South Africa and ICASA - Part 4

27/11/2010

South Africa will join ICASA! Results of the expert meeting on ADHD and Substance Abuse.

I am so happy to announce that South African professionals working in the field of substance abuse, and researchers involved in mental health and addiction are going to join ICASA!!

It is the result of the expert meeting we had on Friday evening 26th November. Moreover several groups are undertaking the first steps to participate in the International ADHD in Substance use disorders Prevalence study (IASP).

Let me tell you a bit more about my experiences:

It was the last day of the conference on Addiction Treatment models, organized by the Bergen Clinics Foundation. In the morning Professor Basil Pillay from the Durban University learned us more about the relation between substance abuse and trauma (violence, traffic accidence, sexual abuse, domestic violence) in South Africa. The figures he presented were unbelievable. I will upload his presentation here, as soon as I will have received it (it will take some time, so please return!). Both on the side of offenders and of the side of victims, substance abuse plays a striking role. To me his presentation opened my eyes for how difficult it must be for the South African society to view Substance Abuse as a medical condition: every citizen is confronted in so many bad ways with the consequences of substance abuse, that this results in a society trying to defend itself to Substance Abuse. And most likely, Substance Abuse in South Africa cannot be viewed only as a medical/psychiatric condition. The sky high level of people using and misusing alcohol and drugs relates to more than substance use disorders. It is part of the social reality in this country.

Thanks to the Bergen Clinics Foundation who organized the conference and who paid for the ICASA participants coming over to Cape Town, the rest of the program on Friday was for the topic of ADHD and Substance Abuse. Again the differences between western addiction treatment and the reality of South African addiction treatmen in: treatment options, the time used for proper treatment, the number of appointments between patients and caregivers, the hours of training invested in care givers is embarrassing. To give you just one example: in Norway in inpatient treatment 3 months are being used to make good diagnoses. In South Africa the maximum length for outpatient treatment is 6 weeks (including diagnoses).

With this in mind I was wondering how we could even ask our South African colleagues to pay attention to ADHD and SUD. So I was worried on how the expert meeting would be.

In the expert meeting we had a good mixture of South African researchers and professionals from addiction treatment. The Sinethemba outpatient drug rehabilitation (Athlone, a suburb of Cape Town) and Sultan Bahu, the alcohol and drug rehabilitation centre in Mitchell’s Plain township were present (see this blog on South Africa, part 2), and we had four Universities involved: University of Cape Town, of Stellenbosch, of Durban and of Limpopo.

Professor Basil Pillay chaired our meeting. We started with four presentations by our South African colleagues. Debbie Kaminer presented us how Post Traumatic Stress Disorder, ADHD and Substance Abuse are intertwined. Lize Weich informed us on how substance abuse treatment is organized in the Western Cape province. Alban Burke informed us on how he and his team at the University of Johannesburg worked on adult ADHD. And Anneke Meyer from the Limpopo university learned us about how she worked on ADHD in Limpopo, the northern province of South Africa. She said that the level of ADHD in 17 different tribes in that province was very much comparable to that in the western world: approximately 5%. So ADHD does exist in South Africa. No reasons for expecting that adult ADHD will not exist here.

I will post links to these presentations and there results here as soon as possible.

After an introduction on the ICASA activities, we discussed the possibilities for collaboration. By all of the South African colleagues participation in ICASA was seen as an opportunity. Although we do not have a clear picture on how to organize, and how to fund all of this, we concluded: let’s just get started!

On several levels we will make first steps: In three different places South African colleagues will try to set up participation in the International ADHD in Substance use disorders Prevalence (IASP) study. So we will be able to compare South African, European, USA and Australian figures on the prevalence of ADHD in substance abusing patients.

The South African experts will look for expertise on this topic in their country. They will look for colleagues who might be interested in joining a South African working group on this topic.

Alban Burke said that he would participate in the next ICASA meeting in Berlin, and also others will try to find out if participation in that meeting will be possible.
We started up a process. It will take time, efforts, money to accomplish concrete results: better treatment, better prevention, less consequences of substance abuse.

I will keep you posted on our progress!

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