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BASIC INFORMATION ON DRUG AND SUBSTANCE ABUSE KENYA NATIONAL AGENCY FOR THE CAMPAIGN AGAINST DRUG ABUSE (NACADA) January, 2002

SECTION 6

6.0 MANAGEMENT OF DRUG/SUBSTANCE ABUSE

Drug/substance abuse is managed through prevention, treatment and rehabilitation.

6.01 Prevention

  1. Restricting availability — government policies.
  2. Reduction of over prescribing by doctors on drugs like the Benzodiozepines and other anxiolytics.
  3. Health education and information about dangers of drugs/substance abuse.
    • School Curriculum
    • Media Forums
    • Religious Forums etc
  4. Identification and treatment of family problems that may contribute to drug/substance taking.

6.02 Treatment

More effort has been put on prevention of drug/substance abuse because as the old adage goes "prevention is better than cure." The situation on the ground however reveals that there are too many persons addicted to drug/substance of abuse who need treatment and rehabilitation Section 52 of the 1994 Narcotic drugs and psychotropic substances (control) act provides for establishment of treatment and rehabilitation centres for persons addicted to Narcotic drugs or psychotropic substances. In its programme of action for the next 10 years and beyond, the Division of the mental health (MOH) recommended the establishment of drug/substance addiction centres in every district in Kenya.

Drug/substances abuse treatment programmes are categorised according to whether they offer inpatient (residential) or outpatient (non-residential) services.

Inpatient

  1. Detoxification centres
    Detoxification is a process whereby an alcoholic or drug addicted person is withdrawn from the drug often under chemotherapy. Medication is necessary for the control of the withdrawal symptoms, which can be fatal if not closely monitored and treated. Admission into a hospital or a detoxification centre is therefore advised.

    The Kenyan society tends to seek assistance for drug abuse victims as a last resort especially when the victim starts showing signs and symptoms of mental derangement. Most of these cases end up in psychiatric hospitals (public or private) where they are detoxified.

  2. Residential treatment centres
    Short Term
    Duration of stay is 28 days. Detoxification, which lasts from 5-10 days, is followed by individual and group therapy. Most of these 28 days treatment programmes are tailored along the 12 steps of the Alcoholics Anonymous (A.A) or Narcotics Anonymous (N.A.).
    Mid Term
    Duration of stay is 3 - 6 months. Individual and group therapy sessions are carried out in a therapeutic community set up. Relapse prevention training and work motivation is an essential component of the rehabilitation process.
    Long Term Duration of treatment is 6 - 12 months. Treatment is based on the concept of a therapeutic community (TC). In the developed countries, long-term treatment programs are gaining popularity in the criminal justice system where TCs are incorporated as part of the correction system within the prison.

The institutions listed below have been engaged in drug abuse treatment and rehabilitation in Kenya.

  • MATHARI MENTAL HOSPITAL - NAIROBI
    12% of all the patients admitted at Mathari Hospital suffer primarily from drug/substance abuse and drug/substance induced psychosis. Some form of rehabilitation is carried out by the occupational therapy department. The republic of Kenya’s Drug Control master plan (Year 2000) recommended establishment of a National drug abuse rehabilitation unit within Mathari hospital. The unit has not been established yet.
  • ASUMBI TREATMENT CENTER - NYANZA
    Establishment in 1986, Asumbi is the oldest alcohol and drug abuse rehabilitation centre in Kenya. The centre is situated in the interland of Nyanza province.
  • BRIGHTSIDE D.A.R.T. CENTRE - NAIROBI
    Brightside drug abuse rehabilitation and treatment centre, situated in Kitisuru, Nairobi, is a residential facility for detoxification, treatment and rehabilitation for alcohol and substance abuse. The institution, which has been operational from 6/4/1998 offers short term and mid-term treatment, programmes.
  • RED HILL PLACE - KIAMBU
    Situated at the Red hill in Tigoni, off Limuru road, the Red hill place opened doors to patients on 2/4/2001. On admission, patients are assessed and those requiring detoxification are referred to an appropriate facility before admission. The Red hill place offers mid-term alcohol and drug rehabilitation programmes.

6.02 OUTPATIENT

The cost of residential drug/substance abuse treatment is substantial. Outpatient treat is cheaper and reaches a wider clientele. There are four categories of outpatient treatment programmes.

Outpatient clinics

Most hospitals with psychiatric units or drug/substance abuse treatment facilities have outpatient clinics, which are used as part of follow-up after the patient is discharged. In Europe and America, some clinics provide methadone maintenance for heroin addicts. Methadone maintenance has not gained acceptance in Kenya.

Physician clinics

Psychiatrists and clinical psychologists provide drug/substance abuse treatment in form of counseling and psychotherapy in their private offices.

Counseling centres

There are several counseling centres e.g. Amani counseling centre, which assist the victims through supportive counseling.

Self-help groups

Self-help groups such as Alcoholics Anonymous and Narcotics Anonymous made up of recovered alcoholics and drug addicts assist others to recover and maintain sobriety through sharing. These groups also act as aftercare for patients who have completed drug/substance abuse treatment in rehabilitation centres.

6.03 Rehabilitation

Many drug takers have great difficulty in establishing themselves in normal society. The aim of rehabilitation is to enable the drug depended person to leave the drug subculture, and develop new social contacts. Unless he can do this, any treatment is likely to fail.

Rehabilitation is often undertaken after therapeutic community treatment. Patients at first engage in work and social activities in sheltered surroundings. They then take greater responsibility of themselves in conditions increasingly like those of every day life as they continuously get social support.

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