The head of the Directorate for Priority Crime Investigation (Hawks), Lieutenant General Godfrey Lebeya, has confirmed South Africa has an opioid crisis. Presenting the country’s national crime statistics on 13 October 2024, Lt Gen Lebaya said that international organized criminal groups had a foothold in the country and were introducing fentanyl into the local market.

He said that "while dagga, cocaine, heroin, methamphetamine and nyaope have been in the hands of traffickers, a more highly potent synthetic opioid called fentanyl has entered the trafficking conveyer belts.

Drug traffickers,said the General, were mixing fentanyl in with known drugs to make a highly toxic mix leading to overdose and subsequent death.

What is Fentanyl?

Fentanyl is a potent synthetic opioid drug approved by the Food and Drug Administration for use as an analgesic (pain relief) and anesthetic. It is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic. It is snorted/sniffed, smoked, orally by pill or tablet, spiked onto blotter paper, patches, sold alone or in combination with heroin and other substances, has been identified in fake pills, mimicking pharmaceutical drugs such as oxycodone.Similar to other opioid analgesics, fentanyl produces effects such as: relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea and vomiting, urinary retention, pupillary constriction, and respiratory depression.Overdose can cause stupor, changes in pupil size, clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of a triad of symptoms such as coma, pinpoint pupils, and respiratory depression strongly suggests opioid intoxication.

Lt Gen Lebeya said:  “One kilogram of fentanyl, has the potential to kill 500 000 people. As reported by the Drug Enforcement [Administration] of the United States, more than 107 000 Americans died of fentanyl overdose this year alone. In July 2024, one suspect was arrested in Cape Town with fentanyl. He reported to have received this drug from someone in Johannesburg to try the market in Cape Town.”

Cannabiz Africa has reported on South Africa’s growing role as a key hub in the international distribution of narcotics, a development that has drawn Interpol’s attention. Although many of the hard drugs coming to South Africa from Asia and South America are mostly destined for the European and Australian markets, a side effect has been the development of a local ‘secondary market’ in hard drugs.

This has prompted concerns that substance abuse is getting out of hand, particularly in Gauteng. Despite Gauteng government’s pledge to help young people with rehab, funding problems have led to the closure of two large drug rehabilitation centres in Randfontein and Witpoort, both managed by Life Nkanyisa.

GroundUp reports that Life Nkanyisa was by far the largest drug rehabilitation operation funded by the Gauteng Department of Social Development., receiving R124 million in 2022/3, which was 25% of the department’s budget that year.

The centres had 606 beds for in-patient rehabilitation and 144 beds for half-way house programmes, by far the largest drug rehabilitation operation funded by the department.

The two centres were previously Life Esidimeni psychiatric facilities funded by the Gauteng Department of Health, which were carelessly shut down by that department in 2015, leading to the deaths of at least 144 people.

In March 2016, the facilities were converted into drug rehabilitation centres, funded by the Department through its non-profit funding system, and were later rebranded from Life Esidimeni to Life Nkanyisa, a subsidiary of JSE-listed Life Healthcare.

However, a spat between the Department and the provincial Treasury led to funds being withheld from the Department and Life Healthcare in turn was left out of pocket to the tune of R187 million.

Meanwhile, people seeking rehabilitation have been left stranded. The closure of Life Nkanyisa’s centres, as well as delays in payments by the department to other in-patient treatment centres in Gauteng, have led to the province severely missing its first quarter targets for drug rehabiliation.

The department aimed to sponsor 1,308 people to complete in-patient drug rehabilitation treatment in the first quarter of the department’s financial year (April-June 2024), but only 149 had done so by the end of the quarter.

There do not appear to be any plans to increase the capacity at other drug rehabs to compensate for the closure of Life Nkanyisa’s centres.

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