Despite a high prevalence of alcohol and other drug use (AOD) in South Africa, little is known about AOD use among women, including those in treatment centres, and changes in use over time. This knowledge is important for the development of gender-sensitive interventions for the prevention and treatment of AOD problems. We aimed to describe changes in patterns of AOD use among women who accessed specialist AOD treatment centres in the Western Cape Province of South Africa. Data were collected from 51 specialist AOD treatment centres participating in the South African Community Epidemiology Network on Drug Use between 2000 and 2013. A total of 74 368 treatment episodes were recorded for the period, of which 22% involved women. The proportion of women seeking treatment increased from 4% to 11% over time. The most common primary substance of abuse among this sample was alcohol, followed by methamphetamine. Multinomial logistic regression analyses showed that young coloured (mixed race) women were almost 18 times more likely than other women to report methamphetamine as their primary substance of abuse (RRR=17.80; 95% CI=13.18–24.04). More than a quarter of women reported poly-substance abuse. Women treated for heroin were significantly more likely to be white and younger than 25 years old (RRR=1.62; 95% CI=1.19–2.21). These data portray an increasing use of AOD treatment services by women; particularly for alcohol and methamphetamine use disorders. Additional investigations into the service needs of women utilising AOD treatment is warranted.

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ObjectiveTo test the effectiveness of a programme aimed at reducing the risky use of alcohol and alcohol-related HIV risk and increase help-seeking behaviour among a sample of municipal employees in the Western Cape Province, South Africa.MethodsA clustered randomised controlled trial was conducted in 2011–2012 among 325 employees. The eight hour intervention, Team Awareness (TA), addressing behavioural risk among employees was administered to 168 employees in the intervention arm and the 157 employees in the control arm who received a one-hour wellness talk.ResultsThe results show that TA had the greatest impact on risky drinking practices and hangover effects. There was a significant group × time interaction (F (1, 117) = 25.16, p < 0.0001) with participants in the intervention condition reducing number of days on which they engaged in binge drinking. There was also a significant time effect with participants in the intervention condition reducing the likelihood of going to work with a hangover (F (1,117) = 4.10, p = 0.045). No reduction in HIV-related risk behaviours were found.ConclusionsThis intervention study was able to demonstrate a modest but significant reduction in risky drinking practices and hangover effects. This provides encouraging evidence for the effectiveness of interventions that address risky use of alcohol among employed persons, further providing a launch pad for strengthening and replicating future RCT studies on workplace prevention, especially in developing country settings.Clinical Trial Registration NumberPan-African Control Trial Registry (201301000458308).

Data from treatment admissions related to codeine misuse and dependence are informative, but provide an incomplete picture of the nature and extent of codeine-related problems in SA. Other data sources must be considered before further regulatory/policy changes regarding codeine are implemented.