Substance Use Patterns and Opioid Abstinence Rates Among Patients on Methadone Treatment at a Referral Hospital in Nairobi, Kenya.

Abstract

Abstract Background Several evidence-based assessments show that the Methadone Maintenance Treatment (MMT) is beneficial. However, patients using multiple substances at the time of enrolment has affected the outcomes of the program. Studies have indicated that patients continue to use opioids and other substances while in the program. We aimed to determine substance use patterns and opioid abstinence rates among patients who were attending the Medically-Assisted Therapy Clinic at Mathari National Teaching and Referral Hospital, Nairobi.Methods We conducted a retrospective cohort study of 713 patients who had enrolled in the Medically Assisted Therapy (MAT) clinic between December 2014 and February 2018. Data for each participant was collected over 24 months. A researcher-designed socio-demographic form and data collecting form were used to collect data. Data was analyzed using SPSS version 26.0.Results Most participants were males 611(85.7%). The mean age was 34.2 years (SD 8.55). The majority had attained primary level of education 333(46.7%), were employed 424(59.47%), and were separated 322(45.1%). All the participants had used at least one other substance apart from opioids. The commonest substances were; tobacco 649(91%), followed by cannabis 591(82.9%) and benzodiazepines 367(51.5%). At 6, 12, 18, and 24 months, opioid abstinence rates were 61.3%, 76.0%, 73.5%, and 81.4%, respectively. Abstinence rates increased from 61.3% at 6 months to 81.4% at 24 months, which was statistically significant (p < 0.001).Conclusions Majority of the patients attending the MAT clinic use more than one substance. There is a need to scale up the program to also offer free management for other substances. This study replicated the evidence of MMT among opioid users. However, there is still a need to explore further why some patients continue to use opioids while in the program.