SOUTH AFRICANS URGED TO SCREEN FOR SUBSTANCE USE DISORDERS

By Cuma Pantshwa

• With South Africa ranking among the highest globally for alcohol consumption, particularly binge drinking, the need for proactive measures to address harmful drinking behaviours has never been more urgent.
• The recently launched Web App version of the World Health Organisation’s ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) provides a free, evidence-based tool developed at the University of Cape Town, allowing both practitioners and the public to screen for substance use risk.
• This tool not only aids in individual self-assessment and encourages a culture of self-care but also equips health practitioners with standardised screening methods, thereby supporting better intervention design and planning across communities.

South Africa is grappling with one of the highest rates of alcohol consumption in the world, with per capita intake rising over the last decade. Harmful alcohol use, particularly binge drinking, represents a significant public health challenge in the country. A recent national review highlighted the high levels of heavy episodic drinking, especially among the youth. In response, South Africans are being encouraged to take proactive steps in managing their mental health and well-being.

On 29 May 2023, Minister Lindiwe Zulu launched the web app version of the World Health Organisation’s ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test). Developed at the University of Cape Town, this tool provides a freely accessible, evidence-based screening resource for practitioners to assess substance use across various social and health contact centres. The ASSIST tool aims to create the first passive risk map for substance use in South Africa, facilitating better intervention planning for communities in need. It also allows the public to self-screen, offering an opportunity for individuals to take ownership of their relationship with substances and, by extension, their mental well-being.

Rev. Jannie Smith, Chair of National SANCA, explained, “Everybody can use the tool if they have a smartphone. By scanning the QR code, users can access a questionnaire that assesses and determines their level of risk.” Cathy Monyemore, Institution Manager at J.B. Marks Treatment Centre in North West, praised the tool, saying, “The great thing is that this is a universal, evidence-based tool. It is user-friendly, and for practitioners moving from paper-based questionnaires, it is time-saving and standardises the screening process.”

Privacy concerns have also been addressed. Rev. Smith assured that the tool complies with the Protection of Personal Information Act (POPIA), and no personal information is captured. Nwabisa Qwabe, Social Work Manager from the Eastern Cape Department of Social Development, highlighted another benefit: “Based on the scores, we can now see at what stage the client is—Low, Medium, or High risk—which guides the necessary interventions and additional assessments.”

Professor Goodman Sibeko, Head of the Division of Addiction Psychiatry at the University of Cape Town and Director of the US-funded International Technology Transfer Centre, facilitated the recent UNODC workshop. He emphasised, “Alcohol and other drugs are a persistent issue in our communities. Innovations like the ASSIST Web App tool offer individuals and communities the chance to take control of substance use risk awareness, identify areas needing attention, and allocate resources more intentionally.”

In his closing remarks, Professor Sibeko called on citizens to take action: “For individuals, awareness is the first essential step towards making better choices and leading a health-focused life. Meaningful change requires individuals and communities to take charge and drive the transformation needed to address substance use effectively.”

By using the ASSIST tool, South Africans can prioritise their mental well-being, foster a culture of self-care, and contribute to building a healthier, more resilient community.

Link to the questionnaire below:

https://assistscreening.uct.ac.za

 ASSIST stands for Alcohol, Smoking and Substance Involvement Screening Test. It’s a tool used to screen for substance use and mental health issues.

• The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a comprehensive risk assessment tool. It makes use of risk categories determined by screening scores to help determine the ideal intervention strategy. 
• The ASSIST asks about recent substance use over the past 3 months and also assesses for lifetime use risks. The tool provides a comprehensive list of substances for consideration, including tobacco and alcohol. 
• The tool goes further to provide a level of risk for each substance assessed. This tool then provides information and feedback about the risks and harms associated for each substance. 
• The information covers physical, medical, and psychological risks of regular substance use. 
• Guidance is then provided for recommended best practice intervention in line with the risk level calculated. This may be in the form of information sharing, brief intervention or recommendation for onward referral for additional assessment and treatment.