The basic principles underlying the South African government’s implementation of a compulsory lockdown during the fight against the COVID-19 viral pandemic are fundamentally sound and in line with global best practice. However, the authorities have erred by prohibiting the sale of alcohol and tobacco during this period.
Although the decision to ban the sale of these two drugs was made with the best intentions, there are two main reasons why it was not a good idea: Firstly, this ad hoc law fails to adequately consider the harms that its enforcement will do to the many vulnerable individuals who suffer from substance use disorders. Especially in the case of alcohol, many of those with substance use disorders cannot simply stop using drugs. If they do, they risk developing a range of symptoms including, psychosis, seizures and ultimately death.
Substance use disorder is medical condition that often affects people with mental illness or underlying psychosocial problems, but can be managed and treated by healthcare specialists with drugs, psychiatric care and other supportive measures.
As our health services are understaffed and unable to cope with substance use disorders during ‘normal’ times, it is unlikely that adequate treatment or support will be available to those who now find themselves without the drugs or help that they need. This will lead to more pressure on an already burdened health care sector. Most people who have problematic drug use rely on more than one drug to get them through the day.
Therefore, someone who is addicted to say, heroin, but can get by with alcohol, cannabis or tobacco, will not be able to cope unless they break the law and buy those drugs on the black market.
This leads to the second reason why the banning of alcohol and tobacco is a bad move: Those who have problematic drug use disorders are now having to break the law by acquiring them from illegal sources of drugs, and run the risk of being arrested. While people who have the space to grow cannabis and have the financial means, were able to buy and store adequate quantities tobacco and alcohol products before the lockdown came into effect.
However, the indigent sector of the population, many of whom have lost their jobs as a result of the lockdown, are expected to confine themselves in cramped, hot, poorly ventilated shacks and houses. And they have to do without drugs that are essential for some and provide some relief for others who find it difficult to cope with the dire situation they find themselves in.
This demand invites criminal elements to meet this need by increasing the supply of contraband alcohol and tobacco.
The lockdown is just one of many measures that has been instituted to deal with what is a public health issue. Before being implemented, all proposed public health measures should be preceded by both risk versus benefit and cost versus benefit analyses.
It appears that if, in this instance, these analyses were carried out, the potential harms were either not considered or not given sufficient weight.
Either way the decision to ban the sale alcohol and tobacco should be reversed as soon as possible, as it discriminates against the poor, puts the health of the mentally ill and marginalized at risk and gifts crime syndicates and gangs another source of income.
Issued by the South African Drug Policy Initiative