How medically assisted therapy helped me overcome opioid addiction

Martin Akatch walks into Jaramogi Oginga Odinga Teaching and Referral Hospital’s medically assisted therapy clinic on a sunny Tuesday morning for a routine counselling session.

After spending hours in a hall with one of his therapists, he heads to the pharmacy for medication. This has been his daily routine since 2021.

“After a counselling session, I normally receive my daily dose of methadone and then head back to school for my lessons,” says the 43-year-old primary school teacher.

Martin is neat and in good health, a complete contrast of what he looked like when he attended the first therapy three years ago.

The father of three willingly went to the facility to seek help after battling pethidine, an opioid pain relief medicine, addiction for four years.

“Those who knew me at the time I was battling addiction might fail to recognise me now. I will be completing my therapy sessions this year a fully changed person,” says a smiling Martin.

Until 2017, Martin led a normal life. Apart from teaching, he was also an author and a public speaker.

On weekends, he would go out to drink with friends at a local pub. 

Trouble began in February 2017 when Martin started experiencing extreme abdominal pain.

“At first, I did not give it much attention. Instead, I proceeded to a club with a friend the same evening after winning a football bet,” he says.

He drank and passed out only to wake up the next day at 11am with his abdomen swollen. The abdominal pain had also worsened.

Martin recalls ordering food hoping that the pain would subside, but he was wrong. It only became unbearable, forcing him to rush to the nearest health facility.

Medical tests confirmed that he had pancreatitis, a health condition resulting from excessive alcohol consumption.

“My pancreas had bruises. It would get irritated whenever the pancreatic juice, which is acidic, was released for digestion, resulting in pain.”

Doctors withdrew him from physical food consumption to limit pancreatic activity. To manage the excruciating pain, he was placed on pethidine, among other antibiotics. The drug would be injected in his body and it had a sedating effect. Martin would thus feel high and fall asleep.

Doctors warned that the drug was very addictive and should not be given to the patient frequently or without prescription.

“At first, the drug would be administered twice a day but the pain became unbearable. Barely an hour after administration, I would be crying in pain,” says Martin, adding that his prescription of pethidine was changed to a dose every six hours.

A few days later, Martin was admitted to hospital, where he stayed for three weeks. During discharge, he was advised to stop taking alcohol to avoid further damages.

He was also to reduce consumption of proteins and only take non acidic vegetables. 

But the pain came back a couple of days later.

He was rushed to the same health facility and placed on the drugs he had been on, including pethidine, and got discharged after two weeks.

A few weeks later, the pain was back, yet again. This time, however, Martin could no longer access in-patient services since he had depleted his health cover.

He resorted to buying over-the-counter drugs for treatment, including pethidine.

With the drugs, Martin could now eat physical foods although his doctor had prohibited him from doing so. To evade the pain, he would inject himself using pethidine.

 “At the time, I had been to several hospitals seeking help so I used my network of medical service providers to access the drugs.”

Pethidine would go for Sh85. At first, a nurse in the neighborhood would help with the injections. Soon after, Martin and his wife could comfortably administer the drug themselves.

“I did that for a while also seeking medical assistance whenever a chance presented itself. After a couple of months, I was healed from pancreatitis but was hooked to pethidine,” he says.

He constantly suffered from withdrawal symptoms, including feeling cold, weak, anxiety and difficulty in sleeping. After administering pethidine, he would instantly get well.

Meanwhile, his wife, who saw him administer the drug at alarming close intervals, assumed that he was still in pain.

At first, Martin would inject himself with one vial of the drug twice a day. Weeks later, he would administer between five to 10 vials per day.

“There is a day I administered 10 vials of the drug, resulting in multiple convulsions before I passed out,” says Martin, adding that his wife alerted neighbours thinking he was dead.

Later that same day, his wife found hundreds of emptied pethidine vials behind a cupboard in the house and immediately knew her husband was struggling with addiction.

Meanwhile, Martin was also struggling financially. He had borrowed loans from friends, online loan applications and banks to sustain supply of the drug.

He had also managed to form a network of friends addicted to the drug and together, they ensured each of the group members had constant drug supply.

“I was transferred to three different schools due to my addiction. The last school I moved to was in Nyakach Sub-county.” says Martin, who temporarily stopped teaching and returned to his home in Kisumu while he continued abusing the drug.

 His wife would later have him enrolled for a counselling Programme at Jaramogi Odinga Hospital’s medically assisted therapy clinic, where he has been undergoing therapy to date.

According to the World Health Organization, opioids include compounds extracted from poppy plants as well as semisynthetic compounds with similar properties that can interact with opioid receptors in the brain.

They are commonly used for treatment of pain. Their non-medical use, prolonged use, misuse and use without prescription can lead to opioid dependence and other health impacts.

Overdose of the commodity can result in death, with a 2019 WHO statistics estimating that 600,000 deaths were attributed to drug use. Close to 80 per cent of the deaths were related to opioids.

Calvin Odhiambo, a wellness and addiction specialist at Jaramogi Odinga Hospital, says the medically assisted therapy center was introduced in Kisumu in 2018 due to increasing abuse of heroin.

According to Mr Odhiambo, the facility combines psychological counseling with methadone, a drug used to reduce drug abuse cravings and withdrawals among those struggling with opioid addiction.

“Just like heroin, methadone gives a client the same ‘highness’ they get from abusing the narcotic drug. The only difference is that unlike heroin, which lasts in the system for four hours, methadone remains in one’s system for up to 24 hours,” says Mr Odhiambo.

Mr Odhiambo notes that drug use is one of the common causes of the growing cases of sexually transmitted infections due to either sexual interactions of the abusers or sharing of injection equipment.

Other health impacts of drug use include death due to factors like impaired immune systems and increased exposure to infectious diseases, as well as increasing cases of tuberculosis due to sharing of the smoked drug.

“One of the major challenges with persons diagnosed with opioid use disorder is poor health seeking behaviour due to stigma,” says Mr Odhiambo.

The medical expert doubling up as a clinical officer says the facility offers therapy to its clients for a period of 12 months while others stay longer depending on the impact of drug abuse.

He adds that the service, which is offered free of charge, has so far benefitted over 400 clients.

The facility’s major challenge is the lack of boarding facilities.

Tom Atenya, a psychiatric and a mental health nurse at Jaramogi Odinga Hospital, says the hospital’s medically assisted clinic is among two other facilities in Nairobi and Coast that were launched by the government in an effort to rehabilitate those recovering from drug and substance abuse, especially opioids.

 He says other commonly abused opioids are tramadol, a drug used for short term relief of moderate to severe pain.

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