Zimbabwe: Ending Drug, Substance Abuse Vital for Zim's Fight Against HIV

Rumbidzayi Zinyuke — Imagine groups of young people from different neighbourhoods participating in a competition.

The atmosphere will definitely be electric as they cheer each other on so that their side can win.

As the cheers from the winning side erupts into the air, one would not be wrong to think the young ones have done well.

The losing side definitely will not take it well; they would want another match to become the champions.

But these are not the type of competitions you may be thinking of. It is definitely not sports! But drugs!

Young people in communities are holding competitions to see which side will remain standing after using as much drugs as they can.

The competition involves members of rival teams challenging each other to see who will use the highest amount of drugs or illicit substances.

The prize?

Nothing, but the chance to become reigning drug use kings in their neighbourhood.

As confusing as that may sound, this is what is happening among the youths in many communities.

Recently, I had a chance to speak with a young man who previously used drugs, who opened up about this and other activities being done by the young people in Zimbabwe and beyond.

Kundai* (not his real name) was part of the winning team back in 2011. He had become a pro and would always propel his side to win whenever they had such competitions.

When his family took him to South Africa to try and remove him from that situation, things got worse.

"In South Africa, I discovered the places where young people were getting drugs. We knew the places that were protected and would not be targeted by police so I spent most of my time there. I would have money to buy drugs, but while there, we met many young girls who needed the drugs, but had no money.

"These were beautiful girls that ordinarily, I would have no chance to hook up with. But because they were desperate, we would be intimate with them in exchange for drugs. A lot was happening there and when under the influence, the thought of using protection does not even come to your mind. We just do it," explained Kundai.

He eventually came back home, but did not stop using drugs until later when he met someone who was willing to assist him.

Two years on, Kundai has not touched drugs. But for how long?

He is not employed and he still has to interact with the same friends who have not managed to leave drugs like him.

Of course he tries to help his friends to get off drugs, but he is just one person and cannot win when he himself still needs assistance to stay off drugs.

He remains hopeful that if he gets something to do, he can stay away from drugs and harmful substances and also help some of his friends to do the same.

The story of Kundai resonates with many young people across the country.

Drug and substance use has for years become a significant challenge among, not only the young population, but also the older generation.

While a lot has been done to try and curb the problem, it has not been enough.

Every day, more and more young people are being drawn to using drugs and other harmful substances and this has brought its fair share of problem to both their lives and the country.

The most commonly used substances in Zimbabwe include cannabis, alcohol, cocaine, heroin, glue, illicit brews (tumbwa), diazepam, codeine-based substances (broncleer) and crystal meth (mutoriro/guka/dombo).

While these are being used frequently, there has been an increase in the number of people injecting the drugs into their system.

These are using drugs such as diazepam, pethidine, ketamine and heroin.

Unfortunately, Zimbabwe has not yet come up with an official population size estimate of people who use drugs and substances but according to the Zimbabwe Civil Liberties and Drug Network (ZCLDN), anecdotal evidence on the ground points to a lot of drug and substance use.

Available statistics show that over 60 percent of admissions in Zimbabwe's mental health institutions are cases linked to drug use. Of these admissions, the majority falls in the 16-40 age groups with more males than females being affected.

Why should dealing with this scourge be a priority for Zimbabwe? There are many adverse outcomes linked to the use and misuse of drugs and substances.

The most worrying being the increased risk of HIV transmission among people who use and inject drugs.

ZCLDN programmes lead Mr Knowledge Mupembe says young people who use drugs engage in risky and unsafe sexual practices, drug overdose, sharing of needles and syringes including Bluetoothing (when a person injects a drug and then uses a syringe to draw blood and inject it into another person for them to also become intoxicated).

"Drug use is now at an alarming level and the ZNASP IV identifies (these people) as a key population at risk of HIV, but acknowledges that there is currently no programming. This is going to affect the country's progress in achieving the 95-95-95 global targets of ending Aids by 2030. People who use and inject drugs are being left out and marginalised," said Mr Mupembe.

Although Zimbabwe had not been reporting high number of injection users, the trend has been shifting.

Sex workers and men who have sex with other men are now among the key population being drawn towards injecting drugs. And this does not bode well for the country's HIV response.

Globally, drug injection accounts for approximately 10 percent of new HIV infections and about 23-39 percent of all new Hepatitis C virus infections occur among people who inject drugs. (UNAIDS).

The Eastern and Southern Africa accounts for approximately 54 percent of all the people living with HIV in the world, yet there is an estimate of about 410 000 people who use and inject drugs and about 21,8 percent of them are living with HIV.

Furthermore, drug use itself can be a risk factor for HIV transmission.

Sharing needles for injecting drugs or engaging in unprotected sex under the influence are well-documented dangers.

This creates a vicious cycle, where drug use fuels HIV infection can lead to further substance use as a coping mechanism.

Mr Mupembe notes that there are other risks that can be exacerbated by the use of drugs including increased risk of STIs.

"Drug use can impair judgment and increase the likelihood of engaging in risky sexual behaviours, such as unprotected sex. This can increase the risk of contracting STIs, including HIV. There is also an increased risk of unintended pregnancy because being hooked on drugs make it less likely that people will use and adhere to contraception," he added.

Drug use is criminalised in Zimbabwe and the possession and use of illicit drugs attracts stiff jail penalties under the Dangerous Drugs Act and the Criminal Code.

Government adopted the Zimbabwe National Drug Master Plan and Treatment and Rehabilitation Guidelines for Alcohol and Substance Use Disorders in 2021.

An Inter-Ministerial Committee on Drug Use was further established and has expanded the Master Plan into the Zimbabwe Multisectoral Drug and Substance Abuse Plan which is working on the implementation of seven pillars that include supply reduction, demand reduction, treatment and rehabilitation and harm reduction, community reintegration, policy and legal enforcement, media and communication as well as resource mobilisation and economic strengthening.

"What is now needed is to reform the current drug control regime by decriminalising drug use, create an enabling environment for the provision of evidence based harm reduction services to address HIV/AIDS among people who use and inject drugs.

"The country should also develop and implement comprehensive drug control strategies that focus on prevention, treatment, and harm reduction.

"These strategies should be based on the best available evidence and should be developed in consultation with people who use drugs," Mr Mupembe notes.

If this is done, it could definitely reduce the risk of those who use drugs progressing to drug addiction and eventually drug dependency.

Zimbabwe's fight against HIV/AIDS cannot be successful without addressing this growing problem of drug use among its youth.

By prioritising rehabilitation programmes, dismantling the stigma around addiction, and fostering a supportive environment, Zimbabwe can empower young people like Kundai to rise from the abyss and contribute to a brighter future for them.

*Kundai's real name has been hidden to protect his identity.

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