Journal of Psychiatry

Substance use patterns and negative urine opioid screen among patients on methadone treatment at a referral hospital in Nairobi, Kenya

13^th World congress on Addictive Disorders & Addiction Therapy

October 24-25, 2024 Webinar

Susan Kuria1, Sarah Kiburi2, Jackline Ochieng1, John Mburu and Fredrick Owiti

1Moi Teaching and Referral Hospital, Kenya 2Aga Khan University Hospital Upperhill Medical Centre, Kenya 3University of Nairobi, Kenya

Scientific Tracks Abstracts: J Psychiatry

Abstract:

Statement of the problem: Substance use is prevalent and associated with a significant burden of disease globally. Studies show concurrent substance use is common among patients with opioid use disorder. Despite evidence that various medications for Opioid Use Disorder are beneficial, some patients continue using opioids while in the program. Unfortunately, majority of Opioid Substitution Therapy programs focus on Opioids Use Disorder alone, rather than a holistic approach inclusive of other substances. We aimed to determine substance use patterns at enrolment and negative urine opioid screens among patients who were attending the Medically Assisted Therapy Clinic at a referral hospital in Nairobi. Findings: Most participants were male 85.7%, with a mean age of 34.3 years (SD 8.6). The majority had primary and below level of education 48.8%, were employed 59.5%, and were single/separated/widowed 78.4%. All the participants had used at least one other substance apart from opioids. The most common substances were; tobacco 91%, followed by cannabis 82.9% and benzodiazepines 51.5%. At 6, 12, 18, and 24 months, negative urine opioid screens were 61.3%, 76.0%, 73.5%, and 81.4%, respectively. At 24 months, 81.3% of the participants were still active in treatment. Conclusions: Many of the patients attending the Medically Assisted Therapy clinic use more than one substance. Many patients had a negative urine opioid screen at 24 months; this replicated the evidence for the efficacy of medications for Opioid Use Disorders. Recommendations: There is a need to scale up the program to also offer free management for other substances. Further studies are needed to explore why some patients continue to use opioids while in the program. Recent Publications 1. Cowan E et al., 2023 Urine Toxicology Profiles of Emergency Department Patients With Untreated Opioid Use Disorder: a Multi-Site View. 65(4):e357–65. 2. MacNeill L et al., 2020. Client characteristics and substance use patterns in different models of methadone maintenance therapy 25(4):377–81. 3. Cicero TJ et al., 2020. Polysubstance Use: A Broader Understanding of Substance Use during the Opioid Crisis. 110(2):244–50. 4. Anh Le T et al., 2019. Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic. 16:3277. 5. Le TA et al., 2019. Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic. 16(18):3277.

Biography :

Kuria is a Consultant Psychiatrist at Mathari National Teaching and Referral Hospital. She has worked at the facility for the past ten years. She earned a Bachelor of Medicine, and Bachelor of Surgery, and a Master of Medicine in Psychiatry from the University of Nairobi. She is an International Certified Addiction Professional (ICAP II) trained by the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) in collaboration with The Colombo Plan. She also received Global Mental Health online training from the University of Washington. She is a dedicated and passionate mental health provider in various topics, especially addiction Psychiatry, maternal mental health, liaison psychiatry, adolescent psychiatry, forensic psychiatry, and geriatric psychiatry, among others. She is an early- career researcher with a keen interest in mental health research. She envisions affordable, accessible and quality mental health services for all.