Addiction is a trap, as many caught in its clutches can testify. It is a perpetual chase, with fleeting highs and enduring lows, and the more it devastates a community, the more those who abuse it seek solace in it. As a result, the conversation around drugs and what needs to be done to contain the damage that they cause is a difficult one, and is easy to forget that at the heart of this conversation are countless stories of people whose lives have been changed irreversibly, and who are trying to pick up the pieces.
In Kenya, it is estimated that at least 26,000 people are injecting hard drugs, with a majority of these using heroin. Additionally, 234,855 persons are addicted to cannabis, a significant portion of whom within the 25-35 age bracket. These figures by the National Authority for the Campaign Against Alcohol and Drug Abuse, NACADA, are not just statistics, they are stories of people caught in a system that is struggling to balance between compassion and justice.
Kenya’s Narcotics, Drugs and Psychotropic Substances Control Amendment Act of 2022 states that possession of drugs is a criminal offence, regardless of whether one intended to consume the drugs or to sell them. As a result, addicts caught in possession of drugs often end up in prison, where they are often unable to access rehabilitation services. While this may seem to be just in the eyes of the law, and in the opinion of authorities such as NACADA, there are those who believe that an addict should be treated differently, and that rehabilitation, not imprisonment, should be the priority.
“You know, somebody who is an addict is actually a sick person, whether of heroine or cocaine. The best thing is to treat this person. When you imprison that person, I don’t think imprisonment will be a deterrent enough for this person to stop taking those drugs,” asserts Dr. Robert Pukose, chair of the Committee of Health in the Kenya National Assembly. The committee is contemplating the idea of drug decriminalisation or amnesty, specifically for those found in drug possession for personal use, seeking a shift in how Kenya confronts its drug crisis.
This conversation around drug decriminalisation comes on the heels of a benchmarking visit to Mauritius by members of the National Assembly’s Health Committee and the Parliamentary caucus against drug abuse in November 2023. The visit was sponsored by the United States Agency for International Development, USAID, as a way for Kenya and Mauritius to exchange best practices in drug abuse management.
Mauritius was chosen because the island nation’s government extensively funds rehabilitation, and treats drug abuse as a chronic mental health condition. This approach is very different from Kenya, where majority of drug rehabilitation facilities are private, with the few public facilities that exist being heavily strained as a result. Mauritius also includes a budget allocation for treatment, and includes the provision of rehabilitation in public primary health care facilities, rather than within specialised health facilities as is the case with Kenya.
The Human Cost of Addiction
Andrew*, aged 48, has used heroin for most of his adult life. Andrew is not his real name, and he wants to use an alias, not out of the desire for anonymity, but as a shield against the judgment and stigma that he has endured for the entirety of his drug addiction journey. From our initial interaction, he was apprehensive, not wanting to share about his struggle, but with time, Andrew opened up and told his story of addiction, a tale darkened from an early age with the permanence of substance abuse.
Pulling up his sweatshirt sleeves, Andrew exposes a map of scars crisscrossing his arms, “There is no place in my body, that I haven’t injected myself, including my buttocks”, he admits, and this confession was punctuated by a nervous laugh that briefly filled the air, only to dissolve into a weighted silence. This silence underscores the tragedy that has followed him for the entirety of his adult life, tracing back to an innocent day in late 1990 when he first experienced the powdered allure of heroin in downtown Nairobi.
As a matatu tout, Andrew had easy access to money, and the decision to explore heroin, he remembers, was an easy one. He soon became ensnared in the web of heroin, which he continuously referred to as “kete”, and he found himself living for the next high. However, the consequences soon caught up with him, and he ended up spending four years in prison from 1998 to 2002 for heroin possession. Behind bars, he encountered a system indifferent to his addiction, and which had its own drug distribution system in place. “Those days they (the prison wardens) never cared if you were an addict or not”, he says, adding, “I met people I knew there, they introduced me to Artane and a drug called “C”. The drugs came from outsiders and my friends would mix it for me, so that I get to sleep and eat.”
Artane is the trade name of Trihexyphenidyl, also known as THP, benzhexol or trihex. It is used to treat stiffness, tremors, muscle spasms, and poor muscle control, and is often used in management of Parkinson’s disease. Aside from managing Parkinson’s, Artane has also been used recreationally due to its hallucinogenic properties. It may be used to manage the symptoms of withdrawal from heroin after long term use, which include muscle aches and stomach cramps.
Andrew’s addiction and incarceration experience finds a haunting echo in the story of Najma*, also not her real name, a 22-year-old mother of a three-month-old infant, arrested on a misdemeanour charge in 2023.
For Najma, the initial weeks in prison were a descent into hell. “I tried talking to the officers there to seek medical help for me because I was a heroin user,” she recalls, “But they all pointed out that my circumstance was of my own doing, and that I shouldn’t have begun using in the first place.”
It took the intervention of an outreach counsellor for Najma to enrol in the Methadone treatment program at Mathari Rehabilitation Center, located in the Mathari National Referral, Training and Research Hospital. Methadone is a synthetic opioid that is used to treat opioid use disorder, as is the case with heroin addiction. It acts by binding to opioid receptors in the brain which heroin also binds to, but do not cause the same feeling of euphoria, thereby reducing the intense drug craving and compulsive use that addicts would otherwise go through.
Najma had to go through withdrawal for two weeks before she was able to go to Mathare Rehabilitation Centre for her daily methadone dose.
While prison could be the first point of change for some of these addicts, John Ochola, an outreach officer and community paralegal in Nairobi, believes that prison does not offer the best environment for recovering addicts.
“Prison doesn’t offer a well balanced meal that a recovering addict requires”, Ochola says. “That is why we are pushing for better meals for addicts behind bars.”
Andrew and Najma’s experiences in prison were vastly different. Starting in 2002, a wave of prison reforms were introduced, spearheaded by then-Home Affairs Minister Moody Awori, with the hope of improving living conditions and management practices within prisons. These reforms emphasized rehabilitation and reform over outright punishment, and included the introduction of adult education, mental health services, and substance abuse treatment as a way to reduce recidivism – the likelihood that a prisoner would re-offend after being released and end up in prison again. While these reforms were introduced as Andrew was leaving prison, Najma encountered a system that had structures that enabled her to access addiction treatment, leading to vastly different outcomes.
Kenya’s Legal Landscape
In Kenyan law, legal and criminal liability is consistent between users and peddlers or traffickers, with the differentiation being the severity of punishment. Under the Narcotics, Drugs and Psychotropic Substances Act, individuals found in possession of cannabis solely for personal consumption face a maximum sentence of five years imprisonment or a fine of up to one hundred thousand shillings.
For those caught with less than one gram of a narcotic drug or psychotropic substance other than cannabis, the penalties are significantly harsher – a minimum fine of five million shillings or a minimum imprisonment term of five years, or both.
Dr. Pukose, the chair of the National Assembly Health committee, believes that any move towards drug amnesty must begin with amendments to this law. “An addict is different from somebody who is engaging in trade,” he emphasises. “Public participation will help determine the acceptable thresholds for personal use.”
While NACADA has explored the idea of non-custodial sentences for drug offenders, drug decriminalisation is still out of the question, as Daniel Konyango, Manager of Legal Services at NACADA, states, adding that it goes against their core mandate of freeing the nation from alcohol and drug abuse. “We support all legal processes and even legislative processes”, Mr Konyango states, adding, “We will ensure that none or as little drugs or as few cases of drug incidents are in the society. But, preferably none at all is within the populations.”
Mr Konyango points to provisions in the legal framework that allow the courts to commit drug offenders to treatment or rehabilitation programs, and that there is a further provision in the law to finance these alternative avenues through the fines imposed by the Narcotics law. However, he maintains that NACADA’s stance is for total prohibition rather than leniency. “The bigger picture”, he says, “is that society is safer without drugs than with treating kindly people who have used and are addicted to drugs. The premium should be placed on supply reduction, because if that were to be realised you would not have the resultant challenges of rehabilitating.”
Lessons from Portugal and Beyond
The dialogue on drug decriminalisation has gained traction in recent years, as nations seek innovative approaches to tackle substance abuse and its repercussions. One groundbreaking example hails from Portugal, once plagued as the heroin capital of Europe.
In 2001, Portugal embarked on a transformative journey by decriminalising the public and private use, acquisition, and possession of all illicit drugs, provided they don’t exceed a 10-day personal supply. This bold move shifted the paradigm, reframing drug use as a misdemeanour rather than a felony.
Instead of punitive measures, individuals caught with personal supplies faced warnings, nominal fines, or consultations with a local commission comprising a doctor, lawyer, and social worker. This holistic approach prioritised harm reduction over criminalisation, fostering avenues for addiction treatment, harm reduction, and support services.
This led to notable decline in overdose fatalities and HIV transmission through drug injections. Inspired by Portugal’s triumph, other nations are following suit. Canada, for instance, has initiated comparable programs, permitting possession of opioids up to 2.5 grams for individuals over 18 years old. This pioneering experiment, launched in British Columbia in January 2023 and slated to run until January 2026, underscores a global shift towards compassionate, evidence-based drug policies.
Closer home, the conversation on drug policy reform is gaining momentum. In 2019, West African ministers of Health presented the Model Drug Law, a set of recommendations aimed at addressing the region’s status as a major transit hub for illicit drugs. The proposed law emphasises a shift away from punitive measures, stating that personal possession and use of controlled substances should not be criminalised.
Ghana has already taken significant steps towards reform, with legislation converting prison terms for personal drug possession into non-custodial alternatives, albeit with provisions for financial penalties and limited jail time for non-payment.
NACADA’s Daniel Konyango believes that the availability of rehabilitation services was instrumental in helping individuals transition away from harmful drug use and towards healthier lifestyles, contributing to the overall success of Portugal’s decriminalisation approach. “We have suggested the implementation of a rehabilitation fund, as outlined in the 1994 Act, which, despite being proposed, has yet to be put into action. This fund, intended to receive proceeds from crimes associated with drugs, would serve as a financial resource for rehabilitation programs,” he adds.
Civil society organizations like KUZA TRUST are at the forefront of promoting and protecting the health and human rights of people with intersectional vulnerabilities. One way that they seek to do this is through advancing the idea of drug decriminalisation.
According to Chris Abuor, the executive director at KUZA TRUST, drug addiction needs to be addressed from a public health perspective. “It is imperative to establish a national law that firmly integrates harm reduction principles”, he says. “Equally vital”, he adds, “is the implementation of laws at the subnational level, ensuring that all counties have comprehensive harm reduction legislation or guiding frameworks in place.” Chris emphasises that these measures are essential to safeguarding, valuing, and inclusively supporting individuals grappling with addiction.
I support Harm Reduction for people who use drugs. I support a health and human rights-driven approach that values support over stigma and coercion to abstinence. I support drug policies based on evidence, not ideology, and not moral objection. #HarmReduction @KuzaTrust pic.twitter.com/LtxGewTN4G
— Christopher Abuor (@MaAbuor) August 31, 2023
As Najma and Andrew persevere through the shadows of stigma, their stories epitomises the silent struggles endured by countless others ensnared in the web of addiction. Meanwhile, within the corridors of power, the National Assembly grapples with the weighty decision of drug decriminalisation, a choice laden with moral and legal implications.
Ultimately, the path towards drug decriminalisation in Kenya is fraught with uncertainty, as policymakers weigh the balance between compassion and law enforcement. While some advocate for a shift towards harm reduction and rehabilitation, others emphasise the importance of stringent drug laws to curb substance abuse. As Najma and Andrew navigate the harsh realities of stigma and incarceration, their stories serve as poignant reminders of the human cost of addiction. In the end, the fate of Kenya’s drug policy rests in the hands of its citizens and leaders, who must confront the uncomfortable truths of addiction and chart a path forward that prioritises compassion, justice, and public health.
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