Professor Dr. G.Hussein Rassool
Professor of Islāmic Psychology, Centre for Islāmic Studies & Civilisations, Charles Sturt University, Australia. Former Professor of Addiction and Mental Health at the University of São Paulo, Brazil.
Senior Lecturer in Addictive Behaviours and Psychological Medicine, Department of Addictive Behaviors, St George’s Medical School, University of London (now City, University of London).
Member of the International Society of Substance Use Professionals (ISSUP).
Addiction today constitutes a complex phenomenon that extends far beyond the consumption of pharmacological substances. While alcohol, tobacco, and psychoactive substances—including opioids, amphetamines, synthetic drugs, and new psychoactive substances (NPS)—remain major concerns, there is growing recognition of behavioural addictions that significantly affect mental, emotional, and social well-being. The rapid expansion of digital technologies has contributed to compulsive behaviours such as internet addiction, excessive social media use, cybersex, pornography, gambling and gaming disorders, and dependence on online content. Eating disorders, often intensified by social pressures and unrealistic body image standards, are also increasingly recognised within this expanded addiction landscape.
Globally, addiction represents a major public health challenge due to its impact on individual health, social cohesion, and economic productivity. It is now widely understood as a chronic, relapsing condition shaped by biological vulnerability, psychological factors, social environments, and structural inequalities. Consequently, responses limited to criminalisation or isolated treatment approaches are insufficient. Effective responses require integrated, public health–driven strategies that combine prevention, education, mental health support, and accessible treatment and rehabilitation services.
This paper proposes a solution-oriented strategy for the prevention and management of both substance-related and behavioural addictions in Mauritius. It highlights national challenges and offers evidence-based recommendations grounded in public health policy, education, community engagement, and rehabilitation, while recognising the Government of Mauritius’ commitment to addressing addiction as a critical public health and social priority.
Context
The Non-Communicable Diseases Survey in Mauritius1 highlights concerning trends in tobacco and alcohol use, which carry major public health implications. Tobacco prevalence stands at 18.1%, with a pronounced gender gap (35.3% among men vs. 3.7% among women), while harmful alcohol consumption affects 15.4% of the population (26.3% of men vs. 4.5% of women). These behaviours, largely shaped by sociocultural norms, are key determinants of non-communicable diseases, including cardiovascular disorders, cancers, respiratory and liver conditions, accidents, and mental health disorders. They also place a significant burden on the national healthcare system, productivity, and family stability.
Additionally, the National Drug Observatory Report2 and UNODC3 data reveal a critical situation regarding illicit substances. Mauritius has one of the highest rates of heroin dependence in the region, with approximately 0.94% of the adult population affected, representing 12,000 to 14,000 regular users at high risk of HIV, hepatitis C, and other health complications. Cannabis is the most widely used substance, followed by synthetic cannabinoids, with Mauritius being the leading consumer among several East African countries. Despite the availability of methadone substitution treatment, rehabilitation and follow-up services remain limited, resulting in frequent treatment dropouts and relapses. These data point to systemic gaps in continuity of care, psychosocial support, and long-term recovery pathways. Together, these findings highlight the urgent need for a coordinated, evidence-based, and sustainable approach to addiction management in Mauritius.
New strategy: New challenges
The establishment in December 2025 of a new Board of Directors under a new Chairperson represents a strategic opportunity to consolidate and enhance the work of the National Drug Agency (NADC). However, this transition introduces key challenges that must be addressed to realise its full potential. Notable among these is the need to ensure that institutional renewal results in substantive change rather than “old wine in a new bottle.” Governance must adopt a comprehensive, coherent, and policy-aligned approach to deliver sustainable responses to both substance-related and behavioural addictions.
Effective leadership in addiction policy requires more than administrative oversight; it demands public health literacy, ethical sensitivity, and long-term strategic vision. While the current inter-institutional representation enhances coordination across public sector stakeholders, a clear strength, it may risk an overly administrative focus on complex public health issues. To address this, the inclusion of professionals with specialised expertise in addiction studies, research, clinical care, and policy development is essential. Mauritian professionals with international experience can contribute evidence-based perspectives, enhance strategic innovation, and reduce the risk of policy inertia.
Another challenge lies in maintaining strategic focus and prioritisation. With competing needs and limited resources, the Agency must avoid dispersing efforts across multiple objectives without achieving sufficient impact. In navigating this landscape, the NADC must balance the risks of superficial change (“old wine in a new bottle”) with overextension, akin to steering between Scylla and Charybdis. Leadership continuity, combined with structured, cross-cutting capacity-building for all stakeholders, is essential for effective implementation and the translation of strategic frameworks into concrete, measurable actions.
Development of innovative and forward-looking policies
An effective policy must combine consistency in implementation with the courage to innovate. Policies should be applied uniformly while anticipating emerging challenges, such as online gambling, new psychoactive substances, and evolving social behaviours. “Thinking the unthinkable” involves integrating socio-economic, political, and public health dimensions, addressing upstream determinants, and implementing preventive measures before harms escalate. Innovation should also include digital surveillance tools, early-warning systems, and real-time data integration to monitor trends and guide policy responses.
Approaches based on symptoms and social determinants
Currently, Mauritius’ response to addiction tends to focus on downstream interventions addressing symptoms rather than root causes. While treatment, harm reduction, and crisis management are essential, they do not prevent new cases. Upstream interventions targeting the social determinants of health such as unemployment, housing insecurity, educational disengagement, and lack of recreational infrastructure are crucial for sustainable, long-term impact. Addressing stigma and social exclusion is also central, as marginalisation significantly impedes help-seeking and recovery. A balanced approach addressing both upstream and downstream determinants is required to reduce the incidence of addiction and improve overall population well-being.
Community and substance-specific care structures
Community Alcohol and Drug Teams (CADTs) are locally-based multidisciplinary teams that act as the first point of contact for individuals experiencing substance use or behavioural addictions. They provide psychosocial support, guidance, and early intervention while linking individuals to appropriate clinical and community services. Satellite units across the country ensure equitable access and continuity of care. CADTs also play a critical role in reducing stigma, raising community awareness, and fostering an inclusive environment for recovery and social reintegration.
Substance-specific specialised units
These units address the distinct needs associated with alcohol, tobacco, opioids, cannabis, synthetic drugs, and NPS. They develop evidence-based treatment protocols, integrate harm reduction strategies, and support long-term recovery. Their embedded research functions allow for continuous policy refinement and adaptive responses to emerging substances and behavioural trends.
Reassessment of pharmacological interventions
Pharmacological treatments, particularly for opioids, must be continuously evaluated for safety, efficacy, and integration with psychosocial and psychospiritual support. Studies on methadone distribution in Mauritius have revealed gaps, including improperly sealed bottles, insufficient patient information, and structural challenges in dose management.4 Regular review and quality assurance are essential to maintain high standards.
Naloxone provision should be systematically integrated into care pathways, ensuring availability to individuals at risk of opioid overdose, their families, and frontline health workers. Coupled with training, naloxone distribution can significantly reduce overdose-related fatalities and strengthen community-level responses to opioid dependence.
Prevention and public health
Prevention and public health education are central to a solution-driven strategy. Establishing a Curriculum Development Team to design age-appropriate programmes for primary, secondary, and tertiary students is critical. Courses should raise awareness about alcohol, tobacco, psychoactive substances, and behavioural addictions. Prevention efforts must also extend to parents, educators, and employers to create a supportive, informed ecosystem.
Top-to-bottom capacity building
Effective policy implementation requires a fully trained and certified workforce at every level. From senior leadership to frontline staff, personnel must understand the complexities of addiction, evidence-based interventions, and national policy objectives. All field workers should obtain a Certificate of Proficiency in Addiction Studies, validating their skills and knowledge.
Monitoring, evaluation,
and continuous adaptation
A robust monitoring framework is essential to identify gaps, measure impact, and adapt policies in real time. Oversight should include an inspector or dedicated officer responsible for quality assurance across statutory, non-statutory, and voluntary agencies. Transparent reporting mechanisms enhance accountability and public trust.
Conclusion: A solution-driven, upstream–downstream approach
This strategy shifts addiction policy from reactive crisis management to a proactive, evidence-based framework. Using the upstream-downstream metaphor: downstream interventions, such as opioid treatment, methadone maintenance, harm reduction, or crisis teams, save lives but do not prevent new cases. Upstream actions address root causes, including unemployment, inadequate housing, unsafe recreational spaces, limited public health access, and lack of addiction education. Solely focusing on downstream measures keeps the system in constant crisis mode. Integrating upstream prevention with downstream support enables Mauritius to reduce new addictions while providing effective care for existing cases. This approach fosters a holistic, sustainable, and solution-oriented framework. Addiction management requires collective effort; it is not the responsibility of a single profession but a shared commitment among all Mauritians to promote health, resilience, and societal well-being.
References
1. Republic of Mauritius, Ministry of Health and Wellness. (2021). Mauritius Non-Communicable Diseases (NCD) Survey 2021. Mauritius: Ministry of Health and Wellness. https://health.govmu.org/health/wp-content/uploads/2023/10/NAP-Final-2023-2027.pdf
2. Republic of Mauritius, National Drug Secretariat. (2022). National Drug Observatory Report 2022. National Drug Secretariat, Prime Minister’s Office. https://mroiti.govmu.org/Documents/Annual%20Reports/National%20Drug%20Observatory%20Report%202022.pdf
3. United Nations Office on Drugs and Crime. (2024, July). Study on synthetic drugs in Mauritius. United Nations Office on Drugs and Crime. https://allafrica.com/stories/202502050538.html
4. Cartick, J. (2023). An analysis of the quality of methadone dispensing in Mauritius (ID: HR23-793). Abstract presented at the Harm Reduction International Conference. https://hr23.hri.global/abstract/793/print
