The myths surrounding nyaope

Nyaope is a street drug that first emerged in the late 2000’s in the Pretoria townships of Soshanguve and Mamelodi. It has ravaged informal settlements and poorer communities across South Africa, as it is easily available, inexpensive and highly physically addictive. It is known by different street names in other parts of South Africa : ‘whoonga’ or ‘sugars’ in KwaZulu-Natal and ‘pinch’ in the Limpopo and Mpumalanga regions. It appears as a white or brown powder that is smoked with marijuana or, as the addiction progresses – sometimes injected intravenously. The main ingredients in nyaope are low-grade heroin and marijuana which are frequently cut with various other substances such as methamphetamines, milk powder and a host of other easily available items. Though the name of the drug varies from place to place, the components of the mixture remain the same. Because the ingredients vary from region to region, many myths about the exact ingredients of the substance are perpetuated, primarily by the media.

One of these myths is that nyaope users mix antiretrovirals (ARV’s) medications with heroin in order to enhance the effect of the drug. Reports in the media of ARVs being added to nyaope started emerging in 2011 and 2012. According to these reports, several doctors in Soweto reported that their consultation rooms had been ransacked and HIV medication stolen. Media reports also cited HIV patients being robbed of their pills after collecting them from local clinics; others reported patients selling their ARVs to nyaope addicts or dealers. When taken orally as prescribed, an ARV known as Efavirenz is associated with hallucinations, delusions. After seeing a news report about the use of ARVs in nyaope, John Schetz, associate professor at the University of North Texas Health Science Centre in the United States, conducted research into the effects of smoking Efavirenz. His findings, published in the international scientific journal Neuropsychopharmacology, showed that Efavirenz had ” [a] prevailing behavioural effect in rodents [that] is consistent with LSD-like activity”. However, no study has been conducted involving humans smoking Efavirenz. In 2017 the Department of Health replaced Efavirenz with Dolutegravir due to the abnormal rate of liver damage in users of Efavirenz. Many studies have been done on the contents of nyaope and none have recorded the presence of ARV’s within the mixtures.

Another myth regarding nyaope addicts refers to something called “bluetoothing”. This particular myth originated when a photograph of nyaope users appeared in the media. The image went viral in January 2017. The practice of “bluetoothing” referred to injecting heroin into one user and that same user drawing their blood and injecting it into another user and the next user experiencing a high. There is no scientific evidence to support the idea that this would work in the first place. Secondly, researchers have questioned users who say that this is not a practice that occurs amongst themselves.

Nyaope was classified as illegal in March 2014, with the amendment of the Drugs and Trafficking Act of 2014 (Government Gazette, 2014). The Act was amended to include a ban on substances that contain “other prohibited drugs like heroin and dagga, as they are illegal”. People caught using nyaope can now be sentenced for up to 15 years. Those caught selling the concoction face up to 25 years in jail. Data gathered by the South African Community Epidemiology Network on Drug Use (SACENDU), shows an increase in the number of patients reporting Nyaope as their primary substance of use in both 2017 and 2018 and the numbers are continuing to climb.

The high from nyaope creates a feeling of euphoria, contentment and relaxation. The effects of smoking nyaope are less potent, and as dependency builds, the preferred method changes to intravenous use as this produces a more intense high. After the initial effects, a feeling of drowsiness can persist for several hours. Harmful or negative side-effects may include:

• Nausea
• Vomiting
• Infections of the blood, heart, skin, liver and kidneys
• Respiratory problems
• Extreme weight loss
• Tremors
• Sweating
• Extreme muscle and bone pain
• Drowsiness
• Mood swings
• Low levels of motivation
• Mental confusion

The drug may also trigger psychiatric episodes in people who already have a genetic vulnerability.

Withdrawing from the drug needs to be done with medical care. The extreme physical pain that results from abstaining from the drug, creates challenges in successful withdrawal. The withdrawal symptoms can present as severe abdominal cramps, diarrhoea or flu-like symptoms, which can last for four to six days after the patient has stopped using. Nyaope temporarily relieves the pain associated with withdrawal, thereby creating a cyclical pattern of usage. Symptoms may include:

• Nausea
• Vomiting
• Anxiety
• Depression
• Excessive yawning or sneezing
• Stomach cramps
• Severe muscle and bone pain
• Fever
• Sweats
• Chills
• Involuntary spasms
• Diarrhoea

It is thus recommended that withdrawal from the drug be conducted under the care of trained medical professionals together with experienced, trained, addiction counsellors.

There is a dearth of literature on the use of nyaope and the impact it has on individuals and communities. What is known about the drug, has been largely reported by the media and as we have already discussed, much of that is false information. What we are beginning to learn is that addiction to nyaope is particularly pernicious and requires long-term treatment. Relapse rates are, at the moment, high for a variety of reasons. The mixture of heroin and other strong chemicals leaves the addict both physically and psychologically dependent. Nyaope causes major changes to the chemistry of the brain. Recovering addicts need to learn new skills and be motivated to cope with the intense cravings that are associated with this addiction. Success rates for treatment improve, when the family become involved in the treatment. Successful recovery is very much dependent on the support received, the dedication to the programme and large changes in lifestyle.

South Africa has around 80 private drug rehabilitation centres, including those run by SANCA, and eight government facilities. There is a lack of drug rehabilitation services in the public sector and waiting lists are often very long- this, together with the high rates of unemployment in South Africa, means the available private services are unaffordable. Many addicts do not have access to rehab centres. Additionally, the required rehabilitation period is long. At least a full year of intense rehabilitation and family commitment and support are required to successfully rehabilitate a nyaope addict. The situation has become so desperate that some nyaope users even resort to creating their own “rehabilitation” rooms or communities where an addict is often physically restrained. Standard rehabilitation programmes typically remove the addict from his or her social environment, this alone may not be sufficient for someone addicted to nyaope, as upon return, he or she must go back to the same unfavourable social environment, which promotes relapse. An unfavourable social environment is defined as an environment that promotes nyaope use by enabling ease of access to nyaope and an idle lifestyle which does not offer structure in the lives of the users. Factors identified as contributory to drug use include poverty, unemployment and a lack of recreational facilities. A tailored 12-step programme that is uniquely designed to suit the individual user, may hold the key to successful rehabilitation for people who are addicted to this drug.

The consequences of nyaope addiction are long-lasting and devastating, not only for the addict but their families and their communities. Getting professional help is necessary for anyone coming off nyaope, a medical detox is needed- then the addict needs assistance learning to cope and live without the use of substances. If you or a loved one need assistance with detoxing from nyaope – know that help is readily available. The road to recovery is not always an easy one but getting yourself or your loved one the best care from the team at Crossroads Recovery Centre, provides you with a map to sober, healthy living. No matter how bad things seem, there is hope and it is a phone call away. If you or anyone close to you needs help with an addiction to sex,  gambling,  substances,  alcohol or food, please contact us for a free assessment.

www.crossroadsrecovery.co.za

074 89 51043 JHB

012 450 5033 PTA

References :

Mokwena, Kebogile. “Consider our plight”: A cry for help from nyaope users”. Health SA Gesondheid, volume 21, December 2016, Pages 137-142. https://www.sciencedirect.com/science/article/pii/S1025984815000241

Msomi, Nelisiwe. ‘Bluetoothing’: The drug myth that fooled a nation? February 15, 2017. https://bhekisisa.org/article/2017-02-15-00-bluetooth-the-myth-that-fooled-a-nation/

Skosana, Ina. “We need to talk about caving in to nyaope” – June 6, 2014. https://bhekisisa.org/article/2014-06-06-we-need-to-talk-about-caving-in-to-nyaope/

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