Johannesburg faces rising child substance use as under‑18 clients reach 44%

Officials warn of a shifting crisis in Alexandra and beyond

City health workers and community groups are raising alarms after the South African National Council on Alcoholism and Drug Dependence (Sanca) central rand alcohol and drug centre reported a marked rise in young clients in Johannesburg. As of the end of 2025, the centre says children under 13 now make up 10% of its clients, up from 2%, while those aged 14 to 17 account for 34% meaning 44% of clients are under 18.

Stakeholder briefing in Alexandra details trends

Terrence Makananisa, director of the Sanca central rand centre, outlined the figures at a stakeholder engagement event held at the organisation’s Alexandra offices on Tuesday. He said the data shows young people are being drawn into substance use earlier than before.

“That is not just a statistic. That is a crisis. It means the fight is no longer only about treatment, it is about prevention at the earliest stages of life. It is about what is happening in our homes, in our schools, and in our streets.”

Access, family breakdown and schools

Makananisa and others at the meeting attributed the problem largely to children’s easy access to drugs and dysfunctional families. A recovering addict, Peter Mmuse, who now works as a community patroller, told the gathering that the crisis in schools is made worse by parents who allow children to use substances, including alcohol.

Problem is growing and evolving

The centre reported that multi‑drug use has increased to 40%. Alcohol and cannabis remain the most commonly used substances and are often used together, the centre said, a pattern Makananisa said shows the problem is evolving as well as growing.

Some progress, but fragile

Makananisa noted there has been notable progress in the number of women now reporting for treatment, and that schools refer 26% of their clients to the centre. He warned, however, that those gains are fragile and that families and communities are struggling with gangsterism, drug peddling and breakdowns in family structures.

“If Johannesburg and Gauteng can get this right, we can become a blueprint for the rest of South Africa.”

Calls for coordinated action

At the Alexandra meeting, Sanca emphasised the need for coordinated, sustained and well‑resourced responses focused not only on treatment but on early prevention across homes, schools and streets.