Use benzos with care – they are addictive

SANCA Wedge Gardens treatment centre’s Estelle Raath.

While benzodiazepines (also known as benzos) can help treat some mental health and neurological conditions, they are addictive and should only be used for a short amount of time.

This is according to Adèl Grobbelaar, the manager of SANCA Wedge Gardens treatment centre, who confirms that many people suffer from benzo addiction.

Benzos are sedatives, most often prescribed to treat anxiety and panic disorders. They are usually used as a short-term treatment, given for two to four weeks, in pill form. In rare situations, they can be injected to help control panic attacks.

“Benzo addiction has always been a problem, but was often seen in women more than men. Since the coronavirus pandemic hit South Africa, benzo abuse has become more noticeable in both genders.

“Many addicts land up in hospital due the very complicated benzo withdrawal process. Some benzo addicts drink two months’ worth of sleeping tablets a day. No detoxification medication can provide an equivalent of that dose, unless they are placed on a drip in hospital,” says Adèl.

The growth in benzo use during the coronavirus can largely be attributed to an increase in anxiety and depression caused by the pandemic. “For this reason, some doctors prescribed benzos more frequently,” says Adèl.

While people need a doctor’s prescription for benzos, addicts are still managing to get large supplies as they visit numerous doctors. While pharmacies should be able to pick this up, some do not take down people’s personal details when they pay cash for their medicine.

“While there is a codeine survey in place to manage the selling of codeine, not all pharmacies participate,” says Adèl.

Excessive benzo use makes addicts aggressive, even though they are prescribed as sedatives, as withdrawal typically only starts after the fourth day. One client that arrived at SANCA Wedge Gardens for benzo addiction treatment become so violent that he crashed through one of the rehab centre’s windows and had to be admitted to a hospital’s psychiatric ward. He was also an alcoholic, but has since become sober.

“If not medically assisted, these users can start having seizures on the seventh day. The withdrawal symptoms keep them awake day and night, which could cause the aggression.

“When taken in large amounts, a substance users’ tolerance level changes. This is why they have to keep taking more to get the desired effect,” says Adèl.

Rehabilitation for benzo use is also particularly challenging because patients are not honest about the amounts they take. 

“These patients can be very difficult, emotionally needy and seek pills for every complaint they may have. Usually, they are not motivated and have been forced by someone to undergo the rehabilitation process.

“It is not often a success story and these users often don’t complete the rehabilitation programme. They have a better chance if they have already completed the detoxification programme in hospital, before being admitted to rehab centre,” says Adèl.

To people who have been prescribed benzos to ease anxiety, Adèl advises that they only use them short-term to avoid addiction. The risk of addiction is higher if you have a history of drug or alcohol abuse or if you have a personality disorder.

“If anxiety persists, rather consult a psychiatrist so that you can be assessed properly. There is alternative medication available, that is more effective,” says Adèl.

Common side effects

Common side effects of benzos include drowsiness or sleepiness; dizziness; headache; confusion; numbed emotions; reduced awareness; muscle weakness; tremor; problems with balance and walking, speaking and swallowing; and problems with motor skills, including writing and eating.

Some of the common physical side effects of withdrawal include stiffness, weakness, stomach problems, flu-like symptoms and visual problems; while some common psychological side effects of withdrawal include anxiety, insomnia, nightmares, depersonalisation, problems with memory and concentration, depression, hallucinations and delusions.

For more information about SANCA Wedge Gardens and its Full Circle Recovery Programme, visit www.wedgegardens.co.za.

SANCA Wedge Gardens honours its nurses

In honour of National Nurse’s Week 2021, Estelle Raath from SANCA Wedge Gardens treatment centre had the following to say to all of Wedge Gardens’ nurses:

“I acknowledge the work you perform every day. What a fortunate time to publicly share this recognition. I am so proud of all the nurses who work at SANCA Wedge Gardens. Each of you has devoted additional resources to navigate the challenges placed before you for our patients.

“I am proud to be a nurse and to stand by you during the most challenging healthcare crisis we have encountered in a century. Thank you for the work you do so tirelessly and ensuring quality care to our patients. Let’s continue to work together to give the nursing profession a voice to lead!”

Pictured are SANCA Wedge Gardens’ nurses Lydia Maseko, Estelle Raath and Merrios Maluleke.

SANCA Wedge Gardens’ clients put craft skills to good use

SANCA Wedge Gardens Treatment Centre’s part-time occupational therapist Caryn Berman says occupational therapy (OT) has a huge role to play in substance use disorder rehabilitation.

She works with men at the rehab centre who are in the process of recovering from various addictions.

Men at the centre work in groups, that can take the form of discussions, games and crafts.

“Creative groups introduce leisure activities and skills that can be emotionally meaningful and financially rewarding, and consist of activities such as bead work, cooking, leather work, woodwork, decoupage, drawing, adult colouring in, chocolate making and baking, among others,” says Berman.

“Many patients get involved in the creative activities and have been following through with them in their own time in the evenings and on weekends, which helps to fill the long hours when no therapy takes place. This is a realistic training process for life outside of rehabilitation,” she adds.

While doing crafts, one learns valuable skills, such as following instructions, correcting errors and trying again until you master a skill.

“The patients love taking home items that they have made and giving them to their families as reflections of how far they have progressed. This also helps to improve self-esteem,” says Berman.

Vetkoek making at SANCA Wedge Gardens.

The role of nurses at SANCA Wedge Gardens Treatment Centre

Nurses play a vital role in helping patients undergoing drug or alcohol rehabilitation.

At SANCA Wedge Gardens Treatment Centre, in Whitney Gardens, nurses care for patients during detox, treatment and at the halfway house. From day one, the nurses are there to ensure patients are safe, comfortable and supported.

For patients taking the first steps to getting sober, the first few hours and days can be difficult, physically and mentally.

“Our patients are often angry, fearful, irritable and ashamed. We see them at their absolute worst,” says Estelle Raath, SANCA Wedge Gardens’ deputy manager.

“Some have been drinking or drugging one last time before they come in for treatment. Their mental state when they get here is poor. Lots of patients are humiliated that their drinking or drug use has come to this. Some come in as a last effort to save their job or marriage or to get their kids back,” she adds.

During admission, nurses conduct a full assessment and take the patient’s medical history. The assessment includes determining the severity of alcohol and drug dependence; their physical health and chronic conditions, such as diabetes, hypertension, HIV or hepatitis; and establishing whether they are dual diagnosis patients (if they have a co-existing mental health problem, such as depression, bipolar disorder, anxiety disorders or post-traumatic stress disorder).

“Nurses also assess patients for compliance to chronic medication, as most patients neglect taking their chronic medication when they abuse alcohol or drugs. Most patients neglect eating balanced meals when using drugs and alcohol, but you can see the physical change a few weeks later,” says Raath.

The nursing team works with a general practitioner to assess all patients coming in and to assist them with a detox regime according to their substance of abuse. On admission, drug and alcohol screening tests are done so that the general practitioner can get a full picture of what substances they are using.

“Patients in detox can have severe withdrawal symptoms, caused by the body’s response to going without the substance. Patients sometimes experience anxiety, depression, mood swings and even thoughts of suicide when going through withdrawal from drugs.

“Nurses monitor vital signs and stay alert for signs and symptoms of withdrawal. They administer medication, as prescribed by the general practitioner, to manage withdrawal symptoms, and make sure that patients feel comfortable, supported and well taken care of throughout the detox process,” says Raath.

Because addiction is both a physical and psychological health issue, substance abuse nurses need experience in general medical care and mental health.  

“They also play a teaching role in terms of health education and give medical lectures about the dangers of drug abuse and how to make changes through lifestyle management.

“Of all the specialty nursing fields nurses might choose, substance abuse nursing provides an opportunity to not only help those in immediate need, but also help them and their loved ones possibly enjoy a better future,” says Raath.

For more information about SANCA Wedge Gardens and the Full Circle Recovery Programme, visit www.wedgegardens.co.za

A story of hope: Drug addict turns his life around

Randburg resident Jean-Pierre Devilliers Anderson (33), fondly known as JP, has been clean and sober for over 18 months, thanks to his full commitment to taking his life back and SANCA Wedge Gardens Treatment Centre’s Full Circle Recovery Programme.

JP, who grew up in Thabazimbi, Florida and Roodepoort, says while he had a normal childhood, he had a few demons in his closet.

“At 19, when I was offered khat, I went for it… I wanted to be cool. I wanted to fit in. I wanted to be part of something. I wanted an experience to escape the reality of life.

“Once the addiction took hold of me, I needed to explore more and try stronger drugs. I moved on to crystal meth and ecstasy. In the beginning, it was good and fun, I felt fine,” he says.

As the years of addiction passed, JP says he reached a point of no turning back.

“Sadly, instead of getting the help I needed, I carried on. I hit absolute rock bottom a few times. I was completely alone. I lost my family and friends, as they all rejected me. I lost my job. I was not getting anywhere in life. I was going backwards. This lasted for nine years.

“I was filled with hate and anger and blamed everyone and everything around me for what I was going through. In my mind, I thought that I didn’t need anyone or anything. I thought I was good… I could still get a fix,” says JP.

Luckily, JP realised he needed help before it was too late.

“I was frail, skinny and daunting to the eye. This image frightened me. My family tried to help and had me admitted to SANCA Wedge Gardens,” says JP.

He was initially admitted in December 2019, but sadly relapsed.

“I no longer wanted to be a failure to myself, my son, my family and to God. I prayed. I tried so hard on my own to fix my life, but it was not enough. Eventually, I realised that I needed help and guidance. That’s when I called Wedge Gardens and begged to come back. By the grace of God I was allowed back there months later.”

Thanks to Wedge Gardens’ Full Circle Recovery Programme, JP is now a successful ex drug addict.

“The programme was truly interesting, helpful and helped me to succeed. I found my true self again… A man that I am proud to be,” says JP.

“I want so say a very special thank you to my psychologist and all the ‘sisters’ at Wedge Gardens. Without them, I don’t think that I would be where I am today. Their belief in me helped me to believe in myself again. It helped me to choose to turn my life around and I will be forever grateful to all of them,” he adds.

JP has been clean since 26 August 2019. “That’s 589 days and counting. I still struggle every day, but with faith and the love and the support of my family and true friends around me, I choose me and I will not go backwards again,” he says.

JP is now firmly focussed on building a successful business. “I would love for my son, Jayden, to join the business and take it over some day, if he wants to. I am now living my life for my son. I will do anything and everything for him. He is my world. I will prove to him the man I am, and I will be a dad that he can be proud of.”

JP now also enjoys cycling and training, which helps him to relax and reflect on himself and his life.

“The daily struggle is very difficult, but by the grace of God I have no cravings. My mindset has changed. I pray and my faith has helped to keep me clean. I choose to stay away from all substances, including alcohol. I will not go backwards, it is not fair on myself or my loved ones,” says JP.

His advice to struggling addicts is to keep trying. “You will only fail if you stop trying. You need to do it for yourself. We all have it in us to achieve our goals. We just need to believe and realise that we can be who we want to be. Remember your 12 Steps,” says JP.

As for the future, JP is taking it one day at a time. “I am thankful. I take each task and each day on with a sober, strong, Godly mindset,” he says.

For more information about SANCA Wedge Gardens and the Full Circle Recovery Programme, visit www.wedgegardens.co.za.

SANCA Wedge Gardens welcomes OT Caryn Berman

Glenhazel resident Caryn Berman joined SANCA Wedge Gardens Treatment Centre as a part-time occupational therapist in February 2021.

Berman, who works at SANCA Wedge Gardens four mornings a week, believes that occupational therapy (OT) has a huge role to play in substance use disorder rehabilitation. She works with men at the rehab centre who are in the process of recovering from various addictions.

“I am fortunate to have a lovely big therapy department which enables me to run groups, while some individuals work quietly on their own.

“I generally screen people to evaluate their level of functioning and socialisation, before dividing them into groups. The groups are aimed at recovery, to help individuals develop the skills they will need after leaving the rehabilitation centre, good work habits and life skills,” says Berman, explaining that groups can take the form of discussions, games and crafts.

Creative groups introduce leisure activities and skills that can be emotionally meaningful and financially rewarding, and consist of activities such as bead work, cooking, leather work, woodwork, decoupage, drawing, adult colouring in, chocolate making and baking, among others.

“Many patients got involved in the creative activities and have been following through with them in their own time in the evenings and on weekends, which helps to fill the long hours when no therapy takes place. This is a realistic training process for life outside of rehabilitation,” says Berman, explaining that OT plays an essential part in rehabilitation as it provides a tool for leaving and functioning in the outside world. 

“Patients find it easier to discuss matters affecting them – whether these are their emotions, skills or work requirements – when they are busy with a practical activity. It is less threatening when performing activities and often more enjoyable, as one gets involved in the game or task that reflects the skills or attitudes required in life.

“Groups can become quite heated and competitive, and life skills become apparent as one plays the game! While doing crafts, one learns valuable skills, such as following instructions, correcting errors and trying again until you master a skill. The patients love taking home items that they have made and giving them to their families as reflections of how far they have progressed. This also helps to improve self-esteem,” says Berman.

Some of SANCA Wedge Gardens’ patients have skills which they are now teaching others. “This also has a positive effect on their emotional wellbeing. To take your place in society, you need to develop social skills, good work habits and a meaningful, healthy use of leisure time. OT is a meaningful, practical therapy to develop these skills,” says Berman.

She also works with the other therapists at SANCA Wedge Gardens to add value to their work, by assessing and evaluating patients and adding to their insights. 

“Through my own life experiences, I am able to add a mature vision and input. The patients see me as an older person who has had some ups and downs and sees life realistically.

“I enjoy the craft activities and love opening eyes to new skills and possibilities that have never been explored. I enjoy leading the groups and reflecting change to the patients. I find the men show me great respect and are willing to explore areas that they were reluctant to look at before, as these are done through activities which are less confrontational,” says Berman.

Berman graduated from the University of the Witwatersrand in 1979. Initially working in the psychiatric field, with disturbed teenagers, people with eating disorders and adults with mental disabilities, she then went on to work with newly blinded adults before changing to paediatric therapy, where she worked with children with learning disabilities.

Also having been an associate lecturer at the University of the Witwatersrand’s OT Department, Berman encourages students to do their practicals at Wedge Gardens.

“One day, I would love to have an open department where patients can work any time of the day to fill the empty hours. This is not possible at the moment, but I can dream,” she says.

For more information about SANCA Wedge Gardens and the Full Circle Recovery Programme, visit www.wedgegardens.co.za.

Karen says farewell to Wedge Gardens

Social worker and Edenvale resident Karen Griessel has bid farewell to Wedge Gardens after being part of the therapeutic team at the rehab centre for over six years.

“I started at Wedge Gardens in 2015, doing my practical work there during the last year of my social work studies. I was blessed enough to start working there full-time in 2016 and over the years, gained much experience and knowledge.

“The most rewarding part of my time as a Wedge Gardens therapist was seeing men come into treatment as broken and lost souls, with the belief that they had no hope. Despite their many troubles and traumas, I witnessed their healing and saw them blossom into the authentic human beings God intended them to be. In many cases, they reconciled with their families.

“As you can imagine, successful outcomes cannot be guaranteed in substance abuse rehabilitation and, therefore, these successes and victories are what gave me the energy to keep on hoping and helping,” she says.

Karen believes another important part of her job was educating patients, families and society at large about the different aspects of addiction, to help lift the stigma that still exists.

“Now I know more than anyone the destruction caused by substance abuse disorder and respect the feelings involved; however, I believe knowledge and understanding can bring insight and comfort.

“During my time at Wedge Gardens, I decided to do my Honours in Psychology to continue with my personal development as I like studying and wanted, metaphorically, to keep my knife sharp in dealing with the psychological issues and dual diagnoses often found in patients so I can ultimately understand and help them better.

“So it is no surprise that my next step is a Master’s in Psychology, while I still have the study muscle. While I may get involved in part-time therapeutic work, I want to have more balance in my life and the time to practise self-care while continuing my education.

“I want to thank my manager at Wedge Gardens, Adel Grobbelaar, who was not only a great boss to me but also a mentor. She and the team have a challenging job and they do it with dedication.”

The dangers of ketamine

Ketamine is primarily used by medical practitioners and veterinarians as an anaesthetic but is abused by users as an hallucinogenic dissociative drug.

According to Karen Griessel, a social worker at SANCA Wedge Gardens substance abuse treatment centre, ketamine is usually sold on the street as a bitter tasting, grainy, white powder. Users usually swallow, snort or inject it.

“As a general anaesthetic, ketamine reduces sensations in the body, with effects lasting a couple of hours. These effects include being detached and dream-like, relaxed and happy, because it alters the user’s perception of time and space, which leads to hallucinations and numbs pain,” says Griessel.

“If you take too much ketamine, you go into the ‘k-hole’, which users describe as feeling detached from sensations and their surroundings, as if they are floating outside their body,” she adds.

Physical risks to one’s health include increased blood pressure; memory loss; bladder problems; urinary tract issues, due to kidneys being affected; and liver damage. Mental risks include depression, mood changes, personality changes, psychosis and addiction.

“Sadly, this drug is also abused as a date rape drug, as the person who it has been given to finds it difficult to move,” says Griessel.

For more information about SANCA Wedge Gardens and its Full Circle Recovery Programme, contact 011 430 0320 or 010 534 6596 or visit www.wedgegardens.co.za.

The dangers of khat addiction

Khat refers to the leaves and shoots of Catha edulis, a flowering evergreen shrub that grows in East Africa and the Arabian Peninsula.

It is used by chewing the plant’s fresh leaves, which have the most potent effect, and by smoking it, making Arabian tea from it or sprinkling it on food.

Although some users compare khat to coffee, it actually has more similarities with cocaine and other amphetamines, says Karen Griessel, a social worker at SANCA Wedge Gardens substance abuse treatment centre in Johannesburg.

She explains that Cathinone and Cathine are the primary psychoactive ingredients found in khat. Both are chemical compounds, with structural similarities to amphetamine.

When consumed, khat users feel increased alertness, excitement, energy and euphoria and can become more talkative. While their appetite decreases, their heart and breathing rates, body temperature and blood pressure increase.

“Because their appetite is reduced and fatigue is lessened, khat users often rely on the drug to get them through work,” says Griessel.

Khat addiction then develops as the user has a psychological dependence on it.

“Some symptoms of khat addiction include cravings, a preoccupation with the drug and giving up social or professional responsibilities to use it,” says Griessel.

“Chronic khat abuse can lead to mental health impairment and behavioural changes,” she adds.

Griessel explains that high doses of khat, combined with a lack of sleep, can cause paranoid or grandiose delusions, violence and schizophrenia psychosis. Hallucinations may also be present, caused by the high accumulation of dopamine in the brain.

“The long-term effects are potentially life threatening and include anorexia, hypertension, gastric disorders, liver damage and an increased risk of heart disease, heart attacks and cancer of the mouth,” says Griessel.

For more information about SANCA Wedge Gardens and its Full Circle Recovery Programme, contact 011 430 0320 or 010 534 6596 or visit www.wedgegardens.co.za.

Copyright Wedge Gardens Treatment Centre 2016