Imraan Buccus | Time for a rational response to the heroin epidemic

Imraan Buccus

In the 1970s, the South African sociologist Stanley Cohen introduced the concept of the "moral panic" which refers to the exaggerated social reaction to a perceived threat, often involving sensationalized media coverage and scapegoating, which amplifies fear and leads to the marginalization of certain groups.

Cohen’s framework is useful for understanding how the myths surrounding the growing epidemic of heroin addiction in South Africa have fuelled fear and misinformation.

One of the most widely repeated myths is that 'nyaope' and 'whoonga' are uniquely South African drugs concocted from ARVs, rat poison and a mysterious powder extracted from stolen plasma televisions by gangs dedicated to this purpose.

In fact the powder found in plasma televisions is magnesium oxide, a harmless substance commonly used in health supplements, which has no psychoactive properties.

In reality 'nyaope' and 'whoonga' are just local slang terms for heroin.

The findings of recent scientific study on the chemical composition of 'nyaope' confirmed the results of earlier studies and found , once again, that ‘nyaope’ is high-purity heroin.

Another myth that has been debunked is that of 'blue toothing' - where users supposedly inject each other’s blood to share a high.

Another dangerous myth is that the heroin epidemic is something to be blamed on ‘foreigners’ and that it can be resolved by crackdowns on migration.

All these urban legends only serve to heighten fear and stigma, while ignoring the structural issues that drive heroin addiction, such as chronic unemployment and social inequality.

They also mirror the racialised drug policies in the United States, where crack cocaine, predominantly used in poor Black communities, was treated as a criminal issue, while opioid addiction among white populations was addressed as a public health crisis.

The opioid epidemic in the US, described by economists Anne Case and Angus Deaton in Deaths of Despair and the Future of Capitalism, is a telling example of how social and economic conditions shape drug use.

Case and Deaton link the rise in opioid use, alongside increasing rates of suicide and alcohol-related deaths, to long-term structural changes in the economy that have disproportionately affected working-class Americans.

De-industrialization, declining job security, and stagnant wages have led to a sense of despair, particularly among white, non-college-educated populations.

This despair has fuelled the increase in opioid addiction, as many people turn to drugs to cope with their declining prospects and a loss of hope for the future.

The crisis began with the over-prescription of opioid painkillers, such as OxyContin, which led many individuals to develop addictions.

As prescription opioids became harder to obtain, many users turned to cheaper alternatives like heroin and synthetic opioids such as fentanyl, which are significantly more potent and deadly.

Over half a million deaths have been attributed to opioid overdoses since the late 1990s.

The roots of the heroin addiction here also lie in a loss of hope.

As of 2024, nearly 60% of young people between 15 and 24 are unemployed in South Africa, making us one of the countries with the highest youth unemployment rates in the world.

For those aged 25 to 34, unemployment remains alarmingly high, with over 40% jobless.

This results in very high rates of depression among young people as they face the daily stress of financial insecurity, societal expectations, and a lack of purpose or direction.

This mental health burden often goes unaddressed due to limited access to psychological support services and without viable employment opportunities or adequate social support, these young people are at high risk of falling into cycles of addiction.

Mark Hunter, a first rate academic who has shifted his focus from the HIV pandemic to the heroin epidemic, uses ethnographic methods to understand the everyday realities of heroin users.

According to Hunter, most heroin users are not involved in sensational criminal activities but instead survive through low-wage labour in the informal sector.

Their daily struggles are tied to the larger context of South Africa's severe youth unemployment crisis.

Hunter also makes the important point that use of the term 'amaparas’ to describe heroin addicts, is deeply dehumanizing and derogatory label that implies worthlessness, criminality, and social decay.

This kind of language strips people of their humanity, ignoring the complex social, economic, and psychological factors that often drive addiction, such as poverty, unemployment, and trauma.

The use of this term perpetuates a cycle of marginalization and discrimination, preventing meaningful engagement with those in need of support.

To effectively address the heroin epidemic, addiction must be seen as a medical rather than a criminal issue.

In Durban there has been important work towards shifting our understanding of the epidemic from criminal to medical terms.

Monique Marks, through her work at the Urban Futures Centre at Durban University of Technology, has demonstrated the effectiveness of harm reduction.

Her team has provided critical support to drug users by creating safe spaces and offering access to medical care.

These programs not only save lives but also help reduce the spread of infectious diseases like HIV.

Marks' work, as well as the success of harm reduction policies in countries like Portugal, underscores the need for a compassionate, health-centred approach to addiction. Portugal’s decriminalization of drugs, coupled with robust social support, has led to significant reductions in drug-related deaths and HIV infections.

These examples offer valuable lessons for South Africa, where punitive drug policies have done little to address the root causes of addiction.

Hunter also stresses the urgent need for government intervention in the form of rehabilitation centres.

By investing in comprehensive rehabilitation services, the government could provide users with the support they need to recover and reintegrate into society.

A recent report by Jesse Copelyn has highlighted a significant drop in the price of heroin in South Africa, making the drug more accessible to vulnerable populations. As heroin becomes cheaper, it spreads more easily through poorer communities, exacerbating the country’s addiction crisis.

This price drop not only fuels higher rates of addiction but also makes it harder for users to escape the cycle of dependency, as more people can afford frequent use despite their economic hardships.

The addiction crisis seems set to worsen in the coming years if swift action is not taken to address it. We need to stop repeating all the myths that drive the moral panic around endemic addiction and shift towards harm reduction strategies to deal with it including investment in public rehab facilities.

But ultimately we will only resolve the heroin epidemic if we give our young people hope. Instituting a universal basic income grant will do far more to reduce addiction levels than more aggressive policing strategies.

But, ultimately, we need an economy that provides dignified livelihoods and levels of income for our young people.

Perhaps the most dangerous myths of all are those that tell us that it is impossible to build a more inclusive economy and that the victims of our unjust economy should be scapegoated for our failures as a society rather than engaged with the compassion that they deserve.

*Dr Buccus is a political analyst

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