Substances of abuse - Demand for their determinations in the Western Cape
Background. Drug abuse is as relevant today as ever Management of such cases on a primary health care level may be challenging, particularly when laboratory facilities are unavailable. Futhermore, substance abuse and its sequelae place a significant burden on the already overstretched primary health care resources in the country, as well as on other services and society in general. Objectives. The current study surveyed the trends in demand for laboratory determination of amphetamines, opiates, methaqualone, cannabis, cocaine and ethanol for the period 1991 - 2002, in the Western Cape. The survey was conducted by extracting the relevant data from the record of the Pharmacology/Toxicology Laboratory of the University of Stellenbosch and Tygerberg Academic Hospital. This facility processes the largest number of specimens by a single laboratory in the Western Cape. Results. From the data obtained a seasonal pattern emerged for all substances except ethanol, with a trough appearing in early winter. Demand for ethanol analysis was fairly constant thoughout the year, with a peak in the last quarter. Ethanol level was the most frequently requested analysis between 1991 and 1997. This concurs with its status as the main substance and abuse in South Africa and the rest of the world. There was an increased demand for analysis of amphetamines, opiates, methaqualone, cannabis and cocaine between 1991 and 2002, Generally dominating, next to ethanol, were requests for cannabis and methaqualone analysis. Interesting to note was the increase in demand for opiate analysis, following the trend observed in certain other regions of the world. Conclusion. The analysis trends observed in this study demonstrate global patterns of drug abuse emerging in the Western Cape. The medical and social effects of drug abuse impose a grave responsibility on policymakers to ensure that adequate funding is available for analytical laboratories. Only in such a was can these patients be correctly diagnosed and treated.