In South Africa, a Deadly New Drug Is Made With HIV Medications

Nyaope -- "crack with a sickening twist" -- combines heroin, detergents, and ARVs into a lethal cocktail that's ravaging the country's townships.

South African police watch bags full of dagga (drugs) before burning them at Winterton in KwaZulu-Natal in South Africa. (Juda Ngwenya/Reuters)

Twenty-eight-year old Luthando Bulelani sits at the back of a church in the township of Springs some 30 miles outside of Johannesburg, head slightly bowed. His skin is pockmarked and his fingers are blistered from several years of smoking cannabis, or dagga as it is known locally, and drinking home-brewed beer. He speaks of how drugs are ruining the generation below his. "They will use violence, rape, and rob to get their hit. If necessary they'll even kill. Some young men will become rent boys [gay escorts] or even turn to prostitution to feed their addiction."

In the United Nations' annual global drug report, released at the end of June, South Africa was ranked fifth in a list of countries by the highest number of seizures of cannabis. The report also warned that the country is witnessing the emergence of new synthetic designer drugs and "legal highs" made from psychoactive substances such as mephedrone that could pose a huge health risk.

For Bulelani though, who has been clean for nearly three years now, there are designer drugs already being peddled on the streets of townships -- such as tik, a cheap methamphetamine -- that "are being largely ignored by those in power." As a result, young people are finding themselves caught in a vicious circle of poverty: a lack of education and unemployment at a rate of around 57 percent combined with an alarming crime rate (according to the South African Police Services, 60 percent of all crimes are caused by drugs) and the 15,000 murders that occur each year.

The one drug that seems to be causing most concern is a deadly cocktail nicknamed nyaope or whoonga, said to be a mixture of third grade heroin, rat poison, cleaning detergents, and sometimes HIV antiretroviral medication [ARVs] -- " crack with a sickening twist ," the British broadcaster Channel 4. It's sold as bags of white powder and is usually added to dagga and smoked as a joint.

It first emerged in late 2006 to early 2007, but has come to wider attention within the last year or so partly due to increased international media coverage, with some stories claiming it to be an austerity drug similar to krokodil in Russia and sisa in Greece. Bulelani dismisses this claim. "This is not an austerity drug. Nyaope is part of everyday culture in the townships. We're not in austerity, we're in poverty."

Even though the base of the cocktail is typically 10-70 percent heroin, which is illegal in South Africa, nyaope itself isn't. "It may sound like a volatile concoction, but it's not always known whether heroin is in a [nyaope] joint, or what is at all, and it's [therefore] harder to control. You can arrest someone on the assumption that they might be taking heroin, but you can't prosecute someone for a concoction of legal substances," says Johanna Sehgume, a nurse and drug consultant in Duduza.

The South African government announced back in February that they would seek to classify nyaope as illegal by ratifying an amendment to the Drugs and Drug Trafficking Act 140 of 1992. As of yet, there has been no change to the law. With every passing day comes more anxiety from township communities who are witnessing lives being destroyed.

"The sooner it's made illegal, the better. Having a prosecution process in place means that it will be easier for addicts to seek treatment, as they can be referred to us by the police," stresses Sehgume. She is aware of the enormous stigma that comes attached with treatment, and even then unemployment and a subsequent lack of money make rehabilitation services hard to access. "Treatment is confidential. An addict seeking help has to put his trust on the line and that trust can easily be broken," she says.

A recent visit to a drug clinic by Jacob Zuma was heavily criticized by those who claimed he was just attempting to score political points, despite his party calming the situation by saying the trip was designed to help de-stigmatize users.

With bags of nyaope being sold for as little as 30-40 rand ($3-4), users get high within a few minutes of taking it; it's cheap and effective. When they experience stomach cramps they will simply smoke more to relieve the pain; the addition of ARVs is said to be whatgives them hallucogenic highs.

There have been also been reports over the last few years of health clinics being raided for these pills and HIV patients selling their AIDS drugs in order to earn money. Such cases are sporadic, and Sehgume errs on the side of caution, suggesting that speculation may only make the situation worse. "Rumours can create a situation where users fear there is little supply [of ARVs] because clinics are being raided and are running out; and because there's so much demand, they may resort to extreme measures to get their hands on the medication" she says.

Occasionally, addicts may turn to harder substances to lace their nyaope with in order to get a better kick.

"The government needs to act fast on pushing through the changes to the law" says Bulelani. "Nyaope is a killer. In my eyes, the situation is worse than the current unemployment, HIV and AIDS crisis put together".