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Sinking low to get high: whoonga addicts threaten lives of HIV patients

 The Big Issue South Africa 24 January 2019

The government, the South African Police Service and drug addiction facilities, all still grappling to get a grip on the wave of tik (methamphetamine) addiction sweeping the country, may soon be hit by another equally devastating drug scourge, “whoonga”. This new drug cocktail — using antiretroviral drugs as an active ingredient — may have even more tragic repercussions. (880 Words) - By Aidan Fitzgerald and Leanne Farish

BI SA_whoonga

An AIDS patient shows her anti-retroviral (ARV) medication at the Tapologo hospice in Rustenburg, South Africa. HIV/ AIDS patients' lives are being put in danger by "whoonga" users desperate to get their hands on ARVs. REUTERS/Siphiwe Sib

A new drug called whoonga, that has emerged in the Eastern Cape and KwaZulu-Natal over the past year, has South Africa's chief drug addiction authority "deeply disturbed".

What makes this new drug so frightening is that whoonga is a cocktail of a life- giving antiretroviral (ARV) medication for HIV/Aids called Stocrin, rat poison and/or powdered detergent. This toxic combination is then crushed up, added to dagga (cannabis), tik or heroin and smoked.

"The resulting negative impact on communities could be disastrous," warns Rheka Kanaye, Information Officer for the South African National Council on Alcoholism and Drug Dependence (Sanca) in KwaZulu-Natal. "We have heard that some whoonga users have deliberately infected themselves with HIV to ensure they have a regular supply of ARVs."

To obtain the HIV/Aids medication, some whoonga users are turning to crime and there are reports of ARVs being illegally sold to addicts.

"Some patients are robbed of their ARV medication, and that leads to a quicker death, some patients are selling it, and there are even allegations of clinic staff selling it," said Kanaye.

This adds a new, unwelcome twist to South Africa's long battle to persuade government to supply free ARVs to HIV/Aids patients.

Dr Bronwyn Myers of the Medical Research Council (MRC) and a former adviser on substance abuse prevention to the World Health Organisation (WHO) reiterated the potentially debilitating effect that widespread whoonga use could have on clinics and hospitals.

"I have also heard anecdotal reports of people getting their ARVs stolen by young people smoking them [with dagga and/or tik] to get high. It has all kinds of public health implications, as scarce and expensive meds are being diverted."

Although first-hand reports from the Eastern Cape show a marked increase in the use of whoonga, it appears that the Western Cape has yet to be heavily affected.

Grant Jardine, director of the Cape Town Drug Counselling Centre, said that, as of yet, there is no serious whoonga crisis in Cape Town.

"Considering that we see 1,000 clients a year, and are a community-based organisation, one would expect our target market to have smoked ARVs if this practice was significant."

Kanaye, however, believes it may only be a matter of time before whoonga hits the Western Cape. "It is believed that syndicates are operating in KZN, Gauteng, the Eastern and the Western Cape," she said.

Dire need for more research

Despite whoonga becoming a growing concern, little research has been done on the drug, and authorities in the Western Cape seem unprepared for a possible spike in whoonga addicts.

"I've heard about it, and I know it's come to the Western Cape, but I don't know anything about it," admits Dr David Fourie, the regional director of Sanca in the Western Cape.

Very little is known about the drug, and experts are still unsure of the effects of smoking Stocrin and whether doing so is addictive. Although a report produced by news channel Al-Jazeera claimed whoonga was "instantly addictive", doctors have denied the existence of any addictive substances in the ARV Stocrin. Instead, they point to the tik or heroin that it is cut with as the addictive component, and say that smoking whoonga is most likely to induce a hallucinatory or confused state.

"The use of EFV (Stocrin) on its own is unlikely to result in physical dependence or addiction, but the other substances certainly have this potential," says Dr John Joska of the UCT Department of Psychiatry and Mental Health.

"We have not been able to speak first hand with whoonga users in the Western Cape, but we suspect that inhalation of EFV may produce effects typically seen when used orally in the prescribed way. These effects include vivid dreams, confusion and psychotic-like states," he adds.

With a potentially dramatic increase in whoonga use looming, rehabilitation centres and doctors in the Western Cape are calling for more in-depth research.

Commenting on the lack of hard data available on whoonga use in the Western Cape, Dr Myers of the MRC says, "We've heard reports of it increasing but these people do not present themselves at drug treatment centres so we have no idea how many people are actually smoking this medication."

Similarly, Kanaye laments the "absence of information about whoonga use generally."

"Due to our relative lack of knowledge, the effects [of whoonga] are unpredictable and unknown. We do not know the full extent of whoonga use in the Western Cape. All the reports seem to be coming from KwaZulu Natal," says Dr Joska.

"Our own survey returned little in the way of first-hand information, so the time is right for a more thorough investigation," he urges.

Originally published by The Big Issue South Africa ©

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