Scheibe, And ew; Shelly, Shaun; S owe, M. J.
A icle
Insigh s in o he alue o he ma ke o cocaine, he oin
and me hamphe amine in Sou h A ica
Jou nal o Illici Economies and De elopmen (JIED)
P o ided in Coope a ion wi h:
LSE P ess, London School o Economics and Poli ical Science (LSE)
Sugges ed Ci a ion: Scheibe, And ew; Shelly, Shaun; S owe, M. J. (2024) : Insigh s in o he alue o he
ma ke o cocaine, he oin and me hamphe amine in Sou h A ica, Jou nal o Illici Economies and
De elopmen (JIED), ISSN 2516-7227, LSE P ess, London, Vol. 5, Iss. 3, pp. 1-17,
h ps://doi.o g/10.31389/jied.156
This Ve sion is a ailable a :
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RESEARCH
CORRESPONDING AUTHOR:
And ew Scheibe
Uni e si y o P e o ia, ZA
[email p o ec ed]
KEYWORDS:
D ug ma ke ; illici ma ke s;
alua ion; Sou h A ica
TO CITE THIS ARTICLE:
Scheibe, A, Shelly, S and
S owe, MJ. 2024. Insigh s
in o he Value o he Ma ke
o Cocaine, He oin and
Me hamphe amine in Sou h
A ica. Jou nal o Illici
Economies and De elopmen ,
5(3): pp. 1–17. DOI: h ps://doi.
o g/10.31389/jied.156
Insigh s in o he Value o he
Ma ke o Cocaine, He oin
and Me hamphe amine in
Sou h A ica
ANDREW SCHEIBE
SHAUN SHELLY
M. J. STOWE
ABSTRACT
The illici d ug ade gene a es billions o dolla s and sus ains ansna ional c iminal
o ganisa ions. D ug ma ke s can des abilise go e nance and unde mine de elopmen .
Da a indica e inc easing d ug use in Sou h A ica. Howe e , in o ma ion on he size
and alue o he d ug ma ke is limi ed. This is he i s s udy o es ima e he ma ke
alue o cocaine, he oin and me hamphe amine in Sou h A ica. People who use
d ugs we e meaning ully in ol ed in all aspec s o implemen a ion. We used ocus
g oup discussions, e hnog aphic mapping, b ie in e iews, and he Delphi me hod
o es ima e he numbe o use s, olumes consumed, and p ice o each d ug in
Sou h A ica in 2020. Na ionally, we es ima ed he e o be: 400,000 people who use
he oin (p obabili y ange (PR) 215,000–425,000) consuming 146.00 onnes (PR 78.48–
155.13) wi h a alue o US$1,898.00 million (PR US$1,020.18–US$2,016.63); 350,000
people who use cocaine (PR 250,000–475,000) consuming 18.77 onnes (PR 13.41–
25.47) wi h a ma ke alue o US$1,219.86 million (PR 871.33–1,655.52) and 290,000
people who use me hamphe amine (PR 225,000–365,000) consuming 60.19 onnes
(PR 6.58–10.68) and a ma ke alue o US$782.51 million (PR 607.12–984.88). The
combined alue was calcula ed a US$3.5 billion. Findings can be used o s imula e
engagemen o e o m d ug policy and app oaches o mi iga e he impac o he illici
d ug ade. Addi ional s udies ha include people who use d ugs in esea ch design
and implemen a ion a e needed o imp o e ou unde s anding o d ug ma ke s.
*Au ho a ilia ions can be ound in he back ma e o his a icle
2Scheibe e al.
Jou nal o Illici
Economies and
De elopmen
DOI: 10.31389/jied.156
INTRODUCTION
GLOBAL CONTEXT
The illici d ug ma ke is big. In 2013 i was wo h $426–652 billion (May, 2017); app oxima ely
0.7% o global g oss domes ic p oduc (GDP) (S a is a 2022). O e he pas decade he e has
been ma ked g ow h in he size o he d ug ma ke a ound he wo ld (Uni ed Na ion O ice on
D ugs and C ime 2021). P ohibi ionis app oaches ha e had li le o no meaning ul impac on
d ug supply o demand (The Global Commission on D ug Policy 2021). Despi e expendi u e o
$100 billion a yea in an a emp o e adica e he ade, only 1% o launde ed d ug money is
eco e ed by he au ho i ies (The Global Commission on D ug Policy 2021). Be ween 2015 and
2019, seizu e o opioids and amphe amine ype s imulan s (ATS) inc eased mo e han wo- old,
wi h less ma ked inc eases in cocaine seizu es (UNODC 2021). In compa ison, global p oduc ion
o opium and cocaine oughly doubled o e he pas wo decades and supply has emained
ela i ely s able (UNODC 2021). Pa adoxically, e o s o con ol d ug supply ( h ough seizu es
and d ug- ela ed a es s) may inc ease p o i abili y h ough educed compe i ion and inc eased
demand (Boucha d 2007). Flexible and changing anspo a ion solu ions a e employed by
ac o s in ol ed in he illici d ug ade o mi iga e he po en ial e ec s ha geopoli ical e en s
and law en o cemen may ha e on business (UNODC 2015; Eligh 2020, 2021).
Globally, in 2019 an es ima ed 62 million people used opioids o non-medical pu poses, 27
million people used ATS and 20 million people used cocaine (UNODC 2021). Wo ldwide, he
p opo ion o people who used a d ug in he pas yea (±5%), and he p opo ion o people who
used d ugs who had a d ug use diso de (± 13%) has emained ela i ely cons an o e he pas
10 yea s (UNODC 2021). In 2019, he annual p e alence o cannabis use among people in A ica
was 6.4%, and s ood a 1.2% o opioids, 0.3% o cocaine, and 0.4% o ATS (UNODC, 2021).
Due o A ica’s young, g owing popula ion and apid u banisa ion he p opo ion o people who
use d ugs is expec ed o inc ease by 40% by 2030 (UNODC 2021).
DRUG MARKET VALUATION
The alua ion o d ug ma ke s equi es da a on olumes and p ice. Howe e , he c iminalised
na u e o d ug use and he d ug ma ke complica es alua ion. Fo example, he olume o
d ugs aded is some imes calcula ed by ex apola ing police seizu e da a (We b e al. 2013).
Howe e , po ous bo de s, ou -da ed echnology and co up ion enable illici ade, wi h seizu e
da a e lec ing a small ac ion o ade olume (Haysom, Gas ow & Shaw 2018; Mache he &
Mo okeng 2022; S anya d 2022). Impo an ly, d ug seizu es a e in luenced by law en o cemen
capaci y, coo dina ion, and poli ical will (Giommoni, Be lusconi & Aziani 2022), and do no
necessa ily e lec changes in d ug ade olumes.
Fu he mo e, es ima es o he numbe o people who use d ugs a e la gely lacking o inaccu a e
(UNODC 2021). Many exis ing es ima es a e aken om household su eys. Howe e , sub-
popula ions o people wi h highe p opo ions o d ug use (e.g., hose expe iencing homelessness
and people in p ison) a e o en excluded om hese s udies, con ibu ing o an unde es ima ion
o he numbe o people who use d ugs (Johnson 2014). Mo eo e , unde epo ing o d ug use
in household su eys is common due o ea o a es , s igma, and poo ques ionnai e design
(Johnson 2014; Global HIV S a egic In o ma ion Wo king G oup e al. 2017). Heal h se ice
da a can p o ide insigh s in o ends, bu i is limi ed o hose who access ea men (UNODC
2021). D ug- ela ed a es da a is also o limi ed alue o assis ou unde s anding o d ug
demand. Incen i es o a es , he di e en ial likelihood o de en ion based on demog aphic
and socioeconomic cha ac e is ics, and poli ical and legal ac o s in luence policing p ac ices,
esul ing in biased es ima es (Lukas Mun ingh 2013; Mooney e al. 2018; Scheibe e al. 2016).
Simila ly, i is di icul o assess he amoun o d ugs consumed. Es ima es may be based on
da a collec ed h ough he app oaches no ed abo e; howe e , he da a would likely be a ec ed
by he same biases a ec ing o he a iables.
D ug ma ke alua ion es ima es a e mo e easily based on consume p ice, as wholesale p ices
a e a ely known (Eu opean Moni o ing Cen e o D ugs and D ug Addic ion 2019). Howe e ,
consume p ices may luc ua e and a e in luenced by pu i y and he addi ion o bulking agen s
(Cole e al. 2011).
3Scheibe e al.
Jou nal o Illici
Economies and
De elopmen
DOI: 10.31389/jied.156
Specialised me hodologies can o e come he challenges no ed abo e. Fo example, esea ch
conduc ed in pa ne ship wi h people who use d ugs and us ed o ganisa ions using
ecommended me hods (e.g., esponden d i en sampling) can be used o ec ui people
who use d ugs and o ob ain eliable da a (Global HIV S a egic In o ma ion Wo king G oup
e al. 2017). No el analy ical echniques, such as sewage epidemiology, can be used o assess
d ug me aboli e le els in was ewa e o p o ide empi ical insigh s in o he olume o d ugs
consumed (Huize e al. 2021).
THE SOUTH AFRICAN CONTEXT
Eme ging da a poin o a la ge, and g owing d ug ma ke in Sou h A ica (Eligh 2020). Inc easing
lows o he oin,1 cocaine, and me hamphe amine ha e been documen ed o e he pas 20
yea s (Haysom 2019). In 2005, 0.2% and 0.5% o men (aged ≥ 20 yea s) who pa icipa ed
in a na ional household su ey epo ed opioid and cocaine use in he pas h ee mon hs,
espec i ely (Pel ze e al. 2010). P og amma ic da a shows ha he p opo ion o people
admi ed o d ug ea men cen es o opioid dependence inc eased om 16% in 2012 o 20%
in 2017 (Ha ke e al. 2020). A 2017 household su ey ound ha 0.3% o pa icipan s (aged ≥
15 yea s) epo ed opioid, cocaine, and amphe amine use in he h ee mon hs p eceding he
s udy (Pel ze & Phaswana-Ma uya 2018). D ug ma ke esea ch e lec s a ne dec ease in he
p ice o he oin, cocaine, and me hamphe amine be ween 2004 and 2014 (Howell e al. 2015).
In ligh o he inc eased olume o d ugs lowing h ough he coun y, and inc easing use, i is
p obable ha he illici d ug economy is o signi ican size and alue. Howe e , o ou knowledge
he e is no published da a on he alue o Sou h A ica’s d ug ma ke . This s udy aimed o
es ima e he e ail ma ke alue o cocaine, he oin, and me hamphe amine in Sou h A ica
om a demand side, wi h meaning ul engagemen and pa icipa ion o people who use d ugs.
METHODS
The s udy employed ocus g oup discussions (FGDs), e hnog aphic mapping, b ie in e iews,
and he Delphi me hod o ga he inpu s o es ima e he e ail d ug ma ke alue in Sou h A ica
in 2020.
SETTING
Sou h A ica has nine p o inces and is comp ised o 52 dis ic s. Dis ic s a e u he di ided in o
elec o al wa ds. Fieldwo k was conduc ed in nine Sou h A ican ci ies ac oss se en p o inces:
Bloem on ein (Mangaung Dis ic , F ee S a e P o ince); Cape Town (Ci y o Cape Town Dis ic ,
Wes e n Cape); Du ban (eThekwini Dis ic , KwaZulu-Na al P o ince); Johannesbu g (Ci y o
Johannesbu g Dis ic , Gau eng P o ince); Mbombela (Ehlanzeni Dis ic , Mpumalanga Dis ic );
Pie e ma i zbu g (uMgungundlo u Dis ic , KwaZulu-Na al); P e o ia (Tshwane Dis ic , Gau eng
P o ince); Polokwane (Cap ico n Dis ic , Limpopo P o ince); and Po Elizabe h (Nelson Mandela
Bay Dis ic , Eas e n Cape P o ince). The mos populous ci y in each selec ed p o ince was
selec ed o implemen a ion. No ci ies we e included om he No h Wes and No he n Cape
P o inces, which do no ha e me opoli an municipali ies and a e he hi d leas and leas
populous p o inces. An addi ional ci y was included in Gau eng and KwaZulu Na al, P o inces
which a e he mos populous p o inces (S a is ics Sou h A ica 2011). B ie in e iews wi h
people who use d ugs we e conduc ed a ho spo s (loca ions whe e people who use d ugs
cong ega e o a e accessible) in selec ed wa ds in each ci y/dis ic .
PROCEDURES
Ac i i ies ook place be ween May and No embe 2020. The planning, coo dina ion, and
implemen a ion was led by he Sou h A ican Ne wo k o People Who Use D ugs (SANPUD) and
esea che s a ilia ed o he Uni e si y o P e o ia’s Communi y O ien ed P ima y Ca e Resea ch
Uni . People who use d ugs acili a ed FGDs and e hnog aphic mapping ac i i ies, conduc ed
in e iews, alida ed he esul s, and pa icipa ed in popula ion size es ima ion wo kshops.
1 Known locally as nyaope, whoonga, unga, suga s, pinch.
4Scheibe e al.
Jou nal o Illici
Economies and
De elopmen
DOI: 10.31389/jied.156
B oadly, he p ocedu es in ol ed: (1) p ima y da a collec ion (FGDs, mapping and b ie
in e iews wi h people who use d ugs) and alida ion sessions; (2) popula ion size es ima ion
using he Delphi Me hod (p o incial and na ional wo kshops) and (3) ma ke alua ion.
1. P ima y da a collec ion
Na ional and local s akeholde s we e in o med o he p ojec . In he ci ies whe e ieldwo k ook
place, engagemen s ocused on ne wo ks o people who use d ugs and o ganisa ions p o iding
heal h and ha m- educ ion se ices o people who use d ugs, men who ha e sex wi h men,
ansgende people, and sex wo ke s (key popula ions). Engagemen ac i i ies sough o ob ain
suppo o he s udy. Engagemen wi h o he s akeholde s (e.g., d ug, heal h, social and law
en o cemen se ice p o ide s) was ad ised by people who use d ugs who we e om he
espec i e ci y.
P ima y da a collec ion and alida ion sessions we e held in each ci y. The ieldwo k
me hodology was an adap a ion o he P io i ies o Local AIDS Con ol E o s Toolki (PLACE)
me hodology (USAID, PEPFAR and Measu e E alua ion 2019) and apid mapping me hodologies
used wi h people who injec d ugs (Scheibe e al. 2017) and sex wo ke s (Kons an e al. 2015)
in Sou h A ica. Table 1 p o ides de ails o p ima y da a collec ion and alida ion ac i i ies.
People who we e 18 yea s and olde who sel - epo ed o ha e used cocaine, he oin, and/o
me hamphe amine in he pas 12 mon hs we e eligible o pa icipa e. Fieldwo k was done
sequen ially o e 3–5 days in each ci y. Fieldwo ke s, iden i ied du ing FGDs, unde wen a hal -
day aining on he s udy, co e ing: conduc ing b ie in e iews wi h hei pee s using s anda d
ools; da a quali y; e hical conside a ions; sa e y and COVID-19 mi iga ion s a egies. A o al
o 111 people ecei ed aining, o whom 96% (n = 107) we e people who use d ugs. Ac i i ies
we e pilo ed in each ci y be o e implemen a ion.
A he end o he ieldwo k in each ci y, s uc u ed alida ion sessions we e held o each
ag eemen on (1) he cos o each d ug (pe g am); (2) a e age amoun (a ange, in g ams)
o each d ug used in a 24-hou pe iod; (3) p opo ion o daily and in equen (mon hly) use s
o each d ug, and (4) popula ion size es ima es ( o each d ug and o people who injec ) o
he ci y.
2. Popula ion size es ima ion o people who use d ugs
This p ocess in ol ed a bo om up-app oach, building on he ci y-le el es ima es om he
ieldwo k o de elop dis ic , hen p o incial and inally na ional popula ion es ima es.
Table 1 P ima y da a
collec ion ac i i ies in each
ci y.
FGDs and mapping Be ween 6 and 12 people, pu posi ely sampled o di e si y ( ep esen ing men, women, sex wo ke s, men who ha e sex
wi h men, and ansgende people who use d ugs), pa icipa ed in a FGD a he s a o ieldwo k. The FGDs ollowed a
s uc u ed guide ha explo ed d ug usage (me hods, equency, olume) and d ug ma ke cha ac e is ics (numbe o
use s, ho spo s, and d ug uni cos ). The mapping componen included he use o s icke s o plo d ug use ho spo s on
ci y maps. FGDs we e held in p i a e sa e spaces and we e co- acili a ed by he esea ch coo dina o and a pe son wi h
li ed expe ience o d ug use om ha ci y. In o ma ion was cap u ed using a FGD guide and w i en no es. The FGDs
each ook be ween wo and h ee hou s. The in o med consen and FGD guide we e in English wi h ansla ions p o ided
by he co- acili a o .
B ie in e iews B ie in e iews we e conduc ed wi h people who use d ugs in loca ions whe e people who use d ugs cong ega e o
we e accessible (ho spo s) ac oss di e se a eas in each ci y. Feedback om he FGDs and mapping we e used o iden i y
loca ions o conduc in e iews and o ieldwo k planning. Based on a ailable ime and esou ces, as many in e iews
and loca ion isi s we e done in each ci y as possible. Teams con ened a he beginning and end o each day o plan
and e lec on he ieldwo k. Wo king in pai s, he ieldwo ke s conduc ed up o 20 b ie in e iews pe day (las ing
app oxima ely 10–15 minu es each). The in o med consen and ques ions we e in English wi h ansla ions p o ided
by ieldwo ke s. B ie in e iew o ms ga he ed in o ma ion on: obse a ions (numbe o people a each loca ion
isi ed: <10; 10–30; 31–50; >50); in e iewee cha ac e is ics (gende , d ug mos commonly used [he oin, cocaine,
me hamphe amine] and pee ne wo k size [ o each d ug]); numbe o people who use d ugs isi ing ha loca ion a he
busies ime (a ange); ela i e p opo ion o ypes o d ug used and injec ing among people isi ing ha loca ion (none;
e y ew/<10%; ew/10–25%; unde hal /25–50%; o e hal /50–75%; mos /75–100%); he numbe o people who used
he oin, cocaine, and me hamphe amine, and people who injec d ugs in he neighbou hood/wa d.
Valida ion sessions wi h
people who use d ugs
Sessions ook place a he end o he ieldwo k in each ci y. FGD pa icipan s we e in i ed, as well as up o i e people
who use d ugs who had insigh s in o d ug use in ha ci y (Kons an e al. 2015). The esea ch coo dina o led he
sessions, which we e s uc u ed and s anda dised. Cla i y a ound con lic ing o missing in o ma ion was ob ained. The
esea ch coo dina o acili a ed a discussion o alida e he esul s and each ag eemen on es ima es. Da a on he
mos commonly pu chased o m o each d ug, and pe cei ed weigh o uni s o pu chase, was ob ained in each ci y.
Conside ing he loca ions ha we e isi ed, he indings we e ex apola ed o he whole ci y. The esea ch coo dina o
acili a ed hese sessions in English, which each ook 2 o 3 hou s.
5Scheibe e al.
Jou nal o Illici
Economies and
De elopmen
DOI: 10.31389/jied.156
P o incial wo kshops: Fieldwo k eam membe s, ep esen a i es o people who use d ugs
ne wo ks and local s akeholde s (including heal h se ice p o ide s) pa icipa ed in i ual
p o incial es ima ion wo kshops. Se en wo kshops we e held. Pa icipan s in e oga ed he
ci y-le el es ima es om he alida ion sessions in ligh o p og amma ic and esea ch da a
and hei expe ience. The g oup eached consensus on dis ic -le el es ima es and uppe and
lowe plausibili y bounds using he Delphi Me hod (Jo m 2015). This me hod employs ou
ounds o acili a ed engagemen among expe s o each consensus on es ima es. Delphi was
done i ually using an online o ing applica ion (h ps://pingo.coac um.de/ 2022 – coac um
GmbH). Es ima es we e gene a ed o he numbe o people who use cocaine, he oin, and
me hamphe amine, and he numbe who injec d ugs in he espec i e ieldwo k dis ic
( e e ence dis ic ). The dis ic -le el es ima es we e hen used o gene a e p opo ions o
people in ha dis ic (aged 15–64) who use each d ug and hose who injec d ugs using he
mos ecen (2011) census da a (S a is ics Sou h A ica 2011).
P o incial wo kshop pa icipan s o de ed he dis ic s in hei p o ince om he dis ic wi h he
la ges popula ion o people who use d ugs o he smalles . The popula ion o people who use
d ugs was based on he p o ince’s mos commonly used d ug. Ag eemen was eached on he
ela i e size o each dis ic in ela ion o he e e ence dis ic in ha p o ince. The ele an
size was calcula ed as an adjus men p opo ion. Adjus men p opo ions we e hen applied
o he gene al popula ion es ima e (15–64 yea s) o he dis ic s ha we e no isi ed in ha
p o ince. The same adjus men ac o was applied ac oss each d ug ype. This p ocess esul ed
in dis ic -le el es ima es o each d ug and o people who injec d ugs in he p o ince. All o
he dis ic es ima es we e summed o gene a e ini ial na ional popula ion es ima es (poin
es ima es and lowe and uppe plausibili y bounds).
Na ional wo kshops: The esea ch eam con ened a i ual na ional size es ima ion wo kshop
o e wo sessions held a week apa . Pa icipan s included people who use d ugs, key popula ion
ep esen a i es, de elopmen pa ne s, esea che s, heal h wo ke s, social wo ke s, go e nmen
ep esen a i es, and ci il socie y se ice p o ide s. The i s session was used o e iew he
p ocess and pa icipan s in e oga ed he indings o he ieldwo k and he ini ial na ional
popula ion es ima es (i.e., he sum o he dis ic -le el es ima es) in ela ion o o he na ional-
le el esea ch (Se swe e al. 2015; UCSF, Ano a Heal h Ins i u e and WHRI, 2015; Uni e si y
o Cali o nia San F ancisco, Ano a Heal h Ins i u e and Na ional Ins i u e o Communicable
Diseases 2018) and p og amma ic da a (MRC 2020). Du ing he second wo kshop, he p ocess,
ieldwo k indings, and o he a ailable da a we e ecapped and he Delphi me hod was used o
ob ain e ised na ional popula ion es ima es.
3. Re ail d ug ma ke alua ion
The e ail ma ke alue was calcula ed by mul iplying o al annual consump ion by p ice
(Eu opean Moni o ing Cen e o D ugs and D ug Addic ion 2019). Annual consump ion was
calcula ed sepa a ely o he popula ion o people who used d ugs daily and hose who used
d ugs in equen ly (assumed o be once a mon h). These alues we e added o es ima e o al
annual consump ion. Figu e 1 p o ides he o mula used and da a inpu s.
DATA MANAGEMENT AND ANALYSIS
P ocedu es, ools, and aining we e s anda dised. T ained s a luen in local languages who
had li ed/li ing expe ience o d ug use conduc ed he ac i i ies. Fieldwo ke s and he esea ch
coo dina o comple ed e iews o o ms o comple eness. Pape o ms and w i en no es we e
concealed while in he ield and secu ely s o ed. Nei he pe sonal no de ailed loca ion da a
was cap u ed. Da a was consolida ed in o a single Excel da abase, expo ed in o S a a 14
(S a aCo p, College S a ion, Texas) o analysis. Summa y s a is ics we e gene a ed o desc ibe
ieldwo k pa icipan s and quan i a i e indica o s. The ma ke alue was calcula ed using he
o mula ou lined abo e.
ETHICAL CONSIDERATIONS
E hical app o al was ecei ed om he Uni e si y o P e o ia’s Facul y o Heal h Sciences
Resea ch E hics Commi ee ( e . 371/2020). Ve bal in o med consen was ob ained. Pa icipan s
we e eimbu sed o hei pa icipa ion ($16 o a FGD and $6 o a b ie in e iew).
6Scheibe e al.
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Economies and
De elopmen
DOI: 10.31389/jied.156
FINDINGS
FIELDWORK
A o al o 135 pa icipan s ook pa in FGDs; 53% (n = 72) we e men, 24% (n = 32) wo ked
in he sex indus y, and 8% (n = 11) we e men who had sex wi h men. He oin, cocaine
and/o me hamphe amine we e used by 62% (n = 84), 59% (n = 79) and 24% (n = 33) o
FGD pa icipan s, espec i ely. O e all, 897 people who use d ugs (603 men, 280 women,
and 14 ansgende people) pa icipa ed in b ie in e iews ac oss 479 loca ions in 130
wa ds. O e hal he in e iewees a ho spo s mos ly used he oin (59%, n = 533), ollowed
by me hamphe amine (22%, n = 197), c ack cocaine (15%, n = 133), and powde cocaine
(5%, n = 46). People who used he oin had he la ges pee ne wo k (median o 40 people),
and people who used me hamphe amine had he smalles (median o 20 people). A o al o
144 people who use d ugs pa icipa ed in alida ion wo kshops. A alida ion wo kshop was
no comple ed in Pie e ma i zbu g due o logis ical complica ions. Table 2 ou lines ieldwo k
pa icipan cha ac e is ics.
FGD pa icipan s epo ed ha he oin, c ack, and powde cocaine and me hamphe amine we e
a ailable and used in all he ci ies whe e ieldwo k was conduc ed. They sugges ed ha mos
people who use he oin concu en ly used s imulan s, ei he me hamphe amine (in Cape Town
and Po Elizabe h) o c ack cocaine in he o he ci ies. FGD pa icipan s belie ed ha mo e
han hal he people who use he oin injec i , while c ack cocaine and me hamphe amine a e
mos ly smoked, and powde cocaine sno ed. Injec ing me hamphe amine was epo ed o
be mo e common when mixed wi h he oin. Howe e , some people we e epo ed o injec
me hamphe amine on i s own.
Ac oss he ci ies, an a e age o 10–30 people we e obse ed a each ho spo whe e b ie
in e iews we e conduc ed. Gene ally speaking, in e iewees epo ed ha be ween 25 and
60 people cong ega ed a hese loca ions a hei busies imes. He oin was epo ed o be
used by almos all people a he ho spo s, excep in Cape Town, whe e me hamphe amine
was he mos widely used d ug. Mo e han 75% o people a he ho spo loca ions isi ed in
Johannesbu g we e epo ed o use c ack cocaine. Injec ing was epo ed ac oss he ho spo s
in all isi ed ci ies excep o Bloem on ein, al hough injec ing p ac ices we e con i med in he
alida ion session in ha ci y.
Figu e 1 Fo mula and da a
inpu s o calcula e he e ail
d ug ma ke alue (Eu opean
Moni o ing Cen e o D ugs
and D ug Addic ion, 2019).
7Scheibe e al.
Jou nal o Illici
Economies and
De elopmen
DOI: 10.31389/jied.156
RETAIL MARKET VALUATION
The alida ed es ima es o popula ion sizes, p opo ion o people wi h daily and in equen
use, amoun s used in a day and he cos o each d ug a ising om he ieldwo k a e p o ided
in Table 3. De ails o he ieldwo k dis ic s popula ion p opo ions a e in Supplemen a y Table
S1 and he adjus men ac o s and he popula ion size es ima es o all dis ic s and he
ini ial and e ised Delphi na ional popula ion size es ima es a e p o ided in Supplemen a y
Table S2.
Fo he oin, he dis ic popula ion size es ima es anged om 2,508 people in
Bloem on ein/Mangaung Dis ic o 95,000 in Johannesbu g/Ci y o Johannesbu g Dis ic .
Be ween 75 and 100% o people we e epo ed o use he oin daily ac oss he dis ic s. Amoun s
o he oin used by people who smoke/inhale i anged om 0.4 g a day in Po Elizabe h o
3.75 g a day in Cape Town (median ange 0.5 g–2.0 g). Among people who injec he oin, daily
amoun s we e epo ed o ange om 0.2 g in Po Elizabe h o 3 g in Po Elizabe h and P e o ia
(median ange 0.5 g–1.6 g). The cos o he oin pe g am anged om $8 in Cape Town o $16 in
Bloem on ein and Polokwane (median $10 pe g am).
Fo cocaine, he dis ic popula ion size es ima es anged om 900 in Bloem on ein/
Mangaung Dis ic o 92,500 in Johannesbu g/Ci y o Johannesbu g Dis ic . Be ween 75 and
100% o c ack cocaine use s we e epo ed o use i daily in all ci ies, apa om Bloem on ein
whe e 25–50% o c ack use s we e epo ed o use i daily. Daily powde cocaine use was
epo ed among 10–25% o people in six ci ies, wi h <10% daily use in Bloem on ein and no
da a ob ained o Polokwane o Mbombela. Amoun s o epo ed cocaine used a ied ac oss
ci ies. Fo c ack cocaine, his anged om 0.1 g in Cape Town, Po Elizabe h and Mbombela
o 0.8 g a day in Johannesbu g (median 0.15 g–0.7 g). Fo powde cocaine, amoun s
used pe day anged om 0.5 g in Cape Town, Du ban, and Bloem on ein o 5 g in Du ban
(median ange 0.5 g–2 g). The p ice o cocaine was $65 pe g am in all dis ic s apa om
Johannesbu g and Cape Town, whe e i was $78 and $81 pe g am, espec i ely (median $65
pe g am).
Fo me hamphe amine, he dis ic popula ion size es ima es anged om 646 in
Pie e ma i zbu g/uMgungundlo u Dis ic o 190,000 in Cape Town/Ci y o Cape Town Dis ic .
Daily me hamphe amine use was epo ed among 75–100% o me hamphe amine use s
in all dis ic s apa om Po Elizabe h, whe e daily use was epo ed o occu among 50–
75% o people who use me hamphe amine. Da a was no ob ained o he equency o
me hamphe amine use in Pie e ma i zbu g. Amoun s o me hamphe amine epo ed o be
used pe day anged om 0.2 g in Po Elizabe h o 2 g in Cape Town (median ange 0.25 g–1.25
g pe day). The cos o me hamphe amine anged om $5 pe g am in Cape Town o $13 pe
g am in se e al o he ci ies (median $13 g pe g am).
The na ional le el ma ke alue inpu s and esul s a e p esen ed in Table 4. Fo cocaine, 40%
o people we e assumed o use daily (a ounded down mid-poin o he p opo ion o people
epo ed o use c ack cocaine daily (75%) and hose ha used powde cocaine daily (10%)).
The median amoun used in a 24-hou pe iod (0.35 g ams) was based on c ack cocaine.
The median cos o a g am o cocaine was aken as $65. Fo he oin, all people included in
he popula ion size es ima e we e assumed o use 1 g o he oin a day a $10 pe g am. Fo
me hamphe amine, wo- hi ds o use s we e assumed o use daily. The median amoun used
in 24 hou s was assumed o be 0.75 g, a a cos o $13 pe g am.
The na ional popula ion size es ima e o he numbe o people who use he oin was 400,000
(p obabili y ange (PR) 215,000–425,000), consuming 146 onnes (PR 78.48–155.13) o
he oin a yea wi h an es ima ed o al annual ma ke alue o $1,460 million (PR 785–1
551). The popula ion es ima e o people who use cocaine was 350,000 (including 140,000
daily use s), consuming 18.77 onnes o cocaine wi h a ma ke alue o $1,220 million (PR
871–1 656). The numbe o people who use me hamphe amine was es ima ed a 290,000
(including 217,500 daily use s) consuming 60.19 onnes wi h a ma ke alue o $783 million
(PR 607–985).
Table 2 Fieldwo k pa icipan cha ac e is ics.
CT: Cape Town; DBN: Du ban; PMB; Pie e ma i zbu g; PE: Po Elizabe h; BLM: Bloem on ein; PTA: P e o ia; JHB: Johannesbu g; MBO: Mbombela; PLK: Polokwane * de ails o pa icipan s no a ailable.
CITY CT DBN PMB PE BLM PTA JHB MBO PLK TOTAL
FGD (n) 14 22 17 10 13 13 14 17 15 135
Gende
Men 7 12 11 5 3 8 8 7 11 72
Women 6 8 5 4 9 5 5 9 3 54
T ansgende 1 2 1 1 1 0 1 1 1 9
Sub-g oups
Sex wo ke s 1 6 6 6 2 1 4 6 0 32
Men who ha e sex wi h men 0 2 0 7 0 0 0 0 2 11
D ugs used*
He oin (smoke/inhale) 2 8 1 1 1 9 8 8 11 49
He oin (injec ) 6 4 2 2 1 5 4 4 7 35
Cocaine (c ack) 1 9 3 3 2 11 10 9 13 61
Cocaine (powde ) 1 4 4 4 2 1 2 0 0 18
Me hamphe amine 7 4 0 5 4 3 3 4 3 33
B ie in e iewees (n) 91 85 50 44 80 216 102 131 98 897
Gende
Men 68 47 29 35 58 161 67 67 71 603
Women 21 37 19 8 19 52 35 62 27 280
T ansgende 2 1 2 1 3 3 11 2 0 14
D ugs used*
He oin 11 37 36 32 4 208 82 81 74 554
Cocaine (c ack) 0 29 10 0 15 18 23 32 6 133
Cocaine (powde ) 2 9 4 4 23 1 4 1 0 46
Me hamphe amine 76 11 0 14 37 10 16 16 17 197
(Con d.)
15Scheibe e al.
Jou nal o Illici
Economies and
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DOI: 10.31389/jied.156
AUTHOR AFFILIATIONS
And ew Scheibe o cid.o g/0000-0002-3238-0699
Communi y O ien ed P ima y Ca e Resea ch Uni , Depa men o Family Medicine, Uni e si y o P e o ia,
Sou h A ica
Shaun Shelly o cid.o g/0000-0002-8199-876X
Communi y O ien ed P ima y Ca e Resea ch Uni , Depa men o Family Medicine, Uni e si y o P e o ia,
Sou h A ica
M. J. S owe o cid.o g/0000-0002-8640-6532
Communi y O ien ed P ima y Ca e Resea ch Uni , Depa men o Family Medicine, Uni e si y o P e o ia,
Sou h A ica
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TO CITE THIS ARTICLE:
Scheibe, A, Shelly, S and
S owe, MJ. 2024. Insigh s
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o Cocaine, He oin and
Me hamphe amine in Sou h
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5(3): pp. 1–17. DOI: h ps://doi.
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Submi ed: 05 May 2022
Accep ed: 12 May 2023
Published: 14 Feb ua y 2024
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