Drug abuse in Kenya is now bordering on becoming a catastrophe. But how do you know you are abusing drugs?

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol, illegal drugs, and/or prescribed medications in ways that produce harms to ourselves and those around us. More than 2 million Kenyans both young and old are living with a substance use disorder, according to the Mental Health department in Moi teaching and referral hospital, and that number is on the rise.

“Alcohol and drug use can cause physical and psychological dependence, which can lead to a substance use disorder,” says Dr Daisy Saina, from MTRH.

“If the substance you’re using is causing significant problems in your life and has negative effects on your health and despite that, you continue to use it, then you might have a substance use disorder.”

Dr. Saina has been supporting thousands of people struggling with substance use over the years. “Alcohol is the most common substance people seek help for, followed by opiates,” she says. “It often takes a long time before people realize that their substance use has centred itself as a priority in their life.”

“Regardless of what is used, the most important thing to know is that substance use disorders often occur due to circumstances beyond one’s control, but they are treatable, just like other chronic illnesses—through medication and psychosocial support including counselling and therapy”, Dr Saina advices. 

Stigma And the Fight Against Drug Abuse

Unfortunately, the prevailing stigma often prevents people from seeking help. Most Kenyans are already painfully aware of the cost of substance misuse. Many Kenyans believe that there are no viable solutions to what they think of as unfortunate “lifestyle problems”.

“A lot of people feel a huge component of shame and guilt related to their substance use, and they suffer in silence instead of getting help, but their illness is not any different from other chronic illnesses such as hypertension or diabetes,” says  Dr. Saina. “People need to know that the shame you feel, the guilt you feel, is because of stigma – and not because you are a weaker or immoral person.”

Dr. Saina says that a substance use disorder is diagnosed based on meeting two or more of  following DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) criteria:

Signs and symptoms of a substance use disorder

• Negative effect on social functioning, including relationships, conflict with others
• Not meeting life responsibilities at home, work, or school
• Negative effects on physical or psychological health
• Using more of the substance, for longer periods of time, or more frequently
• Spending a lot of time using or sourcing the substance
• Not being able to stop or cut back despite trying
• Avoiding or giving up activities to take the substance
• Cravings including constantly thinking about the substance even if not using
• Tolerance needing to take more to feel the same effect
  
• Withdrawal when the drug is stopped or reduced, including psychological and physical symptoms

According to Dr Saina, the main predisposing factors are:

• Family history of substance use
• History of mental illness
• History of trauma
• Cultural factors, for example, when the use of a substance is socially accepted

If you’re struggling with substance use or know someone who is, Dr Saina encourages finding support and offers this information to help you cope:

• Fill the void
  “If you’re struggling with substance use, it’s important for you to identify the main factor contributing to your use. What is the void that the substance is filling in you? Once you’ve identified that void, get help and/or fill it with something positive and meaningful to you,” says Dr Saina
• Find meaningful support
  Medication and counselling are tools to help you, but having a sense of connection to another person is essential for long-term support. “Establish what support will look like for you, and try to make a meaningful connection to have that sense of fulfilment,” says Dr Saina

If you think you might have a substance use problem, speak with your doctor or healthcare provider.