African Journal of Alcohol and Drug Abuse (AJADA)
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Effect of medication-assisted treatment on psychosocial well-being among patients with opioid use disorder: A case of Mathari National Teaching and Referral hospital Nairobi City County
Full text linkOpioid use is an epidemic globally. Although medication-assisted treatment has been effectivein the treatment of opioid use disorder and the improvement of psychosocial well-being, the epidemic continues with the number of those using opioids increasing, causing a heavy burden of disease and a strain on the healthcare system in many countries. The purpose of the study was to establish the effect of medication-assisted treatment on psychosocial well-being among patients with opioid use disorder in Mathari National Teaching and Referral hospital. It was a descriptive cross-sectional study targeting a population of 1211 patients. The sample size comprised 255 patients obtained using the systematic random sampling technique. The study used Carol Riff’s harm reduction models. Data collection was through questionnaires that were completed by the respondents. The interview schedule was used for the key informants (doctors, nurses, psychologists, and social workers). The instrument reliability and validity were assessed. Data was analysed using a statistical package for social science (SPSS) Version 24.0. The presentation of the results was through tables, pie charts, and graphs. The study findings revealed that most of the respondents were on medicationassisted treatment at 96.3%. There was a reduction in withdrawal symptoms, overdoses, and the number of those injecting drugs, hence a reduction in HIV, hepatitis, and T.B infections. There was resumption to school, employment, and business. However, there was a 40% relapse. The study concluded that there was a statistically significant relationship between MAT and psychosocial wellbeing among patients with opioid use disorder (OUD) as demonstrated by significant Pearson Correlation (r=0.247, p<0.05). Addressing the issue of relapse is important for strengthening the MAT program. Appropriate and programmatic interventions by the policymakers and stakeholders would improve the patients’ psychosocial wellbeing. The study would be useful for future reference by other researchers. It is important to carry out related studies in other MAT clinics in Kenya for comparative purposes. A longitudinal study on the variables under investigation in this current study for five years would be interesting. It is pertinent to decentralize MAT service
Effectiveness of a Music Based Intervention in Enhancing Problem Recognition among Clients with Substance Use Disorders in Residential Treatment Centers in Kenya
Full text linkThe treatment of clients with substance use disorders (SUDs) is a challenge especially when they lack insight into the substance use problem. Such clients may not seek treatment and if they do, may not benefit much from it. Therefore there was a need to enhance problem recognition (PR) among such clients. The study sought to determine the effectiveness of music-based intervention (MBI) in enhancing problem recognition among clients with substance use disorders in residential treatment in Kenya. The objective was to determine if there were significant differences in PR between clients exposed to MBI and the control group in a selected residential treatment center in Kenya. The study used a quasi-experimental, nonequivalent control group pretest posttest design. A total of 40 clients participated in the study, with the experimental and control group having 20 participants each. Findings revealed that the experimental group had significantly higher levels of PR at post-test compared to the control group after controlling for various covariates, suggesting that MBI in addition to treatment as usual may have contributed to increased PR in the treatment group. This indicates that the MBI was effective in enhancing PR among clients with SUDs. Therefore, the MBI may be used as an evidencebased complementary intervention in enhancing problem recognition among clients with SUD in treatment settings in Kenya
Prevalence of co-occurring mental disorders among in-patients at the Alcohol & Drug Abuse Rehabilitation Unit, Moi Teaching & Referral Hospital in Eldoret
Full text linkGlobally, the burden of mental disorders among patients attending treatment for substance use disorders is substantial. Little has been done to explore this subject in Kenya. The aim of this study was to investigate the prevalence rates of mental disorders among persons undergoing inpatient rehabilitation for substance use disorders at the Alcohol and Drug Rehabilitation (ADAR) Unit, Moi Teaching and Referral Hospital. This was a descriptive cross-sectional study. The Mini International Neuropsychiatric Interview Version 7.0 was used to investigate the lifetime DSM-5 mental disorder diagnoses. Fifty three (53) adult patients consecutively admitted to the unit between June 2019 and May 2020 were interviewed by the investigators two weeks after admission. The data was analyzed using descriptive statistics. The mean age for the respondents was 38.13 years (SD=9.26 years). All 53 (100.0%) of the participants had at least one lifetime mental disorder diagnosis. Antisocial personality disorder (69.8%), Social Anxiety Disorder (49.1%), and Major Depressive Disorder (47.2%) were the most common mental disorder diagnoses. A large proportion of in-patients at the ADAR unit, MTRH had a lifetime mental disorder. We recommend routine screening for mental disorders for patients admitted for inpatient rehabilitation at the facility. In addition, management approaches for in-patient substance use disorder rehabilitation should address cooccurring mental disorders
Co-occurrence between Alcohol Use and Tuberculosis among Patients in Othaya Level 4 Hospital
Full text linkAlthough the government and partners have made significant investments in Tuberculosis (TB) prevention and treatment over the last 20 years, tuberculosis remains the fourth leading cause of death in Kenya. Alcohol intake, particularly heavy consumption, is a significant risk factor for tuberculosis. This study sought to establish the association between alcohol abuse and tuberculosis prevalence in Othaya Level 4 hospital, Kenya. The study was anchored on the ecological systems theory and employed descriptive survey design. The target population of this study were patient attending TB Clinic in Othaya Level 4 hospital. The study sample targeted 47 Tuberculosis patients enrolled in Othaya Level 4 hospital clinic, one clinical officer, a nurse, a social worker and a public health officer. Both quantitative and qualitative techniques were used in data collection. Data was collected using structured questionnaires, focus group discussions and key informant interviews. Findings from this study were presented in form of tables and graphs and narration for quantitative and qualitative data respectively. The study found that that 40% of TB patients had low-risk consumption while an equal number had hazardous or harmful alcohol consumption respectively. The results showed that 20% had a score of over 15 meaning that they were alcohol dependent. Age (p=0.0013) and marital status (p=0.013) were statistically significant for alcohol abuse whereby young respondents (<40 years) were 1.484 times likely to have alcohol abuse. Married respondents were 7.2 times likely to have alcohol abuse. Participants identified lack of adequate knowledge on the part of healthcare givers, ignorance and illiteracy on the part of the patients as well as culture as the barriers to overcome alcohol dependence. FGD participants recommended health education and support in overcoming alcohol abuse in treatment of TB
Alcohol Use Disorders and Associated Determinants among Public Sector Employees in Kenya
Full text linkGlobal data estimates that 237 million men and 46 million women have alcohol use disorders (AUDs) representing 5.1% of adults. Despite the growing burden of AUDs in the general population, there is limited attention on the situation in the workplace. Further, there is limited evidence to inform tailored interventions specific to the public sector workplace. This study therefore aimed to assess the status of AUDs and associated determinants among public sector employees in Kenya. A cross-sectional study was conducted from August 2020 – May 2021 where a total of 9,422 public sector employees were interviewed. Results showed that the lifetime prevalence of alcohol use among public sector employees in Kenya was 44.5%; the annual or 12 – month prevalence was 34.2%; and the 30 – day prevalence was 23.8%. Results also showed that 13.2% of the public sector employees presented with an AUD where 5.7% met the criteria for mild AUD, 3.0% moderate AUD and 4.5% severe AUD. Findings of the multinomial logistic regression analysis also showed that public sector employees who were male; married; separated/widowed/divorced; employed for 5 – 14 years; with temporary employment terms; from a state corporation; and from a medium sized public sector institution (PSI) were significantly associated with exposure to AUDs. Even though evidence showed a high burden of AUDs among employees in the public sector workplace, the problem was not generalized. Findings revealed AUDs risk disperaties across gender, marital status, duration of service, nature of employment, category of workplace and institutional size. The study therefore underscored the need for implementation of target specific interventions in the public sector workplace sensitive to the intricate dynamics of employee sub-group characteristics. 
The relationship between depressive disorders and substance use among women in addiction recovery in Kiambu County, Kenya
Full text linkDepressive disorders have far-reaching ramifications especially to affected women since they cannot manage their lives and families well. The intent of this paper was to investigate the relationship between depressive disorders and substance use among women in addiction recovery in Kiambu County. Descriptive research design was employed to evaluate the four selected recovery centres in Kiambu with a sample of 36 participants from a population of 120 individuals. Data was collected using questionnaires, in-depth interviews and focus group discussions. Descriptive analysis was used for quantitative data while qualitative data was analysed thematically. Correlation analysis was used to establish the relationship between depressive disorders symptoms and substance use. The findings identified domestic violence, feeling guilty and feeling worthless as symptoms of depressive disorder symptoms associated with substance use. A strong relationship was established between depressive disorders and substance use with more than 60% of respondents attesting to this. Correlation analysis established strong positive (r=0.603) association between domestic violence and substance use. The study recommended the recovery centers to engage competent and experienced psychiatrists and psychologists in mental health in order to deliver their services effectively and professionally. The study will benefit both the National and County governments in coming up with effective policies to deal with depressive disorders and substance use among women. This will go a long way in reducing the number of women under substance use in Kiambu County and the country at large
Prevalence and Patterns of Alcohol and Drug Abuse among University Students
Full text linkGlobally, 29 million people face challenges on psychoactive substance abuse. Three million deaths and 132.6 million disability adjusted life years were attributed to alcohol globally in 2016. Use of psychoactive substances by the youth negatively affect cognitive development, judgement, health and academic outcomes, Kenya has 7.9 million youths aged 15-24 years, among which are University students. Individual characteristics and environmental influences from family and peers makes the youth vulnerable to psychoactive substance use. This study aimed to determine the prevalence of alcohol and substance use; factors associated with alcohol and substance use; and predictive factors for the vice among University students. The study was conducted at three purposively sampled University of Nairobi campuses. A selfadministered questionnaire on psychoactive substance use was used. Respondents were registered students at the time of study residing in the three campuses. Hostels were systematically sampled and rooms randomly selected. Independent variables included commonly used psychoactive substances. Dependent variables were age, gender, campus and year of study. Data was analyzed using Stata SE 12 software. Descriptive,logistic regression and multivariate analysis were conducted. Majority of students were in the 20-24 years age bracket and the highest student proportion (29.3%) in 3rd year of study. The proportion of male respondents was 55.2%. Alcohol, marijuana and cigarettes were the most prevalent substances used at 41%, 14% and 13.5% respectively. Cocaine and heroin were the least used. Consumption of alcohol was significantly associated with male gender, higher year of study, city campuses (Main and Chiromo) and older age. Marijuana use was significantly associated with the male gender, higher year of study and older age. Use of cocaine and heroin were not significantly associated with any of the demographic factors under study. Male gender, city campuses and higher year of study were predictive factors for alcohol consumption and cigarette smoking
The Role of Conformity to Masculinity Norms on Alcohol Use among Male Teachers in Public Secondary Schools in Murang’a County, Kenya.
Full text linkAlcohol addiction is a problem that continuesto affect the global population. Being male has been reported as higher risk to alcohol consumption compared to being female. This has been linked to many male related factors with limited studies done on the role of conformity to masculinity on alcohol consumption. Alcohol abuse is considerably rampant among teachers and has impacted negatively on teaching and learning especially in public schools where productivity of teachers is extremely low, giving rise to a worrying trend. This study sought to establish the relationship between conformity to masculinity norms and alcohol abuse among male teachers in Murang’a County, Kenya. The study adopted the correlational research design targeting 2642 male teachers employed by teacher service commission in secondary schools in Murang’a County with a sample size of 422 participants. The quantitative data was collected using standardized masculine behaviour scale (MBS) and alcohol use disorders identification test (AUDIT) selfadministered questionnaires. The study found statistically significant correlation between conformity to masculinity norms and alcohol use disorders on all the domains of the Masculine Behavior Scale. This study may be significant to rehabilitation centers in developing and implementing men-centered interventions for treatment and control of alcohol consumption among patients
Emerging Trends on Smokeless Tobacco Use in Kenya
Full text linkIn Kenya, there is growing demand towards smokeless tobacco use especially among the youth and adolescents. Available data shows that 14.5% of secondary school students and 6.0% of primary school pupils in Kenya have ever use tobacco in their lifetime (NACADA, 2016; NACADA, 2018). Smokeless tobacco use is an emerging public health challenge with epidemiologic and laboratory evidence concluding that it causes oral cancer, esophageal cancer, and pancreatic cancer in humans (United Nations Population Fund, 2010; United Nations, 2011). In addition, more than 30 carcinogens have been identified in smokeless tobacco products (Central Intelligence Agency, 2012). Further, smokeless tobacco products contain nicotine, and users demonstrate signs of dependence similar to those of cigarette smokers (Kyaing, 2004). With the elaborate Government interventions to control smoking, smokeless tobacco may become an attractive alternative especially among the youth and adolescents. In this regard, NACADA conducted an assessment to establish emerging trends on smokeless tobacco use. Samples of smokeless tobacco were collected in the 8 regions of Kenya stratified across 18 purposively sampled counties. A total of 33 samples were collected and submitted to the Government Chemist for analysis and identification
New Consumption Patterns of Marijuana and Their Implications for Law Enforcement in Kenya
Full text linkNew consumption patterns of marijuana have emerged in the recent past alongside the conventional ones. In the jurisdictions like Kenya where marijuana is outlawed, these new patterns of consumption comprise the edibles and have posed detection challenges to law enforcers leaving them open to possible abuse and attendant health risks. This manuscript set out to uncover the new patterns of marijuana consumption and their implications on law enforcement in Kenya. The study adopted a mixed methods design to collect data in Siaya and Vihiga counties of Western Kenya. Convenience and purposive sampling techniques were used to identify 327 survey respondents, 20 key informants and 8 FGD participants at the community level. The FGDs included women and men of different age groups while the key informants were different State and Non-State actors at the national and county levels. Semi-structured interview guides were used to collect data from FGDs and key informants. Findings suggest that consumption patterns are changing and new patterns of substance preparations and administration have emerged alongside the conventional ones. Top among the new patterns include using marijuana as an ingredient in cakes and other confectioneries, boiling and blending it into juice, and using it as tea leaves and additive in other alcoholic beverages. A majority of the young people were found to use the drug currently and with no limitation of time for its use contrary to the past when the old were the majority partakers with self-regulation capacity and norms around time, place and occasion of use. Finally, the study unveiled that the law enforcement agencies lack the capacity and tools to detect the new consumption patterns and there is a tendency to over-focus on the low-end traditional consumers and traffickers. The study concludes that there is need for more studies to unravel the new consumption patterns especially in urban centres and train and resource the law enforcement agencies on their detection mechanisms