Tik addiction is rampant in the Western Cape, more than doubling within a year, and young lives are being destroyed, with 80 percent of users under 21. Treatment centres are expensive, relapses are common and we're in crisis.
Jeanne Obert, then, comes as a breath of hope with her Matrix model of treating addiction, which is cost-effective, out-patient based and has a high success rate.
Obert is executive director of the Matrix Institute on Addictions in the United States, and is a world expert on treating stimulant addiction, especially methamphetamine, or tik as it's commonly known.
And it's a worldwide problem, she says, especially in economically depressed countries.
Obert was in Cape Town to run a three-day training seminar on the Matrix system last week that drew people from the government and addiction centres across the country.
Sarah Fisher, of community development programme Smart, who convened the seminar, says there's a recognition at all levels that current treatment methods don't go far enough.
Obert is very clear that we need to use every tool we have and that Matrix is not in competition with other ways of doing things.
"You need to look at everything, the more tools the better. Different approaches work for different people."
Matrix was developed as a model for stimulant abuse in the 1980s, when cocaine addiction started becoming a problem and addiction centres started springing up.
In-patient treatment was a lucrative business - but within three months of treatment, many people were back to using again.
But cocaine was expensive, and tik became an alternative - it's cheap and makes you feel good.
In the US the tik epidemic started with the motorcycle gangs in Los Angeles, who made their money from manufacturing it.
The Matrix programme was asked to come in to help people. However, it was only in the 1990s, when methamphetamine hit big, that people started taking notice of it.
Matrix has now been proved to be a cost-effective, community based out-patient treatment programme.
"If patients stay in treatment for the recommended time (at least four months), 60 percent are drug-free at the end of the year," says Obert. For addiction treatment, that's a very good figure.
In-patient treatment, apart from being very costly, runs into problems once the person leaves the programme. "The important thing we discovered is that stages of recovery are different for stimulants like tik," says Obert.
People feel better quickly - there's no tissue dependence, and none of the classic withdrawal symptoms. After three drug-free weeks, people feel cured.
The brain becomes oversupplied with dopamine to make up for the neurotransmitter depletion.
"People are sure they'll never use again, and think they need no more treatment. But most relapses happen from day 45 to 120, after they've left treatment, and it's very difficult to go through. It's like having constant PMS (premenstrual syndrome) for three months," says Obert. "They get worse before they get better."
And if you don't know about the relapse period - referred to as the "The Wall", and don't have the skills, relapse is likely.
The Matrix programme explains the neuroscience behind stimulant addiction to patients - which is very different from the model that says you have a disease and are powerless.
Tik abuse is so devastating, explains Obert, because it affects the mid-brain, where the life-sustaining drives are sustained, such as drinking water when you're thirsty, sleeping when you're tired. It's not the conscious part of the brain, and is referred to as the addicted brain.
Obert explains: In an experiment, mice could press a bar to get doses of three different drugs: alcohol, heroin and stimulants. Those using alcohol and heroin would eventually creep to the back of the cage when tired or hungry. Those using stimulants never did - they literally starved to death. Once you use a stimulant such as tik a few times, the brain believes it needs it at that level, the craving process, and it's a powerful animal.
"Patients need to know this, they need that information. And they need to learn a set of skills - just not wanting to use again is not enough."
The Matrix programme is very structured: people come three times a week to an outpatient facility, and the goal is that each time they'll get new information.
"We work from a workbook and handouts, addressing important issues. And we do random urine testing."
If someone is found to be using, they're not kicked off the programme as with other treatment approaches. "You wouldn't kick someone off their diabetes programme because they hadn't stuck to their diet or taken their medication. That's crazy, we don't do it."
Matrix is a set of principles and guidelines that seems to work across the board, she says.
Central to the Matrix programme is motivational interviewing, developed for addictions but now used in all fields, which motivates rather than confronts and demands.
"It's respectful, and we work on an equal basis. This does well in Asian cultures, which have a culture of respectful interaction.
The programme, she believes, can work in South Africa.
"My hope is that politics won't get in the way of people getting the information they need."