A Revolving Door of Addiction

In the narrow, sun-drenched streets of Lamu Old Town, a public health crisis is unfolding, not in the open sale of narcotics, but in the quiet, corrosive impact of societal stigma. For hundreds of recovering drug users, the path to sobriety is a lonely one, made treacherous by the very community they seek to rejoin. The result is a devastating cycle of relapse that officials and health workers say is undermining every effort to combat the narcotics trade ravaging Kenya's coast.

Heroin, cocaine (locally known as 'unga'), and bhang are the most peddled and abused substances in the county, according to a recent report by Lamu's security agencies and Judiciary. In response, authorities and partner organisations have established treatment facilities, including Medically Assisted Therapy (MAT) clinics at King Fahd County Referral Hospital and on Faza Island, which opened in March 2021. These clinics use methadone, an opioid substitute, to wean addicts off heroin by alleviating cravings and withdrawal symptoms.

However, the statistics paint a grim picture of the programme's effectiveness in the face of community rejection. This year, the King Fahd MAT Clinic enrolled 403 individuals. As of late November 2025, only 138 remain active in the programme. While 94 have successfully completed treatment, a significant number have relapsed, their current whereabouts unknown.

The Weight of a Label

Health professionals on the front line are unequivocal about the primary cause. Juma Mwamvyoga, the addiction counsellor in charge of Lamu's MAT clinics, directly attributes the high relapse rate to persistent societal stigmatisation. "The community here has always judged drug addicts badly," Mwamvyoga stated in a November 2025 interview. "Once you're spotted visiting a methadone clinic, you're labelled as bewitched, cursed, or mentally ill. You are discriminated against by the public, friends, and even family." This creates what he calls "barriers to healing and fosters a cycle of shame."

This sentiment is echoed by recovering users themselves, who describe an environment of intense prejudice. They report being denied employment opportunities, even menial jobs like street sweeping, which would provide structure and a sense of purpose crucial for long-term recovery. This economic and social exclusion exacerbates feelings of isolation and worthlessness, making the camaraderie of drug dens a powerful lure. "At least here, I have a sense of belonging and support. I have friends," one relapsed user told journalists.

Issak Haji, a psychologist at the Lamu clinic, explained the profound psychological toll. He noted that negative societal beliefs framing addiction as a moral failure, rather than a chronic medical condition, cause addicts to internalise feelings of shame and guilt. This internalised stigma often prevents individuals from seeking or continuing treatment.

Kenya's Coastal Drug Crisis: A National Concern

The struggle in Lamu is a microcosm of a larger battle along the Kenyan coast, a region that has transitioned from being a mere transit route for international drug trafficking to a significant market in its own right. The United Nations Office on Drugs and Crime (UNODC) identifies this as part of the "Southern Route," which channels heroin from Afghanistan through East Africa to global markets. Remnants of these shipments fuel local addiction, with a single hit of heroin costing as little as KSh 200.

According to a 2019 UNODC estimate, there are approximately 27,000 heroin users in Kenya, with a heavy concentration in coastal counties like Lamu and Mombasa. The National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) has previously estimated that over 5,000 people are hooked on hard drugs in Lamu alone. The socio-economic consequences are severe, contributing to rising crime rates as users steal to fund their addiction, loss of productivity, and immense strain on families and public health systems.

A Path Forward: Beyond Medication

While facilities like the Hindi Rehabilitation Centre and the MAT clinics are critical infrastructure, experts and community leaders argue that they are only one part of the solution. The high cost of inpatient services at traditional rehabilitation centres—a three-month stay can cost upwards of KSh 90,000—puts them out of reach for many impoverished families, making the free-to-access MAT clinics a more viable option. However, without community buy-in, even these programmes are failing to achieve their full potential.

Health officials are now calling for a fundamental shift in public perception. They urge community members to see addiction as a treatable disease and to offer support and encouragement rather than judgment. This involves creating an environment where recovering individuals can find meaningful employment and reintegrate into society without fear of being ostracised. As psychologist Issak Haji advises, "The society needs to welcome drug addicts and help them reform." Until Lamu confronts and dismantles the stigma within, the cycle of relapse will continue to claim its youth, leaving a trail of broken families and unrealised potential in its wake.