Pubdate: Thu, 08 Sep 2005
Source: Cape Times (South Africa)
Copyright: 2005 Cape Times
Author: Karen Breytenbach
Bookmark: (Methamphetamine)


The abuse of "tik" (methamphetamine) in the Western Cape has soared to
epidemic proportions, largely because of inadequate research into its
treatment, a top psychiatrist has said.

Speaking at the annual meeting of the South African National Council
on Alcoholism and Drug Dependence (Sanca) yesterday, Lize Weich, a
specialist in substance abuse, said little was known about the
treatment of this dangerous stimulant, compared with depressant drugs
such as dagga, Mandrax or alcohol.

Clinical trials had not delivered a single drug effective in the
treatment of tik addiction, while substitution treatments - as in
using methadone for heroin addicts - were dangerous, said Weich.

Criticising what she described as a passive public and legal attitude
to tik manufacturing and dealing, she said "much more severe penalties
must be issued".

"Here patients are not shy about being manufacturers or dealers, while
abroad it's considered as serious a crime as rape and murder. In
Canada one can be fined up to $1 million for manufacturing

Weich, who worked in Britain for eight years, said she had noticed a
reluctance in South African society to take ownership of the problem.

"Public outcries are rare."

Abuse was also exacerbated by the fragmentation of family structures,
passive or abusive parenting, difficult socio-economic conditions and
the rampant prevalence of shebeens.

"I know I may step on a few toes, but many South Africans have an
attitude of testing boundaries instead of obeying laws and rules.

And tik appeals specifically to this type of person ... people who are
low on harm avoidance and high on novelty seeking," Weich warned.

That tik appealed to children, because it created feelings of energy,
being alert, and euphoria, was a major challenge.

"We've never had to deal with child addicts before. It increases the
libido, therefore appealing to people who engage in group sex,
increasing the spread of HIV/Aids. Since World War 2 soldiers have
used it to become fearless and violence-prone, therefore it appeals to

Studies had shown that tik abusers were four times as likely as
non-users to die a violent death, she said.

Behavioural treatments like long-term out-patient support was most
effective as a primary approach, while traditional short-term
in-patient treatments, which "most members of the public assume to be
effective", proved less effective.

More successful treatments included skills training, relapse
prevention, the creation of incentives - such as gift vouchers for
those who stayed clean for a certain period - and family counselling.
The embarrassment of an employer hearing of a relapse was a

More highly qualified and committed members of staff were needed at
treatment centres as the abusive and paranoid behaviour induced by tik
could become overwhelming to those who lacked specialised knowledge,
Weich said. Specialist treatment centres were needed.

Charles Parry, director of the Medical Research Council's Alcohol and
Drug Abuse Research Unit, and Willie Pienaar, principal psychiatrist
at Stikland and Tygerberg hospitals, received the Sanca National Merit
Service Award.
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