Worldwide 76.3 million persons are diagnosed with alcohol disorders.
At least 15.3 million persons are affected by disorders related to drug use, between 5 and 10 million people currently inject drugs.
Five to 10 per cent of all new HIV cases globally result from injecting drugs, where more than 1.8 million deaths in 2000 were attributed to alcohol-related risks, 205,000 deaths were attributed to illicit drug use.
The burden of substance use disorders in sub-Saharan Africa has been projected to increase by an estimated 130 per cent by 2050.
Despite this, substance use disorder treatment and prevention systems in the region remain under-resourced and the treatment gap at 87 per cent.
Untreated substance use disorders are a big public health problem.
Globally, substance use disorders are the second leading cause of disability among mental disorders with 31,052,000 (25 per cent) years lived with disability attributed to them.
In Africa, the impact of problematic patterns of substance use is, particularly, high.
In 2016, despite lower levels of alcohol consumption compared to elsewhere, the region had the highest age-standardized alcohol-attributable deaths and age-standardized alcohol-attributable disability-adjusted life years (70.6 deaths per 100,000 people and 3043.7 per 100,000 people respectively).
In Kenya, 25 per cent–30 per cent of general hospital admissions are directly or indirectly related to alcohol abuse (McCann, 1993), and 60 per cent– 75 per cent of admissions in specialized substance abuse treatment centres are for alcohol-related problems and dependence
Further compounding this situation, is the fact that substance use disorders are associated with social costs as high as Sh88,360 ($ 800) per head, emanating from their impact on productivity, crime and health systems.
In sub-Saharan Africa where the burden of substance use disorder is high and countries are struggling to end poverty, drug abusers and their families shoulder the main economic burden of drug abuse, and for every dollar invested in drug treatment, seven dollars are saved in health and social costs.
Abuse of alcohol and other substances continues to be one of the most devastating public health problems in both developed and developing countries.
Worldwide, alcohol accounted for 4 per cent of the total burden of diseases in 2000. Governments must prioritise strengthening their substance use disorders treatment and prevention systems.
In African countries, alcohol was the leading risk factor for the global burden of diseases in 2000.
Of an estimated 246,000 alcohol-related deaths in this region, about 61,000 were due to unintentional and intentional injuries (WHO, 2002), all of which could have been prevented.
Alcohol abuse is also responsible for neuropsychiatric disorders, domestic violence, child abuse and neglect, and productivity loss.
In Kenya, 25 per cent–30 per cent of general hospital admissions are directly or indirectly related to alcohol abuse (McCann, 1993), and 60 per cent– 75 per cent of admission to specialised substance abuse treatment centres are for alcohol-related problems and dependence.
Mental disorders are most affect people in urban areas accompanied by urban trauma under the influence of alcohol, and this could be the catalyst to mental health, traffic accident also among other issues in the community which can lead to poor outcomes of health.
WHO defines health systems strengthening as the process of improving the six health system building blocks which are service delivery, workforce, health information, medical products, financing and governance to achieve optimal health outcomes.
A well-functioning health system is, therefore, one that provides services that are safe, affordable, accessible and of quality, has a competent workforce that is sufficient in number.
It should also produce and disseminate health information on time, provides essential medication that is affordable and accessible, allocates adequate funds to health and finally is guided by strategic policies that can improve health outcomes.
In Kenya, the need for an effective substance use disorders treatment and prevention system is pressing.
Over 10 per cent of Kenyans aged between 15 and 65 years have an alcohol use disorder, with most of them (60 per cent) having the severe form.
Moreover, early-onset substance use is a significant problem.
In 2019, one in five adolescents reportedly used at least one substance in their lifetime.
A different survey, show the median age of onset was 11 years and considerably lower than that (16–19 years) reported elsewhere in the world.
Among both adults and adolescents in Kenya, substance use has been linked to risky sexual behaviour which is a key driver of HIV transmission in Kenya.
Unfortunately, the existing treatment and prevention systems in Kenya are inadequate.
The main legislative framework governing substance use disorder treatment and prevention, the Mental Health Act is outdated and focuses on institutional care.
Three out of over 5,000 government-run health facilities deliver treatment for substance use disorders.
Moreover, the Ministry of Health has no separate budget for substance use disorders treatment and prevention.
The writer is a youth Advocate Reproductive Health Network Kenya
Edited by Kiilu Damaris
