Chapter 23: Utilization of community-based outpatient addiction treatment programmes in Kenya by Clement S. Deveau, Ludovick Tengia, Carolyne Mutua, Samuel Njoroge, Lillian Dajoh & Barney Singer

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Introduction
Alcohol and drug abuse continue to be a significant problem in Kenya as well as other African countries. The Kenya National Campaign Against Drug Abuse Authority (NACADA) reported in their 2007 study that 70% of adults aged 15-64 with multiple partners are likely to be substance abusers. In addition, 50% of alcohol users report
ongoing craving for alcohol and 25% need to consume alcohol first thing in the morning (NACADA, 2007). Alcohol abuse in Kenya has also been documented in other studies. According to Shaffer (2004), 54% of patients attending public health clinics in western Kenya reported hazardous drinking behaviour, as measured by the World Health Organization (WHO) Alcohol Use Disorders Identification Test (AUDIT). In a study at voluntary counseling and testing (VCT) centers in eight Kenyan districts, Mackenzie and Kiragu (2007) reported that 76% of males and
25% of females who consume alcohol report hazardous drinking behaviour, also measured by the AUDIT. Alcohol abuse in Kenya has been identified for some time.
In 1989, Nielsen, Resnick & Acuda reported that 54% of the males and 25% of the females attending Kisii district hospital in Kenya met the DIS (Diagnostic Interview Schedule) criteria for alcohol abuse and/or alcoholism.
Types of substances abused in Kenya are similar to other parts of Africa. The most commonly abused substances in Africa are alcohol, cannabis and khat/miraa (Odejide, 2006), while the most commonly abused substances in Kenya are alcohol, cigarettes, cannabis and khat/miraa (NACADA,2007; Ndetei et al, 2006). NADACA (2010a) reports that alcohol, followed by khat/miraa, are the most commonly used substance in the coast province of Kenya. Commonly used substances among Kenyan secondary school students are alcohol, tobacco, cannabis and khat/mirra (NACADA, 2007; Ndetei et al, 2009}. In another study, alcohol, cannabis, khat/miraa and kuber were considered the most commonly abused substances among Kenyan secondary school students (Ngesu, Ndiku & Masese, 2008).

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