The prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya

Ngarachu, Elizabeth Wambui; Kiburi, Sarah Kanana; Owiti, Frederick; Kangethe, Rachel N.

doi:10.1186/s13011-022-00437-7

Cited by 7 publications

(4 citation statements)

References 49 publications

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“…Poverty, political instability, social unrest, and refugee issues in Africa have led to the rapid spread of psychoactive substance use, especially among young people. Low educational attainment is a risk factor for cannabis use disorder (Ngarachu et al, 2022 ; Odejide, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

Trends of the Global Burden of Disease Attributable to Cannabis Use Disorder in 204 Countries and Territories, 1990–2019: Results from the Disease Burden Study 2019

Shao

Gan

et al. 2023

Int J Ment Health Addiction

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Cannabis is the fourth psychoactive substance to be legalized which are of far-reaching significance to the world. We analyzed data from the 2019 Global Burden of Disease Study (GBD) to estimate the incidence and prevalence of cannabis use disorder (CUD) and calculated the disease burden of CUD in 204 countries and territories and 21 regions over the past three decades. We reported disease burden due to CUD in terms of disability-adjusted life years (DALYs), age-standardized rate (ASR), estimated annual percentage change (EAPC), and analyzed associations between the burden of CUD and sociodemographic index (SDI) quintiles. Globally, the number of incidence cases of CUD was estimated to be increasing by 32.3% from 1990 to 2019 and males are nearly double higher than that of female. DALYs increase 38.6% from 1990. Young people aged 20–24 years old with cannabis use disorder have the highest DALYs in 2019, followed by those younger than 20 years old. India, Canada, USA, Qatar, Kenya, and high SDI quintile areas showed a high burden of disease. Nearly 200 million individuals are cannabis users worldwide, and CUD is a notable condition of GBD. The global cultivation of cannabis, rooted in different cultures, diversified access to cannabis, legalization in controversy, the promotion of medical cannabis, and many other factors promote the global cannabis industry is constantly updated and upgraded. It deserves more discussion in the future in terms of pathophysiological mechanisms, socioeconomics, law, and policy improvement.

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Section: Discussionmentioning

confidence: 99%

Trends of the Global Burden of Disease Attributable to Cannabis Use Disorder in 204 Countries and Territories, 1990–2019: Results from the Disease Burden Study 2019

Shao

Gan

et al. 2023

Int J Ment Health Addiction

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“…Studies show concurrent substance use is common among patients with Opioid Use Disorder (OUD) [4,[6][7][8]. The most frequent concurrent substances include alcohol, tobacco, cannabis, benzodiazepines, and amphetamines at different rates [4,[8][9][10]. A national survey on the status of substance use in Kenya showed that more than 50% of the population had ever used a substance in their lifetime [11].…”

Section: Introductionmentioning

confidence: 99%

Substance Use Patterns and Negative Urine Opioid Screen Among Patients on Methadone Treatment at a Referral Hospital in Nairobi, Kenya.

Kuria

2024

Preprint

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Background Studies show concurrent substance use is common among patients with opioid use disorder. Despite evidence that various medications for Opioid Use Disorder are beneficial, some patients continue using opioids while in the program. We aimed to determine substance use patterns at enrolment and negative urine opioid screens among patients who were attending the Medically Assisted Therapy Clinic at a referral hospital in Nairobi.Methods This was a retrospective cohort study of 713 patients who had enrolled in the Medically Assisted Therapy clinic between December 2014 and February 2018. Data for each participant was collected over 24 months. A researcher-designed socio-demographic form and a data collection form were used to collect data. The data was analysed using Statistical Analysis for Data Science (STATA) version 18. 3.10.Results Most participants were male 85.7%, with a mean age of 34.3 years (SD 8.6). The majority had primary and below level of education 48.8%, were employed 59.5%, and were single/separated/widowed 78.4%. All the participants had used at least one other substance apart from opioids. The most common substances were; tobacco 91%, followed by cannabis 82.9% and benzodiazepines 51.5%. At 6, 12, 18, and 24 months, negative urine opioid screens were 61.3%, 76.0%, 73.5%, and 81.4%, respectively. At 24 months, 81.3% of the participants were still active in treatment.Conclusions Many of the patients attending the Medically Assisted Therapy clinic use more than one substance. There is a need to scale up the program to also offer free management for other substances. Many patients had a negative urine opioid screen at 24 months; this replicated the evidence for the efficacy of medications for Opioid Use Disorders. However, there is a need to further explore why some patients continue to use opioids while in the program.

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“…With half of the estimated people who inject drugs (PWID) dwelling in the Kenyan coastal counties, Mombasa and Kilifi counties were prioritized for MMT initiation in 2015 [ 10 – 12 ]. While various studies conducted in Kenya on people with opioid use disorder mostly focused on the period prior to MMT enrolment [ 13 – 15 ], a few studies have enquired about its effect on polydrug use, other related risky behaviour, productivity, household income food insecurity, and the economic cost of methadone [ 12 , 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for poor treatment outcomes among opioid-dependent clients taking methadone in Mombasa, Kenya

Mwanyalu,

Nunga,

Mwanyamawi

et al. 2024

Adv. Drug Alcohol Res.

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Background: The Methadone Maintenance Treatment (MMT) program has been proven to be beneficial in reducing illicit opioid use, increasing access to and retention of HIV treatment and other therapies, and reducing HIV transmission, and other drug-related morbidities and mortalities. However, determinants of treatment retention and outcomes for opioid-dependent persons accessing MMT in Kenya are limited. We sought to identify factors contributing to poor treatment outcomes among opioid-dependent persons enrolled in the Mombasa MMT program, between 2017 and 2019.Method: We conducted a retrospective records review for opioid-dependent persons receiving Methadone treatment in the Kisauni MAT clinic enrolled during 2017–2019. We defined poor clinical or health-related treatment outcome as any client Lost-To-Follow-Up (LTFU), turned HIV or Viral hepatitis positive, and/or missed two or more antiretroviral therapy (ART) appointments intake during MMT. Variables abstracted from clinical and pharmacological MMT service delivery tools included socio-demographic characteristics, clinical history, risk factors, and MMT outcomes. Data were analyzed using Epi Info7. We calculated Prevalence Odds Ratios (POR) and 95% Confidence Intervals (CI) to identify factors associated with adverse health outcomes.Results: Of the total 443 eligible records, the mean age was 37 years (SD ± 7.2) and males comprised 90.7%. The majority of females clients, 79.1% (34/43), were aged ≤35 years, 7.0% (3/43) had no education, 32.6% (14/43) were employed, 39.5% (17/43) were HIV positive and 18.6% (8/43) were HCV-positive. Overall, adverse treatment outcomes were at 27.5% (122/443), namely: LTFU at 22.8% (101/443), new HIV cases at 1.0% (4/391), HCV at 1.2% (5/405), and Hepatitis B Virus (HBV) at 1.2% (5/411), and 1.1% (5/443) died. Of HIV-infected clients linked to Comprehensive Care Clinic (CCC), 3.6% (2/56) defaulted from ART, and 25% (2/8) had detectable Viral Load of those retested. Lack of formal education (POR: 2.7, 95% CI: 1.3–5.7), unemployment (POR: 2.4, 95% CI: 1.4–4.0), and being a Non-Injector (POR: 1.7, 95% CI: 1.0–2.9) were negatively associated with treatment retention.Conclusion: Females were younger, and more educated with higher HIV and HCV prevalence. Being a Non-injector, unemployment, and lack of formal education may increase the likelihood of poor treatment outcomes among MMT clients. Closer monitoring of MMT clients with these characteristics is recommended with the integration of CCC into MMT services.

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The prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya

Cited by 7 publications

References 49 publications

Trends of the Global Burden of Disease Attributable to Cannabis Use Disorder in 204 Countries and Territories, 1990–2019: Results from the Disease Burden Study 2019

Trends of the Global Burden of Disease Attributable to Cannabis Use Disorder in 204 Countries and Territories, 1990–2019: Results from the Disease Burden Study 2019

Substance Use Patterns and Negative Urine Opioid Screen Among Patients on Methadone Treatment at a Referral Hospital in Nairobi, Kenya.

Risk factors for poor treatment outcomes among opioid-dependent clients taking methadone in Mombasa, Kenya

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