Recreational drug use in Kenya

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In Kenya, drug use is an ongoing prevalent issue among those from both rural and urban areas of the country. Drugs such as inhalants, narcotics, and prescription drugs have been abused, resulting in societal issues such as social stigmas, poverty, peer pressure. These issues have had significant repercussions, including increased violence, strain on healthcare services, heightened vulnerability to HIV infection, and chemical dependence. In response, local communities and the national government have undertaken initiatives to tackle these challenges.

Contents

History

The patterns of recreational drug use in Kenya have evolved alongside historical developments. In precolonial times, Kenyan society permitted the consumption of certain substances, such as alcohol, but strictly limited their use to cultural events and specific occasions. The privilege of drug use, including alcohol, was predominantly reserved for male elders within the Kenyan communities, while youth and women were prohibited from participating in such activities. [1] Before the arrival of colonialism, Kenyans engaged in the consumption of various alcoholic beverages, such as chang'aa, and toivo. Additionally, they practice the chewing, smoking, or inhalation of tobacco leaves, khat leaves, and marijuana leaves.

With the expansion of trade during the colonial era, access to alcohol increased significantly. As time passed, the sense of a cohesive social community gradually diminished among Kenyans. The introduction of colonialism brought new economic opportunities, which led to a cultural shift towards individualism. Consequently, the traditional family structure weakened, and the informal restraints on alcohol and drug use became less stringent. [2] In contrast to traditions, contemporary society has witnessed an increase in recreational drug use across various demographics, up to 6.0% by 2017. [3] However, it is important to note that this shift in behavior has also resulted in a higher risk of substance abuse and its associated problems. [4]

Source of drugs

Kenya is classified as a relatively weak, yet independent, state. This classification suggests that the country may lack a centralized and strong government-led military force. Consequently, this creates opportunities for informal actors to engage in illicit activities with limited fear of state intervention. Additional factors, such as widespread governmental corruption, further contribute to the challenges faced by the state. [5] Due to weakened institutions and challenges in maintaining stable financial and transportation services, Kenya has become an attractive destination and transit point for drug traffickers. This vulnerability is highlighted by a report from the United Nations Office on Drugs and Crime (UNODC), which notes the significant quantities of heroin being seized in coastal areas of East Africa. The report further states that a majority of the seized heroin originates from Afghanistan. [6]

The coastal areas of Kenya, including Lamu, Malindi, and Mombasa, are particularly susceptible to drug trafficking due to their proximity to the sea. Traffickers often choose maritime routes as a means of transportation. These areas have been identified as being significantly affected by drug trafficking activities. [7] Drugs are also trafficked through international airports in Kenya. [8]

In Kenya, alcoholic drinks are commonly brewed domestically, with traditional liquor being the most accessible form. However, there is a distinction between rural and urban environments in terms of alcohol production and distribution. In rural areas, it is more common for alcohol to be brewed at home by individuals or small-scale producers. This homemade alcohol often utilizes traditional brewing methods and local ingredients. [9]

Causes

Institutionalized homophobia and social stigma

Kenya holds a conservative perspective regarding the LGBTQ community, and the country's laws criminalize non-heterosexual sexual activity. This viewpoint is reflected in the Kenyan Penal Code, specifically under Section 162. According to this section, engaging in carnal knowledge of a person against the order of nature is considered a felony and is punishable by up to fourteen years of imprisonment. [10] Section 165 of the Kenyan Penal Code criminalizes homosexual acts, specifying that any male who engages in an act of gross indecency with another male person is guilty of a felony and can face a maximum prison sentence of five years. [11]

Due to the legal institutionalization of homophobia in Kenya, individuals, particularly men who have sex with men (MSM), often face harassment from state officials. A report conducted by the Kenya National Commission on Human Rights highlights the challenges faced by MSMs due to the criminalization of same-sex activities. According to the report, these individuals are subjected to frequent harassment, extortion attempts, and false arrests by law enforcement officers and state officials. [12]

According to a study conducted in 2017 among men who have sex with men (MSM) in Kisumu, Kenya, the prevalence of severe depressive symptoms was found to be significantly higher (11.4%) compared to the estimated 4% in the general Kenyan population. Additionally, the study revealed that 50.1% of the participants reported harmful alcohol abuse, while 23.8% reported moderate substance abuse. These findings suggest that MSM in Kisumu may resort to alcohol and illicit substances as a coping mechanism within the conservative social environment they navigate. [13]

In recent years, there have been efforts by LGBTQ activists and allies in Kenya to advocate for the decriminalization of same-sex sexual activity. [14]

Peer pressure

Peer pressure is indeed a significant factor contributing to drug abuse among youths, including female Kenyan youths. A study published in the Bangladesh e-Journal of Sociology highlighted the risk of drug abuse among female youth in Mikindu, Kenya. The study found that approximately 24.14% of participants reported initiating drug use due to peer pressure. In some cases, individuals are influenced by their peers who may promote the perceived benefits or positive feelings associated with drug use. This can create a sense of curiosity or a desire to fit in with their social circle and please their friends or a sense to show equality and sometimes superiority, leading to experimentation and ultimately drug abuse. [15]

Effects

Violence

Violence within the private or domestic sphere is a concerning issue, and substance abuse can contribute to increased aggression and risk of harm. A study published in the Journal of Youth Studies shed light on the influence of substance use on sexual violence among male youth and the victimization of girls. [16] The 2012 report compiled by the National Authority for the Campaign Against Alcohol and Drug Abuse found that those who used alcohol and bhang were more likely to exhibit violent behavior toward family members. For example, "32.4% of alcohol and 28.6% of bhang users reported being violent to a spouse/partner or a family member." [17]

Utilization of healthcare services

Kenyan women who actively engage in drug-injecting can jeopardize their health and the health of their fetuses during pregnancies. Drug injecting can lead to amenorrhea, resulting in women being unaware that they are even pregnant until further along. This lack of awareness resulted in pregnant women failing to follow certain practices and habits to ensure the health of their fetuses.

Drug use also creates a dilemma for women as they weigh the choices of either searching for more drugs or traveling to clinics to receive better care. Women under the influence of drugs feel a need to satisfy their cravings, viewing them as a priority before attending medical appointments. They also consider the possibility that staying at a clinic for a long duration due to long queues can lead to withdrawal symptoms.

For the time being, few health providers fully understand how to treat women who have been injected with drugs. [18]

Greater risk of HIV

One of the more long-term effects brought about by drug use in Kenya is the transmission of HIV among the populace. Under the effects of drugs, those who engage in sexual activities are more likely to make rash and impulsive decisions. [19] Research on women's drug usage in the coastal cities of Mombasa and Kilifi found that the sharing of needles among drug users was common. However, despite understanding the risks attached to such behavior, participants continued to share needles.

Drug use can aid the spread of HIV through transactional relationships. In terms of the makeup of study participants, "53% were single and 27% were cohabiting," leading to conditions by which women exchanged sex for "drugs, protection from the police, and accommodation." A search for drugs, in particular, poses certain health risks, as sexual intercourse with strangers serves to heighten the risk of contracting HIV. Similarly, sex workers are susceptible to contracting HIV due to drug use during work. [20]

Chemical dependence

Chemical dependence refers to various indicators such as needing the substance to live or go about one's day and "craving for the substance, needing the substance first thing in the morning"; concern by someone close to the respondent or a doctor about the person's drug consumption habits. [21] The report indicated that between the age range of 15 to 65, tobacco was the most addictive substance with 62.3% of users expressing a craving for it. 21%, 44%, and 34.4% of alcohol, bhang and miraa users respectively, expressed similar cravings. [22]

Social stigma

A report published by the Harm Reduction Journal examined the impact of stigma faced by women on the Kenyan Coast who injected drugs. Based on the information collected from interviews with study participants who had injected drugs, the researchers formed several conclusions about stigma. The types of stigma included:

According to the study, the stigma of drug use can impede women's access to healthcare. Some women shared their concerns that being identified as a drug user would influence the quality of their interactions with healthcare workers, as certain workers would question the reason and method by which they should provide for the drug users. Some also opted to hide their identities to ensure that they would receive proper care. [23]

Local response

The local community plays a role in regulating the consumption of alcohol and other drugs. According to interviews with members of Kuikui, Baringo North, there is general respect and concern within the community for the well-being of others. If, for example, a youth is caught drinking alcohol or using drugs, the word of a village elder can be sufficient for the youth to cease his or her behavior. The family is also capable of guiding relatives or immediate family members away from alcohol and other drugs. [24]

Government response

Aware of the negative effects of alcoholism and other drug abuse, the Kenyan government has made an active effort in recent years towards informing and preventing the populace from abusing these substances through policy. The Tobacco Control Act of 2007 was designed to protect individuals from disease and death caused by tobacco. It also aimed to better inform consumers on the risks associated with smoking, while preventing those under the age of 18 from purchasing tobacco products. [25] In 2010, The Alcoholic Drinks Control Act was passed to protect "the health of individuals by providing a legal framework to control sale, production & consumption of alcoholic drinks." It also sought to better educate the general populace about the risks of alcohol consumption. [26] These efforts regulate the hours of operation for bars and prohibit the sale of alcohol to individuals under 18 years of age. These rules, however, are frequently broken as customers will pay bribes or bar owners will refuse to adhere to the rules, as they may diminish profits. [27]

The Kenyan government has also cooperated with UNODC and the United Nations Programme on HIV/AIDS (UNAIDS) in its effort to provide proper treatment to those who inject drugs. In Mombasa, the Kenyan government began a process of decentralization, creating 12 outpatient centers capable of providing drug-dependence treatment. UNODC also pledged to provide training for "700 health professionals and civil society workers in HIV services" for those who inject drugs. [28]

See also

Related Research Articles

<span class="mw-page-title-main">Harm reduction</span> Public health policies which lessen negative aspects of problematic activities

Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.

<span class="mw-page-title-main">Alcohol abuse</span> Substance abuse of alcoholic beverages

Alcohol abuse encompasses a spectrum of alcohol-related substance abuse, ranging from the consumption of more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking or alcohol use disorder.

<span class="mw-page-title-main">Pre-exposure prophylaxis for HIV prevention</span> HIV prevention strategy using preventative medication for HIV-negative individuals

Pre-exposure prophylaxis for HIV prevention, commonly known as PrEP, is the use of antiviral drugs as a strategy for the prevention of HIV/AIDS by people that do not yet have HIV/AIDS. PrEP is one of a number of HIV prevention strategies for people who are HIV negative but who have a higher risk of acquiring HIV, including sexually active adults who are at increased risk of contracting HIV, people who engage in intravenous drug use, and serodiscordant sexually active couples. When used as directed, PrEP for HIV infection has been shown to be highly effective, reducing the risk of acquiring HIV through sexual intercourse by up to 99% and injection drug use by 74%.

<span class="mw-page-title-main">HIV Prevention Trials Network</span>

The HIV Prevention Trials Network (HPTN) is a worldwide collaborative clinical trials network that brings together investigators, ethicists, community and other partners to develop and test the safety and efficacy of interventions designed to prevent the acquisition and transmission of HIV. HPTN studies evaluate new HIV prevention interventions and strategies in populations and geographical regions that bear a disproportionate burden of infection. The HPTN is committed to the highest ethical standards for its clinical trials and recognizes the importance of community engagement in all phases of the research process.

<span class="mw-page-title-main">Party and play</span> Drug use to facilitate sexual activity

Party and play (PnP), also known as chemsex or wired play, refers to the practice of consuming drugs to enhance sexual activity. This sexual subculture involves recreational drug users engaging in high-risk sexual behaviors under the influence of drugs, often within specific sub-groups. Activities may include unprotected sex with multiple partners during sessions over extended periods, sometimes lasting days. The drug of choice is typically methamphetamine, commonly referred to as crystal meth, tina, or T. Other substances like mephedrone, GHB, GBL, ketamine, and alkyl nitrites are also used. The term slamsex is used for injection drug users.

Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year, but in 2012 and 2013, it increased to about 600 new cases, and in 2014, it reached 880 new cases per year. According to 2016 statistics from UNAIDS, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13,000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

Vietnam faces a concentrated HIV epidemic among high-risk groups, including sex workers, and intravenous drug users. There are cases of HIV/AIDS in all provinces of Vietnam, though low testing rates make it difficult to estimate how prevalent the disease is. The known rates among high-risk groups are high enough that there is a risk of HIV/AIDS rates increasing among the general population as well. People who are HIV+ face intense discrimination in Vietnam, which does not offer legal protections to those living with the condition. Stigma, along with limited funding and human research, make the epidemic difficult to control.

<span class="mw-page-title-main">Benzodiazepine use disorder</span> Medical condition

Benzodiazepine use disorder (BUD), also called misuse or abuse, is the use of benzodiazepines without a prescription and/or for recreational purposes, which poses risks of dependence, withdrawal and other long-term effects. Benzodiazepines are one of the more common prescription drugs used recreationally. When used recreationally benzodiazepines are usually administered orally but sometimes they are taken intranasally or intravenously. Recreational use produces effects similar to alcohol intoxication.

<span class="mw-page-title-main">Substance use disorder</span> Continual use of drugs (including alcohol) despite detrimental consequences

Substance use disorder (SUD) is the persistent use of drugs despite the substantial harm and adverse consequences to one's own self and others, as a result of their use. In perspective, the effects of the wrong use of substances that are capable of causing harm to the user or others, have been extensively described in different studies using a variety of terms such as substance use problems, problematic drugs or alcohol use, and substance use disorder.The National Institute of Mental Health (NIMH) states that "Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD".Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol (alcoholism); cannabis; opioids; stimulants such as nicotine (including tobacco), cocaine and amphetamines; benzodiazepines; barbiturates; and other substances.

Flashblood is an intravenous drug administration technique used by recreational drug users in which an individual injects himself with blood extracted from another drug user, most commonly one who has injected heroin. The purpose of the technique is to experience substance intoxication or to help combat symptoms of drug withdrawal. The practice was first documented in an announcement submitted by Sheryl A. McCurdy, et al., in an October 2005 issue of BMJ. First reported to be practiced in Dar es Salaam, Tanzania, the practice had spread to other areas in East Africa by 2010.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

Most of the illegal drugs in Pakistan come from neighbouring Afghanistan.

Risky sexual behavior is the description of the activity that will increase the probability that a person engaging in sexual activity with another person infected with a sexually transmitted infection will be infected, become unintentionally pregnant, or make a partner pregnant. It can mean two similar things: the behavior itself, and the description of the partner's behavior.

Discrimination against people with substance use disorders is a form of discrimination against people with this disease. In the United States, people with substance use disorders are often blamed for their disease, which is often seen as a moral failing, due to a lack of public understanding about substance use disorders being diseases of the brain with 40-60% heritability. People with substance use disorders are likely to be stigmatized, whether in society or healthcare.

East African drug trade refers to the sale and trafficking of illegal drugs that take place in East African countries like Kenya, Tanzania, Uganda, Somalia, and Ethiopia. The most prevalent types of drugs traded in East Africa are heroin, marijuana, cocaine, methamphetamine, and khat, all of which are strictly prohibited in East African countries.

<span class="mw-page-title-main">Alcohol use among college students</span> Unhealthy alcohol drinking behaviors by college students

Many students attending colleges, universities, and other higher education institutions consume alcoholic beverages. The laws and social culture around this practice vary by country and institution type, and within an institution, some students may drink heavily whereas others may not drink at all. In the United States, drinking tends to be particularly associated with fraternities.

References

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  2. ↑ United Nations Office on Drugs and Crime. Bulletin on narcotics. UNODC. OCLC   1100004686.
  3. ↑ Morris, Kamenderi; Muteti, John; Okioma, Victor; Kimani, Stephen; Kanana, Felistas; Kahiu, Caroline. "Status of Drugs and Substance Abuse among the General Population in Kenya" (PDF). African Journal of Alcohol & Drug Abuse (1): 54–59. Retrieved 2023-10-26.
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  16. ↑ Mugisha, Frederick; Zulu, EliyaMsiyaphazi (September 2004). "The influence of alcohol, drugs and substance abuse on sexual relationships and perception of risk to HIV infection among adolescents in the informal settlements of Nairobi". Journal of Youth Studies. 7 (3): 279–293. doi:10.1080/1367626042000268926. ISSN   1367-6261. S2CID   143779323.
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  24. ↑ National Authority for the Campaign Against Alcohol and Drug Abuse (Kenya). Rapid situation assessment of the status of drug and substance abuse in Kenya, 2012. OCLC   1086392893.
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