“I never thought I would get hooked,” reprieve for drugs users through a holistic approach

Kiambu, Kenya - People who use drugs (PWUDs) in Kiambu County are since September accessing a medical substitute for opioids- such as heroine- at a clinic set up by Médecins Sans Frontières (MSF)/Doctors Without Borders in Karuri. The Medically Assisted Therapy (MAT) clinic is officially being inaugurated today by MSF and partners.

The clinic provides methadone, as part of the (MAT). MAT is one of the components of the harm reduction package- a set of practical strategies and interventions aimed at reducing negative health, social, legal and financial consequences of drug addiction. In addition to providing methadone, this holistic approach includes the prevention and treatment of tuberculosis (TB), prevention of infections and transmission of (Human Immunodeficiency Virus) HIV and viral Hepatitis- habitually caused by using unsterile injections-, mental health services, and re-integration support with family and society.

“Without sufficient support from family, society and medics, fighting substance abuse can become a lost cause with trickle-down effect on individuals, their family, a country’s economy, social well-being and cohesion,” says the Kiambu County Director of Public Health, Dr. Kellen Kimani. “There has never been a better time for such an initiative, that will ensure that our youth, who are the most affected, regain good health, quit drug use and become more productive in their lives.”

In September 2019, MSF began enrolling PWUDs into the MAT clinic at Karuri hospital, following a six-month construction phase. A total of 149 patients are receiving treatment, with new ones getting inducted and enrolled each day. As a one-stop clinic, in addition to accessing medical services, registered patients visit the clinic daily for their dose of methadone.

“I never thought I would get hooked,” says 30-year old James Njoroge who started using drugs in 2008. “It all started with tasting (heroin), one of my friends would give me small doses. I didn't get hooked immediately.” Years later when he lost his job, his drug addiction habit did not come to a halt, “What do you do when drug cravings start? I was now fully dependent on drugs. What happens is you start looking for money in all ways. Wherever you will get it."

James stole and robbed people to pay for his drugs. A mob justice incident in 2017 that had him admitted to the hospital with broken limbs, and jailed for close to three years was his turning point. “I never thought that there was something I could take to stop the drug craving that's why I wasn’t eager to take MAT. MAT saved my life. Since I started using MAT this is my third month yet I feel I am free of drug cravings.”

Kiambu County comes fourth after Mombasa, Nairobi and Kilifi counties in numbers of PWUDs (heroin users). From a mapping exercise in 2018, LVCT-Health found that there were more than 1300 PWUDs in Kiambu with only a small number having been enrolled in MAT clinics in Nairobi. Many patients have cited the high cost of traveling daily to the country’s capital to get their dose of methadone.

While providing treatment to patients with Hepatitis C in partnership with Medecins Du Monde (MDM) in Kangemi for more than two years until mid-2017, one of the gaps MSF noted was that patients had to go to many different health service providers to seek different services. Those from Kiambu had to go to Kangemi, about 4 hours return-trip, for Hepatitis C treatment after taking their methadone at Ngara- a separate clinic, with some having to visit other medical facilities for other services including for HIV and TB management.

“Drug users have been a neglected population, despite having many people in need of medical assistance. Drug addiction is a disease, not a choice. Offering medical assistance and supporting drug users to access methadone and auxiliary health support services to mitigate the debilitating impact of substance abuse is key to their recovery,” says Julia Jung, MSF’s Project Coordinator for Kiambu.

MSF funded the construction of the facility in Karuri and will run it for the next three years then hand it over to the county government of Kiambu. MAT is a government initiative under the National AIDS and STI's Control Programme (NASCOP) - Key populations programme. The government of Kenya through NASCOP funds the purchase and distribution of methadone.

Currently, there are eight MAT clinics spread across several counties in Kenya.

“It is important to note that relapses are part of the journey and the treatment will take up to several years, sometimes it is lifelong. For all the steps that need to be taken, the ups and downs during this challenging journey, the patients need further support and services – beyond the medical ones we are providing,” adds Ms Jung.