Prevalence Of Cannabis Use Among Patients Attending Themethadone Clinic At Mathari National Teaching & Referral Hospital: A Retrospective Study

Abstract

Background: There is a dearth of evidence on cannabis use among patients receiving methadone in Kenya as the medically assisted therapy (MAT) program is still fairly new in the country. However, polysubstance use especially cannabis is the most commonly used illegal drug by patients on methadone therapy resulting in compromised treatment outcomes. Study Objectives: This study sought to determine the prevalence of cannabis use among patients on methadone treatment at Mathari National Teaching & Referral Hospital. The objectives were to determine the prevalence of cannabis use and the socio-demographic characteristics of patients receiving methadone who use cannabis at MNRTH methadone clinic from December 2014 to November 2018. Methods: This was a retrospective study of 984 patients on methadone therapy at Mathari National Teaching & Referral Hospital from December 2014 to November 2018, using their medical records. We collected data on socio-demographics and drug use through urine drug screens. Data was analyzed using SPSS for windows version 23.0. We used frequency and proportions, chi-square and Fischer Exact test for analysis. Results: The prevalence of cannabis use in participants was 62.8%. Majority of cannabis users were male (88.1%), aged 28-37 years (42.2%), unemployed (74.3%), had low level of education (87.7%) and single (72.4%). Comparing cannabis users and non-cannabis users, statistical differences were observed in the proportions for age, university education and participants who were married. Conclusion: The high prevalence of cannabis use among patients in Nairobi receiving methadone underscores the need for addressing this public health burden. Mental health care professionals in MAT clinics should exercise due diligence in the monitoring and screening of cannabis use through administering the cannabis use disorder identification test (CUDIT) questionnaire to assess for dependence among patients on methadone therapy. Better clinical interventions such as targeted psychotherapy and social support should be conducted to promote MAT retention and long-term recovery outcomes. Policy makers such as Ministry of Health and other agencies should develop appropriate protocols and comprehensive programs for targeted management of this population. Recommendation: To build upon our study findings, we recommend exploratory studies on the drivers for cannabis use in patients receiving methadone and interventions for this gateway drug. Future researchers need to conduct longitudinal studies to assess which pattern of cannabis use results in cannabis use disorder. In our study, more individuals were lost to follow up due to cannabis use compared to noncannabis use thus, more prospective cohort studies on the impact of cannabis use on treatment outcome would be necessary.