Assessment of Psychosocial Factors Influencing Substance Use among Clients on Opioid Substitution Therapy at Mathari Methadone Clinic, Kenya.

Abstract

Substance use among individuals with Opioid Use Disorder (OUD) undergoing Opioid Substitution Therapy (OST) remains a significant challenge despite ongoing interventional measures. This study sought to assess the psychosocial factors influencing the use of drugs and substances such as marijuana, alcohol, jet fuel, and prescription drugs among clients on OST at the Mathari MAT Methadone Clinic in Kenya. The research aimed to determine the prevalence of drug use in OUD patients on OST at the Mathari MAT Methadone Clinic, examine psychosocial factors contributing to substance use among OUD clients on OST at this facility, evaluate the effectiveness of the Mathari MAT Methadone Clinic’s interventions in mitigating drug and substance use among OUD clients, and explore the correlation between psychosocial factors contributing to the use of abusive substances and the effectiveness of the Mathari MAT Methadone Clinic interventional strategies in mitigating substance use among OUD clients on OST. Across-sectional research design was used to collect data from 87 respondents through a standardized ASSIST-V3.0 questionnaire, which was adapted to suit the objectives of this research. The collected data was quantitatively analyzed using the IBM-SPSS Version 29.0, justifying a high prevalence of drug and substance use among OUD clients on OST at the Mathari MAT Methadone Clinic with 68(78.2%) out of 87 reporting to be using tobacco, 55(63.2%) using sedatives, 69 (79.3%) using cocaine, and 55 (63.2%) using marijuana daily in the past three months. Besides, findings indicated that various psychosocial factors influence these clients to resort to using other drugs and substances while on OST, with 58(66.7%) out of 87 clients reporting to have been influenced by sociocultural factors, 66(75.5%) were influenced by environmental factors, 54(62.1%) were influenced by behavioral factors, and 59(67.8%) were influenced by psychological factors. Also, findings indicated that the interventional approaches adopted by the MAT Mathari Methadone Clinic in countering OUD were not holistic and affected treatment outcomes, with 45(51.7%) OUD clients ranking them as ineffective while 42(48.3%) ranking them as effective. The findings established a positive correlation between psychosocial factors and the high prevalence of drug and substance use among OUD clients on OST. In effect, this research recommends strengthening the OST interventional measures by improving the social support systems, addressing stigma, and integrating mental health services to enhance the overall efficacy of OST programs in Kenya. This study contributes to the growing body of literature on substance use in OUD clients on OST and provides actionable insights that should be adopted to improve the OUD, drug, and substance use interventional measures.