The stale odour of marijuana hangs thick in the air, discarded beer bottles are littered around the entrance to *Sam Maseko's room.
Inside the room the stench is overwhelming. It is dark, humid and cold. Scant light streams into the room through the small windows left open in the patched-up wall that is sloppily covered with a floral curtain. Miscellaneous parts of household appliances are clustered in a corner of the room.
On top of a makeshift table, there is a handful of finely crushed marijuana next to a broken blade on a stained piece of paper with faded childlike drawings. Dagga seeds and used matchsticks are scattered on the uncovered mattress and all over the partially carpeted floor. The patchily painted walls are dirty; residual smoke lingers in the air.
Sam (33) sits on the couch in the cluttered room. His light blue jeans are stained.
Disorientated, he slowly licks his blackened lips. He is skinny and looks at least 10 years older than his current age. He rubs his eyes with soiled hands.
"He can stay like this for days," says his mother, Audrey Maseko, waving her hands in frustration at him. "He just locks himself in his room and smokes this thing all day."
Sam is addicted to nyaope, a street drug consisting mainly of dagga and heroin. Though the exact content of the drug is not known, other substances such as rat poison, milk powder or antiretroviral drugs used for HIV treatment are reportedly added to the mixture to enhance the effect of the drug.
This is strongly disputed by the South African National Council on Alcoholism and Drug Dependence (Sanca), "as rat poison is toxic to humans".
Also known as "wunga", the drug first emerged in the 2000s in the Pretoria townships of Soshanguve, Mamelodi and Atteridgeville, according to the justice department.
It has since gained popularity around the country, particularly in townships.
Nyaope is a cheap drug. According to Maseko a small, capsule-size bag of white nyaope powder only costs about R50.
Operation Thiba NyaopeIn 2009 Maseko and other parents in Ivory Park whose children are addicted to nyaope formed Operation Thiba Nyaope [stop nyaope], a nongovernmental organisation that provides support to drug users and their families.
"We started this group because we were trying to find a way to save our children. But instead of helping us rehabilitate them, the government is threatening to send them to jail," she says.
Until recently nyaope was not classified as an illegal drug, making the prosecution of people arrested for selling or possession of the substance "legally impossible".
But earlier this year the Drugs and Drug Trafficking Act was amended to include a ban on substances that contain "other prohibited drugs like heroin and dagga, as they are illegal", a justice department statement reads.
People caught using nyaope can now be sentenced for up to 15 years. Those caught selling the concoction face up to 25 years in jail.
Withdrawal But Maseko and the other members of her organisation say sentencing nyaope users will do them more harm than good.
"Getting off nyaope is very dangerous. Addicts need to get the right treatment from ?the very first day they stop smoking."
Parents like Maseko believe that "if they [their children] are locked up for 15 years without getting the right treatment they will die in jail".
But Cathy Vos from Sanca says that, although withdrawal from the drug can cause excruciating pain, it is unlikely that someone could die from the symptoms, unless their immune system is already compromised by illness or infection.
"The withdrawal symptoms can present as severe abdominal cramps, diarrhoea or flu-like symptoms, which can last for four to six days after the patient has stopped using," says Vos.
Sanca believes that classifying nyaope as an illegal drug "will lead to the arrest and conviction of people dealing in nyaope, thus reducing the availability of nyaope on the streets".
"If they are arrested the court can sentence them to rehab; this is what we call divergence," says Vos.
Beatings and a clean stintBut getting arrested is the least of Sam's worries. His mother fears that he will die at the hands of the people he has been stealing from.
"Since he got into this thing my child started stealing from my neighbours, they would beat him up every other day. He's been in and out of prison, but nothing ever changes," says Maseko.
In an attempt to get away from the environment that has been fuelling his habit, Sam went to stay with relatives in Kimberley for a few months last year.
"When he came back [from Kimberley] he was clean. He was so handsome," Maseko says tears welling up in her eyes.
"There is no nyaope there so he couldn't smoke it for three months. But the sad thing is that he just fell back into this thing."
The one good thing that came out of the trip to Kimberley, she says, is that her son has secluded himself in his room.
"At least he doesn't wander around stealing from people anymore," says Maseko.
"But now he is making nyaope with whatever he can get his hands on. He is an electrician so he often does work for people and undercharges them just so that he can get this thing [nyaope]."
Having her son at home gives Maseko a fragile sense of relief: at least she knows where he is.
"I don't know what to do any more, he doesn't listen to me. I'm a single parent and he is a grown man."
Missing sonMonica Ndalwane lives just a block away from Maseko, also in Ivory Park. Her home is distinguished from those of most of her neighbours; it is big and elegant.
People in her community call it the "Nigerian house" because of its resemblance to mansions they see in Nollywood movies.
Ndalwane's children have everything they need, but this didn't stop her son from developing a nyaope addiction.
Unlike Maseko, Ndalwane doesn't know where her son is. She hasn't seen or heard from him for several days.
Just the week before a neighbour told Ndalwane that her son had broken into his home and that he has reported it the police.
"Later that day the police came to my ?house looking for him," she says, sniffing.
He didn't sleep at home that night, so the next day she went looking for him. "I found him just wandering the streets. So I put my arm over his shoulder and asked him where he sold the furniture he stole.
"He didn't give me any trouble. He just showed me where he sold it."
Operation Thiba Nyaope often recovers valuables stolen by nyaope addicts to protect them from being reported to the police.
Ndalwane and a member of their organisation recovered the stolen furniture from the people her son sold it to.
"I brought the furniture back home with me and called the police to come fetch it. I've made a statement with the police. Since then my child has run away from home. I don't know where he is; he is hiding from the police."
Nyaope in jailNdalwane says she doesn't know whether or not she will hand her son over to the police if he makes contact with her.
"I don't think it is right to sentence nyaope addicts to 15 years in jail, because even now, the users here get arrested and spend about six months in jail, and when they come back they are worse.
"Nyaope is available in jail. So what does that help, because even if they are no longer in the same environment, they are still smoking," says Ndalwane.
"When we started this organisation, I was really hopeful that we would be able to help our children – but we haven't," her voice breaks with emotion.
"Instead of getting better he has gotten worse. We've sent him to rehab, but when he gets out he goes back to the same friends he has been smoking with and picks up the habit again."
Vos says that rehabilitation "only works as a long-term intervention – recovery is a life journey".
RehabThe two main ingredients of the designer drug are why nyaope is so addictive.
"Dagga and heroin are dependency forming. It doesn't take a long time from when a person first uses heroin for them to become physically and emotionally dependant on the drug," Vos says.
The severe withdrawal symptoms are the result of the dependence and a reason why users smoke continually is to curb the cravings.
"The emotional addiction translates into severe mood swings and feelings of insecurity and insomnia," says Vos.
Treatment for nyaope addicts is symptomatic, so the patient will get drugs to relieve the cramps and diarrhoea, just like heroin addicts.
"Rehabilitation includes detoxing; patients are given medication for the withdrawal symptoms and vitamins, because while patients are on the high from the drug they don't eat. They can pick up between eight to 12kg in rehab. Therapy is also a part of the rehabilitation process, to help the patient understand why they keep using," she says.
Although the drug will not be detected in their urine after 14 days, Sanca warns that "addiction is a relapsing disease" and that users often have to go for several rehabilitation treatments to learn to cope without the drug, a process that varies from one person to the next.
Patients are taught life skills and have to change friends and their way of life in general. "The hardest part is understanding what the triggers are," says Vos.
Though Vos admits that there are not enough rehabilitation centres in South Africa to deal with the drug problem, she says people are also scared of seeking help because they fear being stigmatised or are unaware of the options available to them.
South Africa has 80 private drug rehabilitation centres, including those run by Sanca, and eight government facilities. Sanca's nyaope addicts go to centres allocated to dealing with heroin or dagga addiction.
Vos says: "Addiction is a treatable disease. So nyaope addicts can ?be successfully rehabilitated."
The parents who are part of Operation Thiba Nyaope say they want to be granted a licence to function as a rehabilitation organisation so that they can "save their children from themselves".
The organisation says the only way they can solve their community's problem is by helping their children to kick the habit themselves; all they need is for government to allocate land to them where ?they can provide a rehabilitation service.
The start"My spirit is broken. He is my only son and he has been doing this for years now," says Ndalwane, her voice quivering as she holds back the tears.
Ndalwane's son used to wake up every morning and go to school, but in 2003 when he was only 10 years old she heard rumours that he had stopped going to school. One day she decided to follow him to where he was going.
"When I got into the house he was hanging out at, there's this table in the middle of the room with weed on it. At that time I didn't know what nyaope is, but he was smoking it.
"The next morning I went to the school and met with his class teacher who told me that the last time she saw him at school was in January when the schools opened. That time it was around November. He was in Grade 5. The class teacher never bothered to tell me that she didn't see my child at school any more. They just kept quiet until I went to the school."
The tissue in Ndalwane's hands is soggy. Eleven years later, at the age of 21, her son is still addicted to nyaope.
"My life has never been the same since. I have high blood pressure and diabetes. Things at home are sour and his father blames it all on me.
"My husband blames our son's addiction on me. He says I am spoiling the child. But I don't know what I am supposed to do – abandon him? He's my child," her voice breaks as tears stream down her face.
As if speaking to herself, Ndalwane mutters: "I can't abandon him."
She shakes her head, now sobbing uncontrollably.
"I'm scared that people in the community will end up killing him. Breaking into people's houses and stealing from them is going to get him killed."
*Not his real name
Private hell: Nyaope addict Sam Maseko's room. He spends his time locked up in here, smoking the drug and fixing appliances to make money for his habit.
Nyaope is a drug that first emerged on the streets of townships around Pretoria in the early 2000s. Also known as "wunga", it is sold as a tiny parcel of white powder for about R50.
The drug is a concoction of mainly heroin mixed with other white powders, such as milk powder, to bulk it up. The powder is combined with marijuana and smoked.
Other substances such as antiretroviral (ARV) medications used to treat HIV are said to be added to the mixture to enhance the effect of the drug.
Reports of ARVs being added to nyaope started emerging in 2011 and 2012, with several doctors in Soweto reporting that their consultation rooms had been ransacked and HIV medication stolen.
Media reports cited HIV patients being robbed of their pills after collecting them from local clinics; others reported patients selling their ARVs to nyaope addicts or dealers.
When taken orally as prescribed, an ARV known as Efavirenz is associated with hallucinations, delusions and euphoria, according to the online HIV information service Aidsmap run by the United Kingdom-based charity NAM publications.
Peter Ucko, from South Africa's Central Drug Authority (CDA), says that the idea that smoking ARVs would increase nyaope's effect was most probably sparked by "rumours" and misconceptions.
Some nyaope addicts also stole LCD screen televisions because they believed there was a powder behind the screen that could also be added to the concoction.
"These are all criminal elements. There is no proof that smoking ARVs has any psychedelic effect," he says.
But after seeing a news report about the use of ARVs in nyaope, John Schetz, associate professor at the University of North Texas Health Science Center in the United States, conducted research into the effects of smoking Efavirenz.
His findings, published in the international scientific journal Neuropsychopharmacology, showed that Efavirenz had " [a] prevailing behavioural effect in rodents [that] is consistent with LSD-like activity".
No similar studies have been conducted on humans.
According to the South African National Council on Alcohol and Drug Dependence (Sanca), the main ingredients of nyaope – dagga and heroin – are dependency forming.
A person on nyaope becomes both physically and psychologically addicted to the drug.
When addicts do not smoke, they will get severe withdrawal symptoms such as muscle spasms, pain, stomach cramps and flu-like symptoms.
"The emotional addiction translates into severe mood swings and feelings of insecurity and insomnia," says Cathy Vos from Sanca.
Parents of nyaope addicts say that their children have reported insomnia, "seeing things in the middle of the night", severe mood swings and aggression.
Exact figures on the extent of the use of nyaope are not available but Ucko says that there is "anecdotal evidence that shows that nyaope use has increased over the years".
He says that a lot of the evidence about nyaope is collected from media reports and from what the CDA is told by various communities.
Though the name of the drug varies from place to place, Ucko says that the components of the mixture remain the same.
"It is possible that there may be a similar concoction in other countries under different names, but nyaope is a South African name product."
Ucko says the change in the names of the drugs is part of a ploy by drug dealers to make their product sound appealing.
The social development department's National Drug Master Plan 2013-2017 states the use of a "poly-drug is meant to enhance the effect of the specific drugs on the individual or, in certain cases, to disguise or conceal the use of a specific drug.
"In addition, it is common for drugs, especially combinations of drugs, to be given local or street names. In South Africa the street names and the combinations differ from province to province and region to region, and change from time to time."
Have something to say? Tweet or Facebook us on @Bhekisisa_MG
Drug 'nyaope' to be made illegal in South Africa
Life's precipice puts addiction into perspective
Interested in health and social justice reporting and willing to put in the hours to do it? This internship might be for you.
Traditional West African ‘healers’ and Sicilian psychiatrists are struggling to help free Nigerian women forced into prostitution.
Despite our complicated relationship with it, our poo could one day power our cell phones, tablets and laptops.
Bhekisisa means "to scrutinise" in Zulu
In South Africa, Zulu patients who would like to be thoroughly assessed by a doctor, would ask the physician to "bhekisisa" them.