Nyaope is taking hold

Heroin-based drugs have grown rapidly among black users in some parts of the country.

A national report on alcohol and drug abuse trends compiled by the SA Community Epidemiology Network on Drug Use found that in Mpumalanga and Limpopo the proportion of black heroin addicts increased significantly from 75% in the second half of 2013 to 89% in the first half of 2014.

The organisation used data from 9086 patient admissions at 64 centres across all nine provinces.

"Of the illicit drugs, nyaope [a mix of heroin, dagga and ARVs, among other substances] is probably the biggest concern as it seems to be quite widespread in poorer communities and has been linked to crime and other negative consequences," said Charles Parry, director of the SA Medical Research Council's drug research unit.

Bronwen Myers, a specialist scientist at the council, said the abuse of nyaope (also known as whoonga or sugar) was a concern.

"The name differs by location but the most active ingredient causing the problem is heroin," Myers said.

Tik was still the primary drug of choice in the Western Cape. However, alcohol and dagga remain the "dominant substances of abuse" in the country, the report found.

Alcohol was abused more in KwaZulu-Natal, Eastern Cape, Free State, Northern Cape and the North West, while dagga abuse was most common in Gauteng, Mpumalanga and Limpopo.

Myers said the challenge was to design effective responses.

"We often react to problems rather than pro-actively designing services to respond to emerging threats," she said. "We have been warning about the increasing use of heroin but we still do not have the most evidence-based services for heroin dependence, specifically medication-assisted therapy."

She said the system had the potential to help but it "takes a long time" for the information to be acted upon.