Beyond the Bottle: Substance Abuse & Mental Health

Each year from 22-27 June, South Africa marks South African National Council on Alcoholism and Drug Dependence (SANCA) Drug Awareness Week, shining a light on a growing crisis. Substance use and mental health often intertwine in a dangerous cycle, unresolved trauma frequently leading individuals toward addiction, and addiction exacerbating psychological distress.

Two sides of the same coin

In South Africa, substance abuse is alarmingly common: lifetime prevalence sits at approximately 13%, more than double the global average of 5% (Source: healthmag.co.za). Alcohol ranks highest, followed by tobacco and cannabis (dagga) (Source: mentalhealthsa.org.za). Young people often get involved early, experimental use beginning around age 10 and rising sharply among teenagers.

Meanwhile, around 30 % of South African adults experience a mental health condition in their lifetime, with many cases linked to trauma from violence and poverty to family breakdowns. For many, substance misuse becomes a coping strategy, a way to numb fear, pain or emotional wounds caused by PTSD, anxiety or depression .

The dual-diagnosis trap

Known as “dual diagnosis”, this combination complicates treatment. Research from UCT shows that individuals with conditions like schizophrenia or PTSD are more likely to misuse substances, and using drugs, in turn, deepens mental health problems. As SANCA explains, substance dependency often spirals into social and emotional isolation, worsening mental distress (Source: mentalhealthsa.org.za).

Spotting the signs

Warning signs include insomnia, impulsivity, mood swings, aggressive behaviour, frequent legal troubles, or even a shift to risky habits like gambling or overuse of caffeine. In youth demographics, methamphetamine (including street drugs like nyaope) shows increasing treatment admission rates (Source: samrc.ac.za).

Starting a conversation

For families and friends, addressing substance misuse requires care. Instead of confrontation, begin with empathy: “I’ve noticed you’ve been struggling, can we talk?” Encourage them to consult a healthcare provider or reach out to confidential helplines such as SANCA, SADAG or AA/NA groups. The SANCA helpline (0800 12 13 14) offers advice, referrals and aftercare support.

Available support structures

·       Rehabilitation and counselling: SANCA chapters nationwide provide outpatient and inpatient treatment, including detox and therapy.

·       Dual-diagnosis care: Facilities equipped to address both substance use and mental health issues are increasingly available.

·       Peer support groups: Organisations like Alcoholics Narcotics Anonymous, temporary shelters, and community healing circles help individuals feel understood and less isolated.

·       Workplace & school–based programmes: Education, early screening and resilience workshops can interrupt the cycle before it deepens.

During SANCA Drug Awareness Week, the message is clear: substance abuse and mental illness are linked, not separate. By confronting trauma and psychological distress head-on, we can prevent self-medication and support better outcomes.

10 Tips for Helping a Loved One

·       Choose a calm, private setting.

·       Speak from care, not accusation.

·       Offer to research treatment options together.

·       Provide contact details for SANCA, SADAG, AA/NA.

·       Help confirm appointments or transport.

·       Offer help with daily tasks like childcare or cooking.

·       Check in regularly.

·       Suggest stress-relief strategies (e.g. walking groups).

·       Join them at a support group or therapy session.

·       Take care of your own mental well-being too.

In confronting South Africa’s dual challenges of addiction and trauma, we can begin to break destructive cycles, and support brighter, healthier futures for those we love.