Johannesburg is facing a deepening crisis of substance use among children, and the South African National Council on Alcoholism and Drug Dependence (Sanca) warns that people and organisations can no longer afford to treat national strategies as documents gathering dust.

Terrence Makananisa, director of Sanca Central Rand Alcohol and Drug Centre, said the time had come to fully implement and respect the Prevention of and Treatment for Substance Abuse Act 70 of 2008, not in theory, but in practice. He stressed that the National Drug Master Plan must become ‘a living, breathing strategy on the ground’. This comes amid rising substance use among young people under 18 years of age.

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Speaking at a recent stakeholder engagement event in Alexandra, Makananisa revealed alarming figures, noting that children under 13 now make up 10% of their clients, up from just 2%, while those aged 14 to 17 account for 34%. In total, minors represent 44% of their clients. “That is not just a statistic. That is a crisis,” he said.

He added that the fight was no longer only about treatment but about prevention at the earliest stages of life. Families, schools, and communities are struggling to contain the problem, with easy access to drugs and dysfunctional households fueling the crisis.

Makananisa warned that multi-drug use has risen to 40%, with alcohol and cannabis often consumed together. “The problem is not only growing, but it is evolving.” While there has been progress, more women are reporting for treatment, and schools now refer 26% of Sanca’s clients. Makananisa cautioned that these gains were fragile. “Behind these numbers lies a deeper reality: families are overwhelmed. Parents are struggling to contain their children. Communities are grappling with gangsterism, drug peddling, and the breakdown of family structures.”

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He called for strong, functional structures such as a provincial substance abuse forum and an active and resourced local drug action committee. “These cannot exist only in name. They require real backing; funding from both the province and the city, skilled personnel, and accountability. And most importantly, they must be connected to the lived realities of communities like Alexandra.”

Makananisa said Johannesburg and Gauteng have the potential to become a blueprint for the rest of South Africa if they could get implementation right. “We need capable and committed NGOs. We need schools, churches, and community institutions. And above all, we need the community itself. Without community participation, all strategies will fail.”

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