‘I can change my life’: Perceptions and experiences of people who use drugs engaging in MAT in Kiambu County, Kenya.

Author: Doris Burtscher, Winnie Riitho, Morris Kariuki, Angela Thiong’o, Tolbert Ayuaya, Annelotte Speelman, Edi Atte, Jesse Verschuere , Livia Tampenilli , Umberto Pellecchia , Lucy O’Connell, Tom Ellman , Janet Ngethe, Annick Antierens

Theme: Social Science & Policy Research Year: 2023

In 2020, approximately 284 million people worldwide used drugs. Heroin, cocaine, and methamphetamine is increasingly available in Africa. In Kenya, it was estimated that 26,673 people used opioids in 2021, with 3,312 of them in Kiambu County. Th MSF Kiambu People who use Drugs (PWUD) project started in September 2019. By the end of April 2022, 590 PWUD had been enrolled in the medically assisted therapy (MAT) program with a retention rate of 69.8 per cent. This study generates understanding of PWUD’s experiences regarding their lives, drug use, and their challenges in engagement with the MAT program. 

This qualitative study involved in-depth individual interviews (39), paired interviews (7), and group interviews (15). Purposive sampling was applied. Participants were selected by PWUD peer educators. Interviews were audio recorded and transcribed verbatim. Transcriptions were coded with NVivo and analysed using qualitative content analysis. Methodological triangulation enhanced interpretation. 

PWUD faced various challenges to enrol and remain in the MAT program. Respondents reported the motivation to manage withdrawal with MAT, as expressed by one female participant in a focus group: ‘I can change and transform my life’. However, replacing heroin with MAT, the ‘medicine’, was insufficient to ensure meaningful recovery. Stopping heroin use required personal motivation to exit the hotspots that their lives revolve around. Coping with changed lifestyles and behavioural patterns, and the need to develop new perspectives on dealing with ‘idleness’ were identified as barriers. Structural challenges ranged from accessing the program daily to maintaining or finding work. 

The study revealed the complex realities PWUD are confronted with when trying to stop using heroin. MAT programs need to integrate measures to address medical, psychosocial, employment and other structural factors while supporting people to restore their broken social conditions.

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