Highlights
- Meth's popularity, accessibility, and perceived normality contribute to initiation.
- A lack of socio-economic opportunities contribute to meth initiation.
- Peers, more so than family, are influential in introducing others to meth.
- Meth initiation may occur as a means of coping with stress and trauma.
- Many reported transitioning to meth from other substances, like alcohol.
Background
Despite
a significant rise in methamphetamine use in low- and middle-income countries,
there has been little empirical examination of the factors that contribute to
individuals’ initiation of methamphetamine use in these settings. The goal of
this study was to qualitatively examine factors associated with methamphetamine
initiation in South Africa.
Methods
In-depth
interviews were conducted with 30 active methamphetamine users (13 women and 17
men) in Cape Town, South Africa. Interviews included narrative descriptions of
the circumstances surrounding methamphetamine initiation. Interviews were audio
recorded, transcribed, and translated. Transcripts were analyzed with document
memos, data display matrices, and a constant comparison technique to identify
themes.
Results
On
average, participants began regularly using methamphetamine around age 21 and
had used for seven years. Four major themes emerged related to the initiation
of methamphetamine use. The prevalence of methamphetamine users and
distributors made the drug convenient and highly accessible to first time
users. Methamphetamine has increased in popularity and is considered “trendy”,
which contributes to social pressure from friends, and less often, family
members to initiate use. Initiation is further fueled by a lack of
opportunities for recreation and employment, which leads to boredom and
curiosity about the rumored positive effects of the drug. Young people also
turn to methamphetamine use and distribution through gang membership as an
attempt to generate income in impoverished communities with limited economic
opportunities. Finally, participants described initiating methamphetamine as a
means of coping with the cumulative stress and psychological burden provoked by
the high rates of violence and crime in areas of Cape Town.
Conclusion
The
findings highlight the complex nature of methamphetamine initiation in low- and
middle-income countries like South Africa. There is a need for community-level
interventions to address the availability and perceived normality of
methamphetamine use, and to provide young people opportunities for recreation.
On an individual level, addressing mental health and misconceptions about the
dangers and benefits of methamphetamine could ameliorate willingness for
initiation. Potential points of intervention include mass media campaigns and
school-based interventions to raise awareness of the physical and social
impacts of methamphetamine, and structural interventions to create safer
neighborhoods, provide opportunities for employment and recreation, and expand
mental health services to improve emotional health and coping skills.
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Affiliations
Duke University School of Medicine, Department of Psychiatry
& Behavioral Sciences, Duke Global Health Institute, 310 Trent Drive, 333
Trent Hall, Durham, NC, 27708, USA
Correspondence
Corresponding author. Duke University, Duke Global Health
Institute, 310 Trent Drive, Trent Hall, Room 333, Durham, NC, 27708, USA. Tel.:
+1 919 613 5061.
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