Cannabis and pills: Study uncovers the growing drug use among Kenyan medics

The specialties of surgery and internal medicine are most affected –Nurses not far behind

by JOHN MUCHANGI

Health01 April 2025 - 13:44

In Summary

Researchers interviewed 1,768 healthcare practitioners (doctors, nurses, and allied workers) from nearly all the counties, representing public, private and mission health facilities

When Dr Miriam*, a consultant physician in Nairobi, found herself reaching for a joint late at night, she convinced herself it was just a way to relax. A habit that began as a casual indulgence during her gruelling residency soon became a necessity.

“I wonder if my colleagues suspect something,” she recently told The Star. After all, doctors are supposed to heal, not medicate themselves. But Dr Miriam is not alone.

A new study on substance use among healthcare professionals (HCPs) in Kenya reveals a troubling trend: their use of addictive substances – including cannabis, opioids, alcohol, and prescription drugs – is increasing and is currently higher among doctors than in the general public.

About half of doctors now say they have used addictive substances.

Cannabis is the most used substance, chosen by 58 per cent of the subset of doctors who have ever used any addictive substances in their lifetime, the findings show.

The next substance of choice is tobacco (51 per cent), then sedatives such as sleeping pills (44 per cent), and alcohol (37.5 per cent).

The survey, conducted by researchers from the Brain and Mind Institute and the Department of Internal Medicine at Aga Khan University, also found that substance use among doctors is significantly higher than among other healthcare workers.

They interviewed 1,768 healthcare practitioners (HCPs) in 2023 and published their findings last week in the Plos Global Public Health journal, under the title “Substance use among healthcare professionals: A cross-sectional study in Kenya.”

Those interviewed were doctors (34 per cent), nurses (34.5 per cent), and allied staff (31.4 per cent).

The use of most substances is nearly twice as common among doctors compared to nurses and allied health workers.

The specialties of surgery and internal medicine are most affected.

“The intense nature of surgery and potentially being in life-or-death situations daily, may lead to increased substance use to help cope with work related stress,” the authors explained.

“Additionally, potentially high workloads and long hours for internal medicine physicians in Kenya may propagate unhealthy coping habits, but this theory merits further investigation.”

Dr Miriam, whose name has been changed, said her bhang use is under control and that it does not interfere with her work.

But subtle changes are beginning to surface – lapses in concentration, mood swings, and moments of uncharacteristic irritability, according to one colleague.

The researchers said while use does not necessitate abuse, it can still lead to impairment, affect the quality of care and be detrimental to patient safety.

They said many factor place all healthcare workers at a higher risk of substance use disorder.

They include “extended duration of medical training, extreme competition, stress, excessive workload, burnout, fear of failure, compassion fatigue and frequent contact with illness and death.”

The authors called for programmes to support healthcare workers from sinking into substance abuse.

In total, nearly half (51.7 per cent) of all health workers (doctors, nurses and allied workers) said they have ever used any substance in their lifetime.

“Lifetime use” refers to any use of a substance at least once over the course of a person’s life, regardless of the frequency or recency.

Those who reported “lifetime use” were then asked whether they had used the substance in the past three months, which may denote active use.

About 64.1 per cent of them (of those who have ever used any substance) admitted to drinking alcohol within the last three months. The next substance is amphetamine, which 50 per cent of those health workers have used in the last three months.

Amphetamines are highly addictive prescription drugs that stimulate the central nervous system. People with some conditions, including ADHD, take them as medication.

Cannabis follows. About 47 per cent of all HCPs who have ever used any addictive substance, reported using it in the last three months.

Other key drugs used in the last three months are sedatives (46.7 per cent), and opioids such as morphine (41 per cent).

Use of such prescription drugs is higher among Kenyan doctors partly due to the prescription privileges doctors have that nurses do not, which may lead to higher accessibility to controlled substances for doctors.

The authors said that for all of these substances, there is evidence suggesting lingering effects on cognitive abilities which may affect HCP performance, even following a period of abstinence.

“Therefore, understanding patterns of use and raising awareness of the lasting effects of substances of abuse is crucial in Kenyan healthcare settings,” they said.

The study also found that healthcare workers from private and faith-based institutions are more likely to use substances than those from public institutions.

“The reasons for this are largely unknown, however there is evidence of faith based hospitals having poor organisational structures, which could possibly lead to less regulation of substances of abuse,” the authors explained.

Participants with higher levels of education (master’s and above) were more likely to use substances.

Being single was associated with substance use. Christians were more likely to use substances.

Substance use among HCPs can play a vital role in counseling their patients.

The study refers to evidence that suggests that medics who smoked or were former smokers were less likely to counsel their patients on quitting smoking.

“This suggests that the lifestyle choices of HCPs may indirectly impact behavioral choices of their patients, though this needs to be investigated further in Kenya,” they said.

The authors are Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, and Sayed K. Ali from AKU.