TIK ABUSERS OVERWHELM CAPE TOWN HOSPITALS

The use of tik is taking its toll on the city's health care system,
with at least one major hospital treating up to eight times the number
of psychiatric patients it can accommodate in one day.

On one morning last week, the GF Jooste Hospital in Manenberg, which
has a capacity to observe three psychiatric patients at a time, had 24
people in for observation.

Now doctors have called for more psychiatric beds to treat psychotic
tik abusers.

And the provincial health department is exploring a proposal for 30
extra mental health beds within the city metro.

Senior management from hospitals around Cape Town met last week to
discuss the increasing number of psychiatric patients who seek help at
state hospitals.

At least two doctors, who did not want to be named, told the Cape
Argus that the staggering rise in tik abuse was to blame for the
rising number of psychiatric patients in the past few months.

"The scourge is forcing hospitals to treat psychotic tik abusers,"
said one doctor.

Among its many effects, tik induces psychotic symptoms such as
paranoid delusions, delusions of persecution and sometimes full psychosis.

Andreas Plueddemann, senior scientist at the Medical Research
Council's alcohol and drug abuse research unit, said the tik induced
psychosis could be triggered by long term abuse of the drug.

"Those sort of episodes happen after a little while; it could be after
weeks or months of abuse," he said.

Plueddemann said the condition could be treated, but there was a risk
of lasting psychosis, even schizophrenia.

"When people stop using (tik) it can go away, although sometimes
symptoms don't go away," he said.

Grant Jardine, director of the Cape Town Drug Counselling Centre,
agreed that psychotic episodes were not un-common among tik abusers.

"We've had to change our treatment to deal with tik patients. You have
to stabilise them first before you can start treatment," he said.

Jardine said that with the increase in tik abuse, they had had an
increase in the number of clients with psychotic episodes.

He explained that the effects of tik differed.

"If, for instance, you are genetically predisposed for a mental
illness, then tik abuse will increase your chances of psychotic episodes."

Provincial Health Department spokesperson Faiza Steyn admitted that
there was a growing problem with tik addiction.

"The fact is that our hospitals are experiencing an increase in
patients portraying psychotic behaviour, which is largely attributed
to substance abuse, most specifically tik.

"In fact our records show that the most common primary substance of
abuse is tik, which amounts to nearly 60 percent of all known
substance abusers under the age of 20."

Steyn said that as a result, the department had established safe
observation rooms at district hospitals which could accommodate about
three patients at a given time.

"A proposal for 30 extra mental health beds within the metro is also
currently being explored," said Steyn.

One doctor, who didn't want to be named, said the new Mental Health
Act stated that district hospitals must keep new psychiatric patients
for a 72-hour observation before referring them to a psychiatric
institution.

But in many cases, these hospitals don't have the facilities to care
for more than three patients at a time and are now being forced to
keep patients in "overflowing" rooms.

"Psychiatric hospitals are also experiencing shortages which means
they can't admit these patients even when we refer them. We are then
forced to keep them," said the doctor.

Steyn said the health department had put in place an acute emergency
case load management policy specifically for clinicians and facility
managers to deal with situations like this.