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Addiction is the continued use of a mood altering substance or behavior despite adverse dependency consequences, or a neurological impairment leading to such behaviors.

Addictions can include, but are not limited to, alcohol abuse, drug abuse, exercise abuse, pornography and gambling. Classic hallmarks of addiction include: impaired control over substances/behavior, preoccupation with substance/behavior, continued use despite consequences, and denial.

How does addiction start?

People try drugs or other potentially addictive behavior because they are seeking some sort of reward or benefit. Those who take drugs, for instance, do so because of the physical effects they hope to experience. Drugs have a marked effect on the body and mind. If there were no effect, people would be unlikely to repeat the experience. No one sets out just to become addicted.

Who’s at risk of addiction?

What makes some people more susceptible to becoming dependent or addicted is perhaps a genetic predisposition. This theory, with some evidence to support it, makes sense especially since addiction crosses social divides. However, this is still debatable.

There are also cultural and social factors that put people at greater risk. For instance, you’re less likely to become alcohol-dependent growing up in a country where alcohol consumption is unacceptable than where it’s a normal part of everyday life. Growing up in a family where there’s alcohol or drug abuse increases the risk. This is also the case for people who suffer childhood trauma, abuse and neglect.



Poverty, a lack of education and unemployment can also increase the risks. If your environment is stressful and you feel unable to change it, you may turn to substances for relief. Significant life events may contribute. If your inner world is in turmoil, you may turn to substances as medication to feel better.

People who don’t receive adequate nurture as children or who are more emotionally sensitive may be more susceptible. These factors won’t always lead to substance misuse or dependency or any other addictive behavior, but they can increase vulnerability.


Since addiction aspects all aspects of a human person, treatment should likewise focus on all aspects namely physical, psychological, spiritual and social.

Components of Comprehensive drug treatment:

  • Medical Management e.g. detoxification, ailments care, nutritional therapy, pharmacotherapy
  • Occupational therapy: teaching of skills and attitudes necessary to gainfully earn a living
  • Psychosocial therapies and counseling (individual, group, family)
  • Re-integration into normative society
  • The professionals employed in the process of addiction treatment are doctors, nurses, social workers, psychologists, and addiction counselors, occupational and family therapists.

Levels of Care

  • Level I: Outreach & prevention programmes
  • Level II:Risk Reduction (Early Intervention)
  • Level III: Non-Residential (Day Care/Out-patient)
  • Level IV: Residential/In-Patient
  • Level V: After Care

Prescription Drugs

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What Is Prescription Drug Abuse?

Prescription drug abuse is when someone takes a medication that was prescribed for someone else or takes their own prescription in a manner or dosage other than what was prescribed. Abuse can include taking a friend’s or relative’s prescription to get high, to treat pain, or because you think it will help with studying.

What Are the Most Commonly Abused Prescription and Over-the-Counter Drugs?

Opioids (such as the pain relievers OxyContin and Vicodin), central nervous system depressants (e.g., Xanax, Valium), and stimulants (e.g., Concerta, Adderall) are the most commonly abused prescription drugs. Drugs available without a prescription—also known as over-the-counter drugs—can also be abused. DXM (dextromethorphan), the active cough suppressant found in many over-the-counter cough and cold medications, is one example. It is sometimes abused to get high, which requires large doses (more than what is on the package instructions) that can be dangerous.

How Are Prescription Drugs Abused?

It depends—some people take other people’s drugs for their intended purposes (to relieve pain, to stay awake, or to fall asleep). Others take them to get high, often at larger doses than prescribed, or by a different route of administration. Most prescription drugs come in pill or capsule form. Sometimes, people who abuse prescription drugs break or crush the pill or capsule, then swallow the drug, sniff it, or “cook” it—turn it to liquid—and then inject it.

What’s Wrong With Abusing Prescription Drugs?

Virtually every medication presents some risk of undesirable side effects, sometimes even serious ones. Doctors consider the potential benefits and risks to each patient before prescribing medications. They understand that drugs affect the body in many ways and take into account things like the drug’s form and dose, its possible side effects, and the potential for addiction or withdrawal. For example, doctors know how to change the dose of a painkiller to prevent withdrawal symptoms. People who abuse drugs might not understand how these factors may affect them or that prescription drugs do more than cause a high, help them stay awake, help them relax, or relieve pain.

Form and dose. Doctors know how long it takes for a pill or capsule to dissolve in the stomach, release drugs to the bloodstream, and reach the brain. They also take into account a person’s weight, how long they’ve been prescribed the medication, and what other medications they are taking. When abused, prescription drugs may be taken in inappropriate doses or by routes of administration that change the way the drugs act in the body, risking overdose. For example, when people who abuse oxycodone (OxyContin) crush and inhale the pills, a 12-hour dose hits their central nervous system all at once—which increases their risk of addiction and overdose.
Side effects. Prescription drugs are designed to treat a particular illness or condition, but they often have other effects on the body, some of which can be dangerous. These are referred to as side effects. For example, OxyContin stops pain, but it also causes constipation and drowsiness and slows breathing. Stimulants such as Adderall increase attention but also raise blood pressure and heart rate. These side effects can be made worse when prescription drugs are not taken as prescribed or are abused in combination with other substances—including alcohol, other prescription drugs, and even over-the-counter drugs, such as cold medicines. For instance, some people mix alcohol and benzodiazepines (e.g., Valium), both of which can slow breathing. This combination could stop breathing altogether, requiring emergency care, or worse—it could be fatal.
Addiction. Studies show that when people take a medication as it is prescribed for a medical condition—such as pain or attention deficit hyperactivity disorder (ADHD)—they usually do not become addicted, because the medication is prescribed in dosages and forms that are considered safe for that person. The drug is compensating for a problem, which makes the person feel better, not high. But medications that affect the brain can change the way it functions—especially when they are taken repeatedly or in large doses. They can alter the reward system, making it harder to feel good without the drug and can lead to intense cravings, which make it hard to stop using. This is no different from what can happen when someone takes illicit drugs—and addiction is a real possibility.
Withdrawal. Taking drugs repeatedly over a period of time can cause changes in the body as well as the brain, resulting in physical dependence (which is different from addiction). That is, the body adapts to the drug’s presence, and when its use is abruptly stopped, the person can experience withdrawal symptoms. This can happen even in someone who is prescribed medications and takes them appropriately—which is why a physician should be consulted when stopping prescription medications as well as when starting them. The withdrawal symptoms depend on the drug itself—for opioids, they can include nausea, chills, vomiting, muscle pain, and diarrhea. These symptoms can often be controlled or diminished with proper medical supervision.



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In Kenya, the current usage of tobacco products is 8.6% it is largely limited to males. Data shows that 16.8% of the males are current users of tobacco products. This contrasts sharply with 2.1% of the females. Across regions, data is overwhelming in pointing at men as the critical users of tobacco products.

Tobacco Effects

Respiratory problems such as increased coughing, phlegm, wheezing, chest colds and shortness of breath.
Serious ailments such as bronchitis, pneumonia, emphysema, strokes, heart attacks, ulcers, ear infections, osteoporosis and impotence.
Asthma attacks or increased asthma symptoms.
Dental problems such as yellow teeth, gum disease, tooth decay and tooth loss.
Dulled sense of smell and taste.
Cold fingers and toes.
Zits –It takes longer for a smoker’s acne to heal.
Hair loss –even for some teens.
Low sperm count: Even teenage smokers have fewer than half as many sperm per ejaculate as non-smokers.
Premature wrinkling and related signs of premature aging.
Infertility, sudden infant death syndrome and low birth-weight babies.

Statistics and Trends

On average, smokers lose 15 years of life.
Tobacco kills 1,200 people A DAY.
Researchers estimate that 50% of smokers who began smoking when they were young will die of a smoking related illness.
Smokers have more colds than non-smokers because their bodies aren’t as efficient at clearing out germs.
Four out of five lung cancers are caused by smoking.
Nine out of 10 people who get lung cancer die from the disease, usually within two years of diagnosis.
More people die from smoking than from AIDS, car accidents, suicide, murder, fires and other drugs COMBINED.

In Kenya, the current usage of tobacco products is 8.6% it is largely limited to males. Data shows that 16.8% of the males are current users of tobacco products. This contrasts sharply with 2.1% of the females. Across regions, data is overwhelming in pointing at men as the critical users of tobacco products. Central region leads with 22.6% of the males interviewed reporting that they use tobacco products. This is closely followed by Nairobi at 22.5%. For females, Eastern region leads with 5.7% of the females interviewed reporting that they use tobacco products.



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Immediate effects of alcohol on the brain and body

The first few drinks affect judgment and reaction time.
More alcohol causes reactions to become even more sluggish and delays physical coordination.
Far too much alcohol can suppress some body functions and, in extreme cases result in death.

The physical effects of alcohol

From the second you take your first sip, alcohol starts affecting your body and mind. After one or two drinks you may start feeling more sociable, but drink too much and basic human functions, such as walking and talking become much harder. You might also start saying things you don’t mean and behaving out of character. Some of alcohol’s effects disappear overnight – while others can stay with you a lot longer, or indeed become permanent.
If you’ve drunk heavily the night before, you’ll almost certainly wake up with a hangover. Alcohol irritates the stomach, so heavy drinking can cause sickness and nausea and sometimes diarrhoea. Alcohol also has a dehydrating effect, which is one reason why excessive drinking can lead to a thumping headache the morning after.


Drinking too much alcohol isn’t good for your skin either. As well as causing bloating and dark circles under your eyes, alcohol dries out your skin and can lead to wrinkles and premature aging. If you drink heavily you may develop acne rosacea, a skin disorder that starts with a tendency to blush and flush easily and can progress to facial disfiguration, a condition known as rhinophyma.

Alcohol poisoning

In the worst cases alcohol poisoning can cause lung damage (as you inhale your own vomit) and even lead to a heart attack.
Many traditional ‘cures’, such as drinking black coffee; just don’t work – or even make things worse.

Diseases and cancers

Liver disease
Liver disease used to affect mainly drinkers in middle age, but now sufferers are getting younger. Up to one in three adults drinks enough alcohol to be at risk of developing alcohol-related liver disease.


Alcohol misuse is an important factor in a number of cancers, including liver cancer and mouth cancer, both of which are on the increase. Alcohol is second only to smoking as a risk factor for oral and digestive tract cancers.
Evidence suggests that this is because alcohol breaks down into a substance called acetaldehyde, which can bind to proteins in the mouth. This can trigger an inflammatory response from the body – in the most severe cases, cancerous cells can develop.

Pancreatitis and diabetes

Chronic pancreatitis is another disease associated with heavy drinking. It’s caused when your pancreas becomes inflamed and cells become damaged. Diabetes is a common side effect of chronic pancreatitis. There’s evidence that heavy drinking can reduce the body’s sensitivity to insulin, which can trigger Type 2 diabetes.
For more information read our Alcohol and pancreatitis factsheet and Alcohol and diabetes factsheet.

Heart disease

While studies suggesting that alcohol can help heart disease often hit the headlines, the reality is that the jury’s still out on the extent of any benefits. And it is clear that any benefits which there may be are limited to very low levels of consumption – probably no more than 1 unit alcohol per day.

Mental health

Alcohol alters the brain’s chemistry and increases the risk of depression. It is often associated with a range of mental health problems A recent British survey found that people suffering from anxiety or depression were twice as likely to be heavy or problem drinkers.

Extreme levels of drinking (defined as more than 30 units per day for several weeks) can occasionally cause ‘psychosis’, a severe mental illness where hallucinations and delusions of persecution develop. Psychotic symptoms can also occur when very heavy drinkers suddenly stop drinking and develop a condition known as ‘delirium tremens’.

Heavy drinking often leads to work and family problems, which in turn can lead to isolation and depression. For heavy drinkers who drink daily and become dependent on alcohol, there can be withdrawal symptoms (nervousness, tremors, palpitations) which resemble severe anxiety, and may even cause phobias, such as a fear of going out.


If you drink large quantities of alcohol on a regular basis you run the risk of becoming addicted. This can have serious effects on their families, friends and partners, as well as their mental health.

Statistics and Trends

Current use of alcohol is defined as those reporting use of alcohol in the last one month. About 16.6% of urban dwellers are current users of various types of alcohol compared to 11.4% of rural dwellers. This represents a marginal decline from the estimates of the 2007 rapid assessment survey. Besides North Eastern and Central regions where current usage of alcoholic drinks is less than 10%, in all other provinces at least 10% of the residents are current alcohol consumers. Considering individual alcoholic beverages, Nairobi has the highest current usage of packaged/legal alcohol (15.7%) followed by Central (9.2%). For chang’aa, Nairobi has the highest current usage (7.2%) followed closely by Western (7.1%). Rift Valley has the highest current usage of traditional liquor (6.0%) followed by Nyanza (5.1%). For current usage of 2nd generation alcohol, it is highest in Rift Valley (2.0%) followed by Nairobi (1.3%).


Inhalants and Solvents

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Within seconds of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech, an inability to coordinate movements, dizziness, confusion and delirium. Nausea and vomiting are other common side effects.

Short-term effects

Within seconds of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech, an inability to coordinate movements, dizziness, confusion and delirium. Nausea and vomiting are other common side effects. In addition, users may experience lightheadedness, hallucinations, and delusions.
Long-term effects

Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. Additional symptoms exhibited by long-term inhalant abusers include weight loss, muscle weakness, disorientation, in-attentiveness, lack of coordination, irritability, and depression.

After heavy use of inhalants, abusers may feel drowsy for several hours and experience a lingering headache. Because intoxication lasts only a few minutes, abusers frequently seek to prolong their high by continuing to inhale repeatedly over the cours



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Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical (or neurotransmitter) associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, thus shutting off the signal between neurons

How Does Cocaine Affect the Brain?

Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical (or neurotransmitter) associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of the neurotransmitter to build up, amplifying the message to and response of the receiving neuron, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.

What Adverse Effects Does Cocaine Have on Health?

Abusing cocaine has a variety of adverse effects on the body. For example, cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea. Because cocaine tends to decrease appetite, chronic users can become malnourished as well.

Different methods of taking cocaine can produce different adverse effects. Regular intranasal use (snorting) of cocaine, for example, can lead to loss of the sense of smell; nosebleeds; problems with swallowing; hoarseness; and a chronically runny nose. Ingesting cocaine can cause severe bowel gangrene as a result of reduced blood flow. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV and other blood-borne diseases. Binge-patterned cocaine use may lead to irritability, restlessness, and anxiety. Cocaine abusers can also experience severe paranoia—a temporary state of full-blown paranoid psychosis—in which they lose touch with reality and experience auditory hallucinations.

Regardless of the route or frequency of use, cocaine abusers can experience acute cardiovascular or cerebrovascular emergencies, such as a heart attack or stroke, which may cause sudden death. Cocaine-related deaths are often a result of cardiac arrest or seizure followed by respiratory arrest.

Added Danger: Cocaethylene – when cocaine and alcohol are consumed together, the body forms a unique cocaine metabolite named cocaethylene. It is unique because it is formed only during the combined ingestion of cocaine and alcohol. (The name “cocaethylene” is derived from the words “cocaine” and “ethyl alcohol.”) It is unique also because it is the first known example of the body forming a third drug following ingestion of two other drugs. It is not a natural alkaloid of the coca leaf, and is not found in street cocaine.

Polydrug use—use of more than one drug—is common among substance abusers. When people consume two or more psychoactive drugs together, such as cocaine and alcohol, they compound the danger each drug poses and unknowingly perform a complex chemical experiment within their bodies. Researchers have found that the human liver combines cocaine and alcohol to produce a third substance, cocaethylene that intensifies cocaine’s euphoric effects. Coca ethylene is associated with a greater risk of sudden death than cocaine alone.

Statistics and trends

Global cocaine use has remained stable at 0.3-0.4 per cent of the population aged 15-64 (between 13.2 million and 19.5 million users) but there have also been some shifts in its use, with a substantial decrease in the prevalence of cocaine use in North America and in some countries in South America and indications of increases in Oceania, Asia, Africa and some countries in South America.

In 2010, the regions with a high prevalence of cocaine use remained North America (1.6 per cent), Western and Central Europe (1.3 per cent) and Oceania (1.5-1.9 per cent) the latter effectively reflecting its use in Australia and New Zealand. While global estimates of cocaine use have remained stable at 0.3-0.4 per cent of the population aged 15-64 (between 13 million and 19.5 million users), a substantial decrease was reported in North America and some countries in South America, with the annual prevalence of cocaine use in North America decreasing from 1.9 per cent in 2009 to 1.6 per cent in 2010.
The current prevalence rate of cocaine is 0.1% in Kenya.



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Central Nervous System

Bhang affects the perception of time, distance, and speed. It upsets coordination, causing unsteady hands, a change in gait, uncontrolled laughter, and a lag between thought and facial expressions. Sexual functions are disturbed.

One may suffer illusions and hallucinations, difficulty in recalling events in the immediate past, slowed thinking and narrowed attention span, depersonalization, euphoria, depression, drowsiness, lack of sleep, difficulty in making accurate self-evaluation, a lowering of inhibition, loss of judgment, mental and physical lethargy.

Heavy use over a long period of time cause permanent changes in the brain. It has been found, for instance, that the brains of young heavy users of cannabis reduce in size. The loss in brain substance is comparable to that normally found in people seventy to ninety years old. Progressive brain damage may explain the psychic changes that occur after heavy long-term use.

The respiratory system

Individuals who smoke Bhang/hashish for long periods show a tendency toward bronchitis. The lungs of bhang users are more blackened than those of tobacco smokers because, to get an effect, cannabis smoke must be inhaled deeper and held longer in the lungs. Indeed the concentration of THC in the lungs is much higher compared to the body as a whole.

Effects on the hormonal system

Studies have shown that testosterone, the most potent of the male sex hormones, is depressed in the blood of Bhang users, and reproductive function is inhibited. Sperm counts are lower and there is a decrease in sperm motility and an increase in number of abnormal sperm.

Bhang is anti-androgenic and the effects may translate into decreased libido and impaired fertility. In females, Bhang causes hormonal disruption of the female reproductive cycle, a suppression of ovarian function and disorders of menstruation.

The cell function

The recent work with perhaps the broadest implication is that which shows the effect of cannabis on chromosomes that carry the hereditary information for each cell. Normal human cells except the reproductive cells contain 46 chromosomes in 23 pairs. Long -term users of psychotropic substances have a higher number of broken chromosomes hence leading to birth of malformed offspring.

Another serious implication of the damage to cells is the suppression of immune response. Diminished immune results through the interference with genes that regulate the defense cells.

Statistics and trends

Cannabis remains the most widely used illicit substance globally, with an estimated annual prevalence in 2010 of 2.6-5.0 per cent of the adult population (between 119 million and 224 million users aged 15-64 years). Overall, annual prevalence of cannabis use remained stable in 2010 (2.8-4.5 per cent of the adult population in 2009), the highest prevalence of cannabis use being reported in Oceania (essentially Australia and New Zealand) at 9.1- 14.6 per cent, followed by North America (10.8 per cent), Western and Central Europe (7.0 per cent) and West and Central Africa (5.2-13.5 per cent). While the prevalence of cannabis use in Asia (1.0 – 3.4 per cent) remains lower than the global average, due to Asia’s large population the absolute number of users in Asia, estimated between 26 million and 92 million, remains the highest worldwide.

The current use of marijuana (bhang) in Kenya is (1.2%)



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Heroin is a powder obtained from the dried milk of the opium poppy plant. Pure heroin is white, but with impurities, it is brown powder

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