Why Lamu drug addicts shun rehab centre and opt for methadone clinic

In April 2019, the first-ever rehabilitation centre for drug addicts was launched in Lamu, through the Kenya Red Cross Society (KRCS) sponsorship. The Sh98 million Hindi Rehabilitation Centre is at the Hindi Showground in Lamu West.

Others who partnered with KRCS to establish the centre were the Nons Verbe Foundation, the Italian Red Cross, and the Lamu County government, which provided land and offered technical support.

However, over the six years of its existence, the rehab centre has attracted very few client

s despite the prevalence of drug abuse in the region. Instead, hundreds of addicts are now turning to a recently established methadone treatment centre on Lamu Island.

The centre, known as the Medically Assisted Therapy (MAT) Clinic, is located inside the King Fahad County Referral Hospital. It was established in March 2021, just about three years after the Hindi Rehabilitation Centre was built and opened to the public.

MAT clinics are centres where drug addicts receive methadone treatment to gradually wean them off of their drug addiction cravings, particularly heroin.

Available statistics indicate that the King Fahad methadone treatment clinic has become a place of solace for many hard drug addicts compared to the Hindi Rehabilitation Centre.

From 2019 to date, the Hindi Rehabilitation Centre, which had initially been viewed as the sole saviour of the high number of drug users in Lamu, registered only 161 clients who sought services there. The centre can hold up to 100 patients at once, both men and women. It offers detox, inpatient, and outpatient services.

On the other hand, the Lamu MAT Clinic has since 2021 attended to 381 clients. This is more than double the number of drug addicts that have so far been handled at the Hindi rehab centre.

The Lamu Methadone Clinic at King Fahd County Referral Hospital in Lamu County. (Photo: Farhiya Hussein)

The Eastleigh Voice sought to understand why many drug addicts in Lamu and their families have found solace at the MAT clinic instead of going to the rehabilitation centre in Hindi.

Poverty

Those interviewed cited poverty as among the key reasons behind them abandoning the rehabilitation centre for methadone treatment.

Mohamed Khalifa, a community leader in Lamu Old Town, said the high cost of services at the rehab centre is beyond the reach of many of the drug addicts and their families.

A three-month stay at the Hindi rehabilitation centre costs not less than Sh90,000 for an addict. The money caters for food, clothing, guidance and counselling, medication, and family therapy sessions.

The facility has an innovation lab that offers training on special skills for reformed addicts.

"Most families that have people abusing drugs are poor and can’t afford the Sh90,000 to pay for rehab services. That’s why people are resorting to methadone treatment. Services there are free,” said Khalifa.

He added that although the Hindi rehab centre was viewed as a relief to residents of Lamu where bhang, cocaine, and heroin are turning many youths into zombies, it is unaffordable and inaccessible to many.

Lamu MAT Clinic Monitoring and Evaluation Officer Abdulkadir Ahmed Jeneby said that many of the afflicted individuals find rehabilitation centres unfriendly because addicts are normally contained and live in controlled conditions.

According to him, many of the addicts end up struggling to cope with the rehab lifestyle which seems to be lonely and strict. But for the methadone treatment, addicts are free to visit the clinic, take daily doses and return home.

Abdulkadir said that the high number of clients at the MAT Clinic includes individuals who had earlier been at the rehabilitation centre but later relapsed shortly after completing their treatment.

Lamu MAT Clinic Monitoring and Evaluation Officer Abdulkadir Ahmed Jeneby. (Photo: Farhiya Hussein)

“At the rehab, many times individuals feel isolated and that nobody cares about them anymore. They lack close family ties and support in their journey to recovery. Many find it an obstacle when it comes to going to rehab. That’s why they opt for the MAT Clinic,” Abdulkadir said.

Reforms

At the methadone clinic, patients are given ample time to reform as there is room for those who end up relapsing after months of methadone dosage.

“For us, relapsing isn’t a problem. It’s a step towards recovery. That’s why once we see a person resorting back to heroin use after taking methadone, we give them other chances, counsel them, and allow them to proceed with treatment. This can’t happen at the rehab where one needs to be sober always,” said Abdulkadir.

MAT clinics use methadone as a medical substitute for opioids to wean addicts off the hard stuff. The pace gives their brain a chance to slowly adjust to the absence of heroin.

Methadone helps alleviate opioid cravings and ease withdrawal symptoms with minimal risk of tolerance and compulsive opioid use.

The Lamu MAT Clinic is an initiative by the Muslims Education and Welfare Association (Mewa) and is sponsored by the United Nations Office on Drugs and Crime, through USAID in partnership with the Lamu County administration and the national government.

Aziza Shee Mbarak, the clinical officer in charge of the Lamu King Fahad MAT Clinic, said part of the success stories emerging from the facility since it started three years ago is the rebuilding of many broken families and marriages.

“Here we provide psychosocial counselling and methadone treatment among others. So far we’ve about 25 clients who have been weaned off. Some had divorced their wives and husbands owing to drugs but now they are back together again after methadone treatment. Others who had abandoned their children are now back to parenting,” said Aziza.

She said since Lamu County is vast, they have opened a branch on Faza Island in Lamu East.

Aziza Shee Mbarak, the clinical officer in charge of the Lamu King Fahad MAT Clinic. (Photo: Farhiya Hussein)

“Clients from Lamu East could not keep up with methadone treatment at King Fahad Hospital due to challenges in water travel and the fact that the areas are far apart. We’ve opened the Faza MAT Clinic and inducted about 12 clients. We’re confident many drug addicts will be assisted there,” she said.

Plans are also underway to build more MAT clinics in Hindi and Mpeketoni on the mainland to help fight the drug menace in Lamu.

But is the introduction of the methadone clinics marking the end of rehabilitation centres and services in Lamu County?

Lamu Kenya Red Cross Society Coordinator Abdulhakim Abdul, who is in charge of the Hindi Rehabilitation Centre, said despite having a low number of clients, the facility remains vital for those suffering from drugs and substance abuse.

He said between 2020 and 2023, less than ten clients were being admitted to the facility each year. For instance, in 2022, only three clients were admitted to the facility despite it having the capacity to hold between 50 to 100 patients. In 2023, only six clients were admitted to the rehab.

Abdulhakim defended the cost of services offered at the facility, arguing that various specialists, including medical staff, counsellors, and trainers run the rehab centre.

“People have been complaining about the high cost of rehab services. But we’re in discussions with the county leadership to see how they can help people struggling with addiction. Currently, we’ve 14 clients undergoing rehabilitation at Hindi rehab,” he said.