of those cultures. Substance use in South Africa has increased in recent years. Alcohol is still the most widely used substance with methamphetamine (tik), cannabis (dagga), and mandrax (Quaaludes) smoked with cannabis, and cocaine and heroin following closely behind.
Recognizing that substance use is taking a toll on the citizens of South Africa and the communities that encompass this beautiful country, agencies, government and professionals have joined together to develop a comprehensive plan and policy to address addiction in South Africa. This plan emphasizes special needs populations, such as those infected with HIV/AIDS, those involved in the criminal justice system, homeless, youth and women.
Just recently in the city of Cape Town, a comprehensive treatment program was developed to treat those most vulnerable to addiction. With the Office of the Premier of the Western Cape, the City of Cape Town, agencies, professionals, and Substance Misuse, Advocacy, Research and Training (SMART) joining forces to develop a strategic plan for Western Cape province, programs have been implemented to address the impact of addiction on Cape Town. Sarah Fisher, Executive Director of SMART, has been a critical figure in bringing evidence-based programs and treatment to the Cape Town area.
Last month the Community Awareness Rehabilitation and Education Services (CARES) Center was opened. This program is a one-stop, drop-in center to provide evidence-based treatment and to reduce crime and economic issues caused by substance use disorders. This program will target those most vulnerable, such as those citizens with HIV/AIDS. The CARES program provides an intensive array of services, such as substance abuse treatment, case management, education, access to primary health care, job development, parenting skills and aftercare programs – to name a few.
During the past several years, Cape Town has developed a model of care that incorporates Matrix-Model, evidence-based addiction treatment into four primary health centres/clinics . This type of comprehensive program will utilize not only evidence-based treatment models, such as motivational interviewing and Matrix Model, but will also seek to utilize staff that is competent and credentialed in the treatment of addiction. With no current credentialing process in place in South Africa, it is recognized that development of such a process is vital to the future of appropriate treatment.
Sarah Fisher with SMART has not only been instrumental in bringing training to South Africa for evidence-based models, she has also been a key figure in adding IC&RC credentialing into the provincial strategy for the Western Cape. Government offices such as the Office of the Premiere, Office of the Mayor, SMART and other agencies recognize that appropriate treatment need to employ a diverse group of individuals who have demonstrated education, skills, and experience in working with addictions. This past year IC&RC was added to the provincial policy/laws and strategy to bring about standards for addiction credentialing processes in South Africa. IC&RC very much looks forward to working with South Africa as they formalize their board and certification process.