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The Methaqualone Menace: A Deep Dive into Mandrax Use in South Africa

Updated: Jan 27

Mandrax in South Africa: Understanding Usage, Harms, and Urgent Interventions

This article delves into the significant concern of Mandrax (Methaqualone) use in South Africa, examining its nature, usage, and repercussions. It highlights Mandrax's prevalence in treatment centres, emphasizing region-specific trends, especially in the Western Cape. The piece underlines the alarming co-use of Mandrax with other substances and the need for nuanced, tailored interventions. Ongoing monitoring and research are presented as crucial in the battle against Mandrax abuse, providing valuable insights for policymakers. The conclusion stresses the importance of a comprehensive understanding and urgent interventions to address the Methaqualone menace in South Africa.



Methaqualone, colloquially known as Mandrax, has emerged as a significant concern in South Africa, posing both a public health challenge and a socio-economic threat. This article delves into the nature, usage, and repercussions of Mandrax, shedding light on its prevalence in treatment centres and the imperative need for targeted interventions.

Nature and Use of Mandrax

Mandrax, a sedative-hypnotic medication primarily available in tablet form, extends its influence beyond the medical realm. Individuals either consume these tablets orally or engage in the troubling practice of crushing them and mixing them with cannabis, giving rise to the notorious 'white pipe.' This combination, when smoked, unleashes a potent concoction that intensifies the impact of the substances.

Harm and Side Effects

Abusing Mandrax comes at a steep price, as evidenced by the myriad of harmful effects it can inflict. From slurred speech and convulsions to a reduced heart rate and numbness of extremities, the consequences are diverse and, in severe cases, fatal. Death through cardiac or respiratory arrest looms as a haunting possibility for those who succumb to the allure of Mandrax abuse.

Prevalence in Treatment Centres

While the primary use of Mandrax remains relatively low across treatment centres, its secondary presence paints a different picture, particularly in the Western Cape (WC). Analysis of data from January to June 2020 reveals that between 5% (KwaZulu-Natal - KZN) and 29% (WC) of individuals attending specialist treatment centres report cannabis/mandrax as their primary or secondary substance of use (SAMRC, SACENDU 2021).

Treatment and SACENDU Data

Data from specialist treatment centres indicate that individuals may report cannabis/mandrax as either their primary or secondary drug of use. The disparity between regions, with a more significant prevalence in the Western Cape, emphasizes the need for region-specific interventions and tailored strategies to address Mandrax-related challenges effectively.


While the primary use of cannabis/mandrax might be comparatively low, the alarming rate of co-use with other substances necessitates a nuanced approach. Tailored interventions focusing on the secondary use of Mandrax, especially in combination with cannabis, become paramount in the broader spectrum of substance abuse treatment and prevention efforts.

Trends and Monitoring

Ongoing monitoring and research emerge as critical components in the battle against Mandrax abuse. Understanding evolving trends, patterns of co-use with other substances, and associated harms requires a continuous commitment to research. The data gleaned from treatment centres provides valuable insights for policymakers and public health professionals, offering a foundation upon which targeted strategies can be built.


As South Africa grapples with the Methaqualone menace, a comprehensive understanding of Mandrax's nature, usage, and consequences is imperative. The data from treatment centres not only elucidates the current landscape but also serves as a compass guiding policymakers and public health professionals towards effective strategies. In the ongoing battle against Mandrax abuse, vigilance, tailored interventions, and a commitment to research stand as our strongest allies.

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