Issues of Alcohol Misuse and treatment in Multicultural South Africa: An Interview with Varoshini Nadesan, PhD

In South Africa for many years, substance use consisted primarily of the misuse of locally produced alcohol, cannabis, and tobacco due to the isolation wrought by apartheid (United Nations Office for Drug Control and Crime Prevention (UNODCCP), 1999). While the use of other illicit drugs has increased (Atkins, 1997) alcohol continues to be the most commonly misused substance, most especially among males (South African Community Epidemiology Network on Drug Use (SACENDU), 2006). In the 2002– 2004 South African Stress and Health study, researchers reported that 38.7% of the population use alcohol, 30% use tobacco 8.4% use cannabis, with other drug use and nonprescription psychoactive drug use at 21.3% (Van Heerden et al., 2009). However, over 80% of those who abuse substances, report that alcohol is their primary substance of misuse. Despite efforts to control alcohol consumption through ‘demand reduction,’ alcohol use is reported to remain high (Vellios & Van Walbeek, 2018) and is considered the primary substance of abuse in the country, with an estimated burden of disease attributed to it of 7.1% of all deaths (Peltzer et al., 2011). Not only is the amount of alcohol consumption the greatest on the African continent, fetal alcohol syndrome (FAS) is reported to be higher than almost any other countries in the world (Parry et al., 2005). The percentage of women in Africa who drink alcohol is also above the world average, raising concerns for minor children in their care (Cupido, 2021). There are many different treatment resources available to persons in South Africa, but the 12-step program advocated by Alcoholics Anonymous is a consistent element across treatment programs. Outpatient treatment program, rehabilitation centers, and referral to AA support groups is strongly supported. Today we talk with Dr. Varoshini Nadesan, Senior Lecturer in Social Work and Community Development at the University of Johannesburg, South Africa. Dr. Nadesan has worked closely with many community organizations and has served three terms as a nonalcoholic Board member of Alcoholics Anonymous South Africa and was recently elected as an AA World Services Delegate in 2020, representing South Africa on AA International. We discuss with her the patterns of drinking and treatment among various groups in multicultural South Africa.