Drug Awareness Week

Substance abuse is a growing and urgent public health concern in South Africa.  Its impact goes way beyond the individual as it strains families, employers and society at large.

Society needs to recognise the serious nature of alcohol and drug abuse, and this Drug Awareness Week, the CMS encourages you to learn how it develops, what signs to look out for, and how your medical scheme can support treatment and recovery.

What is substance abuse?

Substance abuse refers to a pattern of using alcohol or drugs in a way that causes significant problems or distress. It is a recognised medical brain disorder and includes the misuse of illegal substances like marijuana, heroin, cocaine, or methamphetamine. It may also be the abuse of legal substances, such as alcohol, nicotine, or prescription medicines.

Signs and symptoms

The following are the most common signs, symptoms and behaviour of a person having a problem with drug or alcohol abuse:

Physical Signs

• Bloodshot or glazed eyes: May indicate intoxication or fatigue from substance use.
• Sudden weight changes: Especially weight loss, due to appetite suppression or neglecting nutrition.
• Pupil dilation or constriction: A common indicator of opioid (constricted pupils) or stimulant (dilated pupils) use.
• Unusual body odours: Certain drugs (like alcohol or cannabis) may leave a noticeable scent on breath, clothes, or skin.
• Track marks: Scarring or bruising, often on the arms, from injecting drugs.
• Frequent nosebleeds or runny nose: May indicate snorting of substances like cocaine.

Behavioural Signs

• Secrecy or withdrawal from family and friends: Avoiding interaction to conceal use.
• Neglect of responsibilities: Declining work or school performance, missed deadlines, or absenteeism.
• Legal or financial problems: Due to purchasing substances or behaviours linked to intoxication e.g. theft
• Risk-taking behaviour: Engaging in unsafe sex, reckless driving, or violence while intoxicated
• Changes in social circles: Associating with new friends who also use substances.

Psychological Signs

• Mood swings or irritability: Emotional instability due to the drug’s effects or withdrawal.
• Paranoia or hallucinations: Especially with substances like methamphetamine, LSD, or cannabis in high doses.
• Anxiety or depression: Can both precede and result from substance abuse.
• Lack of motivation or apathy: Loss of interest in hobbies or goals.

Causes

Substance abuse is influenced by a combination of personal, social, and environmental factors. While public laws determine what types of drug use are legal, cultural and societal norms shape what is considered acceptable.

Underlying causes include:

• Genetic vulnerability and individual personality traits
• Environmental stressors and social pressures
• Mental health conditions like depression, anxiety, or post-traumatic stress disorder (PTSD)

Prevention

There are practical ways to reduce the risk of substance abuse:

• Know how it starts: It often begins with using addictive substances recreationally or misusing prescription medication.
• Avoid temptation and peer pressure: Surround yourself with supportive, substance-free relationships and learn how to say no.
• Address mental health: Seek help for conditions like anxiety, depression, or PTSD, as these often go hand in hand with substance abuse.
• Examine the risk factors: A family history of addiction or mental illness may increase your risk, but awareness can help with prevention.
• Live a well-balanced life: Manage stress, set personal goals, and stay focused on a healthy, purpose-driven lifestyle.

Diagnosis and treatment

Families need to monitor the suggested signs and symptoms closely and seek the assistance of a family doctor or mental health professional for a formal diagnosis.

Treatment depends on the individual’s health and the type of substance involved, and may include:

• Detoxification to safely manage withdrawal symptoms
• Cognitive behavioural therapy and possibly medication
• Support through individual or group therapy in treatment centres or hospitals

The goal is not only to treat the symptoms, but also to understand and overcome the root causes of the substance use.

PMB level of care

Alcohol and substance abuse are included in the PMB Regulations under the Diagnosis and Treatment Pair 182T. This means your medical scheme must fund the diagnosis, treatment, and care in full.

Treatment includes:

• All clinically appropriate diagnostic tests.
• Consultation with a doctor, psychiatrist or mental health professional.
• 3 weeks of in-hospital treatment per year.
• Follow-up consultations to review medical treatment (excluding psychotherapy).

*Remember to use a designated service provider (DSP) to avoid any co-payment on the PMB funding.

Download and share the CMScript to learn more and help raise awareness, it could be the first step to recovery for someone in need.