What Is Mandrax? Effects, Risks and Getting Help in South Africa
Updated: Oct 5
Key Takeaways
Mandrax is the street name for methaqualone, a sedative drug that was withdrawn from medical use because it is highly addictive.
In South Africa it is most often crushed, mixed with cannabis and smoked as a "white pipe".
Street names include buttons, MX, mandies, ndanda and white pipe.
Heavy use can cause seizures, slowed breathing and, in overdose, death.
The Western Cape has the highest rate of mandrax use among people entering treatment.
Stopping after regular use can bring on withdrawal seizures, so medical support is strongly advised.
What is mandrax?
Mandrax is the South African name for methaqualone, a sedative-hypnotic drug that slows down the central nervous system. It was first made in 1951 and sold as a sleeping tablet under brand names including Quaalude and Mandrax, but it was removed from the market in 1984 because of its strong addiction-forming properties. Today it has no legitimate medical use and the pills sold on the street are made in illegal laboratories.
Methaqualone is listed under Schedule 2 of the 1971 UN Convention on Psychotropic Substances because of its high potential for dependence. Possessing or dealing in it is a criminal offence in South Africa.
Mandrax in South Africa
South Africa has one of the longest-running mandrax problems in the world. The drug became popular here in the 1960s and 1970s and never went away. Instead of importing finished pills, criminal networks now make mandrax locally, using chemical precursors that are largely sourced from India and China.
The latest national treatment data from the South African Medical Research Council shows how uneven the problem is across the country. According to the SACENDU Research Brief covering January to June 2025:
Nationally, around 3% of people entering specialist treatment named cannabis and mandrax as their main drug, rising to 7% when it is counted as a primary or secondary drug.
In the Western Cape, 6% named it as their main drug and 26% reported it as a secondary drug, down from 31% in 2024.
People entering treatment for cannabis and mandrax were, on average, 31 years old, compared with 22 for cannabis alone.
That last figure matters for families. Mandrax use is often not a phase that someone grows out of. Many people who seek help have been using it for years, often alongside other drugs such as methamphetamine (tik).
What does mandrax look like?
Mandrax is usually sold as a small tablet. The pills are often colourful and stamped with a logo, although they can also be white, grey or yellow, and may look freckled or crumbly. Because they come from illegal laboratories, there is no standard size, colour or strength, and two pills that look the same can contain very different amounts of the drug.
Signs you may find at home include:
small, crumbly tablets or pill fragments
a broken-off glass bottle neck, often blackened at one end (used to smoke a white pipe)
a strong, unusual chemical smell mixed with the smell of cannabis
small plastic bank bags or twists of paper
Street names for mandrax
Mandrax goes by several names depending on the area. Common ones include:
Buttons and MX (ISS Africa)
Mandies (Choose Life)
Ndanda, used in parts of Gauteng (Daily Maverick)
Lizards and flowers (ISS Africa)
White pipe or bottle neck, which refer to the way it is smoked
If you hear any of these words in conversation or see them in messages, it may be worth a calm, open conversation.
How is mandrax used?
Some people swallow the tablets, but in South Africa mandrax is far more often crushed, mixed with cannabis and smoked through a broken bottle neck. This is known as a white pipe. Smoking it sends the drug to the brain much faster than swallowing a pill, producing a strong rush of calm and detachment that lasts roughly one to two hours. The short high is one reason people smoke it again and again in a single session.
Effects of mandrax
Short-term effects
heavy relaxation, drowsiness and a sense of detachment
slurred speech and poor coordination
glazed or bloodshot eyes
slow reflexes
numbness in the hands and feet
Risks of heavy use and overdose
Methaqualone depresses the nervous system. Large doses can cause slowed breathing, muscle spasms, convulsions, coma and death. The risk rises sharply when mandrax is combined with alcohol or other sedatives, because the effects stack on top of each other.
Long-term effects
Regular use over months or years is linked to memory problems, difficulty making decisions, depression, anxiety, paranoia, and damage to the lungs, liver and kidneys. Many people also notice changes in hygiene, sleep, work and relationships well before the physical effects appear.
Signs someone may be using mandrax
If you are worried about a partner, child or friend, these are some of the signs families most often describe:
slurred speech, drowsiness or "nodding off" at odd times
glazed or bloodshot eyes
sudden mood swings, irritability or paranoia
losing interest in work, school or people they used to enjoy
money or possessions going missing
spending long periods with a new group of friends
neglecting their appearance and hygiene
None of these signs on its own proves someone is using drugs. Together, and over time, they are worth taking seriously. Our family resources page has practical guidance on how to start that conversation without it turning into an argument.
Mandrax withdrawal: why stopping should not be done alone
Regular mandrax use builds tolerance and physical dependence. When someone stops suddenly, they can experience anxiety, agitation, insomnia, tremors, headaches and, in severe cases, generalised convulsions.
Because withdrawal seizures are possible, stopping after heavy or long-term use is safest under medical supervision. At Pace Recovery Centre, substance withdrawal management is the first stage of care, so the body can adjust safely before therapy begins.
Treatment for mandrax addiction
Mandrax addiction affects the body, the mind and the people around the person using it, so treatment needs to address all three. At Pace Recovery Centre in Sabie, Mpumalanga, care for drug addiction can include:
Individual therapy to understand what drives the drug use
Group therapy for peer support and accountability
Family therapy to rebuild trust and set healthy boundaries at home
Aftercare and relapse prevention to support life after treatment
Programmes range from a 10-day Reset Programme to longer primary and secondary programmes. The right length depends on how long someone has been using and whether other drugs are involved.
Frequently asked questions
What is mandrax made of?
Mandrax is methaqualone, a sedative drug. Street pills are made in illegal laboratories, so they can also contain other substances, and their strength varies from pill to pill.
What is a white pipe?
A white pipe is crushed mandrax mixed with cannabis and smoked through a broken glass bottle neck. It is the most common way mandrax is used in South Africa.
Is mandrax addictive?
Yes. Methaqualone was withdrawn from medical use because it is highly addictive. Regular use leads to tolerance and physical dependence.
What does mandrax do to the body?
It slows down the nervous system, causing drowsiness, slurred speech and poor coordination. In large doses it can slow breathing, cause seizures and be fatal.
Can you stop using mandrax on your own?
Stopping suddenly after regular use can cause withdrawal symptoms, including seizures. Medically supervised withdrawal is the safer option.
Is mandrax illegal in South Africa?
Yes. Possessing, using or selling mandrax is a criminal offence in South Africa.
Getting help
If you are worried about your own mandrax use, or someone close to you, you do not have to work it out alone. Our team can talk you through the options and what the admissions process involves, with no pressure to decide straight away.
Call or WhatsApp us on 061 657 0948, or send us a message.
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