MHM Magazine

8 | MENTAL HEALTH MATTERS | 2024 | Issue 5 MHM Highlights The article “The Hidden Disease of the Waiting Room: Understanding and Addressing Addiction in South Africa” sheds light on the pervasive issue of substance addiction in South Africa and its intricate relationship with mental health. It emphasises the challenges in providing integrated care for both conditions, highlighting the significant overlap between mental illness and substance abuse. The reciprocal relationship between substance use and mental health is discussed, emphasising the need for holistic approaches to address both issues concurrently. The article also delves into the specific challenges posed by nicotine, alcohol, cannabis, and opioids, as well as the impact of cannabis decriminalisation and the rise of opioid misuse. Furthermore, it addresses the stigma and barriers to care, the role of healthcare providers, and the call to action for integrated care and advocacy. The conclusion emphasises the urgent need to address addiction and improve the quality of life for individuals in South Africa. Significance of Topic Substance addiction is a pervasive and devastating issue in South Africa, affecting millions of people from various walks of life. The increasing use of substances like nicotine, alcohol, cannabis, and opioids is a major concern with significant public health implications. Addiction often exists alongside mental health issues, creating a complex interplay that is difficult to treat if not approached holistically. We highlight the significant overlap between mental illness and substance abuse, which exacerbates the challenges of managing both conditions effectively. Almost half of individuals with a mental illness also have a problematic pattern of substance use. This dual diagnosis, known as a co-occurring disorder, underscores the importance of integrated care to address both mental health and addiction concurrently. However, this is not always the case in South Africa, where health systems often lack the necessary coordination to provide such comprehensive care. Substance Use and Mental Health The relationship between substance use and mental health is reciprocal. In many cases, individuals suffering from mental health disorders turn to substances as a form of self- medication. For instance, a person dealing with untreated depression might turn to alcohol to numb emotional pain or to nicotine to cope with anxiety. However, this self-medication often leads to addiction, which in turn exacerbates the underlying mental health condition, creating a vicious cycle that’s hard to break. Nicotine Nicotine remains one of the most commonly abused substances in South Africa. However, the landscape of nicotine use is changing, with the rise of vaporising devices (vapes) becoming increasingly popular among younger generations. While vapes are often marketed as a safer alternative to smoking, they still contain nicotine, which is potently addictive, has well-known detrimental effects on multiple organ systems, and influences the metabolism of medication used to treat mental illness. Nicotine addiction is closely linked to increased anxiety and should be proactively addressed when managing individuals with mental illness. Furthermore, early detection and intervention with motivational interviewing will improve the health of those who use nicotine. Alcohol Alcohol continues to be a matter of great concern in South Africa, The South African Addiction Medicine Society addictionsocietysa@gmail.com www.saams.co.za THE HIDDEN DISEASE OF THE WAITING ROOM: UNDERSTANDING AND ADDRESSING ADDICTION IN SOUTH AFRICA MHM | 2024 | Volume 11 | Issue 5 | The Hidden Disease of the Waiting Room: Understanding and Addressing Addiction in South Africa H