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Murimi Mutiga @murimimutiga

As Kenya and the rest of the world battle coronavirus, health experts are warning that drug users could be hit hard if the spread of virus is not stopped.

The experts say populations with Substance Use Disorders (SUDs) are more vulnerable to the virus due to the drug effects on respiratory and pulmonary health.

Apart from the underlying health issues, social marginalisation, stigma, higher economic and social vulnerabilities, including a lack of access to housing and health care, have also been cited as other factors which expose drug users to the disease.

Dr Willis Akhwale, the former Head of Disease Control at the Ministry of Health, says because Covid-19 attacks the lungs, the disease could be a serious threat to those who smoke or inject themselves with drugs. He adds  that those with a compromised lung function could be at risk of serious complications of Covid-19. 

“Smoking of bhang, cigarettes and others affects lung tissue. This decreases the number of air spaces and blood vessels in the lungs, resulting in less oxygen to critical parts of your body, this shows that if a drug user is exposed to the virus, then he or she is at high risk of serious complications of Covid-19,” he added.

Health threat

Dr Akhwale says Covid-19 is an emerging health threat to drug users and the government must enhance surveillance to curb the spread of the virus in this particular community.

“Sharing of needles, cigarettes, social distancing, stay-home orders, curfew and all other Covid-19 safety protocols are particularly hard for drugs users to adhere to. This therefore exposes them more to the disease,” he says.

“Drugs are sold in the underworld, users have to hide to take them and therefore there is need for the government to map out drug dens and disrupt the business to curb the spread of the virus,” adds Dr Akhwale.

Another concern is that users of drugs such as cocaine, heroin and methamphetamine could die from severe withdrawal symptoms due to scarcity of the narcotics.

The concerns emanate from the facts that cocaine and heroin are imported drugs and with many countries closing their borders, transportation of the substances is also constrained and thus this could lead to shortage

“Shortage in supply of these drugs means that the price will go up and because most of the drug abusers are people who are socially and economically venerable, they will result in sharing what they have, social distancing aspect cannot be there thus such people are at higher risk for infection,” the doctor says.

“What we are seeing is the likelihood of an increase in use of bhang when there is scarcity of those hard drugs. The drugs users will resort to using bhang because it is locally available,” he says.

However, anti-drug activists in Mombasa say no effort has been done to curb spread of the virus among vulnerable groups like the drug users, warning that this could be a ticking time bomb.

Citizens Against Child and Drug Abuse (CICADA) director Farouk Saad  says  supply of heroin and cocaine, which are some of the highly abused hard drugs in the country, has not been disrupted by lockdown and closure of borders in many countries.

Grave danger

“We have not seen any effort to reach out to drug users and we are seeing a grave danger if one of the addicts gets the virus. They are very vulnerable because most have very weak immune system and also do not observe the social distancing protocol,” says Saad.

“Some of the addicts sleep in groups at drug dens, they are homeless and this can expose them to environments where they are in close contact with others. This tells you that they are at higher risk,” he adds.

“We want to tell the government that any infections among the drugs users would be catastrophic, the spread of the virus could be serious and it would be very difficult and expensive to even quarantine those people,” says Saad.

Ramadhan Hussein, 31 one of the addicts under the government’s methadone programme in Kisauni, and who has been using cocaine and heroin since 2018, says he is finding it hard to comply with the safety regulations imposed by the Ministry of Health because he has no money.

“I cannot stay at home the whole day, I have  cravings and I must get my dose. If I don’t get them I  have serious withdrawal symptoms, sometimes I cannot even stand or walk.

I fear this coronavirus disease but I can’t stop injecting drugs, I have to go look for money and get the substance,” he says.

Social distancing

 Hussein says social distancing among drug users is hard because when people are high, they somehow become “slow on thinking, understanding and reasoning.”

 According to National Authority for the Campaign against Alcohol and Drug Abuse (Nacada), Coast region has the highest cases of drug abuse in the country.

The authority says there are about 17,000 drug abusers in Coast region following a baseline survey conducted in 2017.

The survey shows that 2.3 per cent of them use heroin, 0.9 per cent are on cocaine while 0.4 per cent abuse hashish.

Heroin, cocaine and chang’aa have been strongly associated with the burden of negative health. This is where the danger lies when it comes to the  coronavirus.

Saad says Mombasa, having recorded the second highest confirmed cases of the virus, is at high risk of the spread among the drug users because it is leading in the current use of heroin and cocaine.

Data from Nacada shows that Mombasa has a 12.1 per cent  heroin use while that of cocaine stands at 3.5 per cent. Lamu county is leading in the current use of hashish at 1.1 per cent among the six counties.