Prevalence of Psychiatry and Other Substance Use Disorders Among Heroin Users on Methadone Maintenance Therapy (Mmt) at Ngara Clinic, Nairobi County.

Abstract

Background: Individuals attending Methadone Maintenance Treatment (MMT) frequently present with coexisting psychiatric ailments. Heroin is considered one of the most commonly used drugs which is also dangerous to the health of injecting drug users (IDUs). Psychiatric ailments place these persons at an elevated danger of utilizing other psychotropic substances generating the growth of numerous substance use disorders. Besides, co-occurring psychiatric disorders are associated with a heaving danger of continuous heroin use which in turn leads to addiction. Objective: The broad objective of this study was to identify the prevalence of psychiatry and other substance use disorders among heroin users attending Methadone Maintenance Therapy at Ngara Methadone Clinic in Nairobi County. Study Utility: This study sought to fill the gap by advancing the available literature. The study identified the prevalence and patterns of drug use among clients attending Ngara Methadone Clinic. The study will be of greater importance in that it assessed the severity of the psychiatric comorbidities among individuals on Methadone Maintenance Therapy. Study Design: A descriptive cross-sectional study design was employed in this study. This method was appropriate for this study since it helped in examining the association between psychiatric disorders and other substance use disorders. Methods: 235 participants attending methadone maintenance therapy at Ngara Clinic were recruited. The study used a systematic sampling technique; the sampling interval was calculated by dividing the population size by the desired sample size. The clinicians at the Ngara MAT clinic helped in identifying clients who meet the eligibility criteria. After identifying the potential xii study participants, the researcher administered the Mini-Mental Status Exam to access the clients’ ability to answer questions as required. Those who failed to meet the threshold were excluded from the study. The researcher then explained the purpose and aim of the study to the study participants. The risks and benefits of the study were also explained. Those willing to participate signed the consent forms while those not willing to participate were excluded from the study. Results: Results of the study showed that 30.6% (n=72) presented with symptoms of Major Depressive Episode-Current (C.I. 25.1; 36.6), while 29.8% (n=70) had experienced Major Depressive Episode in the past (C.I. 24.3; 36.2). Moreover, 9.8% (n=23) had contemplated suicide (C.I. 6.4; 14.0), 6.8% (n=16) presented with Suicidal ideations (C.I. 3.8; 10.2), 2.6% (n=6) with Manic Episodes (C.I. 0.9; 4.7), 2.6% (n=6) had Hypomanic Episodes (C.I. 0.9; 4.7), 2.6% (n=6) had Bipolar 1 Disorder (C.I. 0.9; 4.7), 0.4% (n=1) had experienced panic attack (C.I. 0.0; 1.3), 0.4% (n=1) had agoraphobia (C.I. 0.0; 1.3) while 7.2% (n=17) presented with Socio Anxiety Disorder (C.I 4.3; 10.6). In addition, 0.4% (n=1) presented with Obsessive Compulsive Disorder (C.I 0.0; 1.3), 16.2% (n=38) presented with Post-Traumatic Stress Disorder (C.I 11.5; 20.9), 0.4% (n=1) with Psychotic Disorder (C.I. 0.0; 1.3), 3.8% (n=9) presented with Generalized Anxiety Disorder (1.3; 6.4), while 6.4% (n=15) presented with Antisocial Personality Disorder (C.I. 3.4; 9.4). Conclusion: The study suggests that there are a high prevalence of psychiatry and other substance use disorders among heroin users. However, the study found differences in the socio-demographic characteristics among the participants. The study, therefore, guides future research, especially in a bid to examine the pattern of polysubstance use among clients on MMT