In a global landscape where the fight against illicit drugs continues, Kenya is intensifying its efforts to prevent the emergence and spread of fentanyl, a synthetic opioid significantly more potent than heroin. This comes as the United States reports a notable decrease in overdose fatalities, offering a glimmer of hope in tackling the global opioid crisis.

Fentanyl, a synthetic opioid, is estimated to be 50 to 100 times more potent than morphine and 30 to 50 times stronger than heroin. Its extreme potency means even a small dose can be lethal, making it a major contributor to fatal overdoses in countries where it is prevalent.

Global Trends: US Sees Decline in Overdose Deaths

The United States, which has grappled with a severe fentanyl crisis, has reported a significant turnaround. In 2024, the number of fatal drug overdoses across the US fell by approximately 25% from 2023 figures. Provisional data from the Centers for Disease Control and Prevention (CDC) indicates an estimated 80,391 drug overdose deaths in 2024, a decrease from 110,037 deaths in 2023. This represents nearly 30,000 fewer deaths, saving dozens of lives daily. This decline is the first since tracking began in 1999. North Carolina, a state previously at the forefront of the crisis, is among those experiencing this positive trend.

The CDC attributes this decline to factors such as expanded access to the overdose-reversal drug naloxone and increased access to substance-use treatment. Despite this progress, overdoses remain a leading cause of death for Americans aged 18-44.

Kenya's Proactive Stance Against Fentanyl

While fentanyl's widespread presence in Kenya has not been conclusively established, the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) launched investigations in August 2023 into alleged fentanyl use in coastal counties. This proactive measure follows concerns that injecting drug users are increasingly engaging in polydrug use, raising the possibility of fentanyl abuse. Samples collected from drug dens in Mombasa are currently undergoing analysis to determine the presence of fentanyl.

Kenya has historically served as a transit hub for illicit substances, but recent research indicates a growing domestic drug consumption problem. The government, through the National Police Service and the Directorate of Criminal Investigations (DCI) Anti-Narcotics Unit (ANU), is intensifying efforts to combat drug trafficking and abuse. Inspector General of Police Douglas Kanja has vowed to strengthen the ANU, aiming to elevate it to the same level as the Anti-Terror Police Unit (ATPU). Collaboration with international partners, including the US Drug Enforcement Administration (DEA), is also being enhanced to disrupt transnational organised crime networks.

The Broader Challenge of Substance Abuse in Kenya

The potential threat of fentanyl adds another layer of complexity to Kenya's existing struggle with substance abuse. A national survey on the Status of Drugs and Substance Use in Kenya, 2022, revealed that one in every six Kenyans aged 15-65 (approximately 4,733,152 individuals) were currently using at least one drug or substance of abuse. The report, published by NACADA, highlighted that alcohol, tobacco, and khat have the highest awareness levels at 97%, 95%, and 88% respectively.

Alarmingly, adolescents and young adults aged 15-35 years account for more than half of all drug users in the country. Specifically, one in every 11 youths aged 15-24 years (approximately 632,846 individuals) uses at least one drug or substance of abuse, while over 1.5 million Kenyans in the 25-35 age group are affected. The Western region recorded the highest prevalence of overall drug and substance abuse at 26.4%, followed by Eastern at 20.7%, and Nairobi at 19.1%. Cannabis use is highest in Nairobi, Nyanza, and Coast regions.

The government has identified 10 counties with the highest drug and substance abuse prevalence: Garissa, Kakamega, Kericho, Kisumu, Laikipia, Machakos, Meru, Mombasa, Nakuru, and Uasin Gishu.

Rehabilitation and Treatment Efforts

Kenya has several rehabilitation centres, both public and private, offering various treatment programs for substance use disorders. NACADA licenses and monitors these facilities. In 2023, Nairobi City County opened its first public rehabilitation centre, Sinai Health Centre, in Viwandani Ward, offering free outpatient services to residents of informal settlements. This initiative aims to address the affordability barrier, as private rehabilitation services can cost up to KSh 100,000 for a three-month session.

Organisations like Médecins Sans Frontières (MSF) have also been instrumental in providing Medically Assisted Therapy (MAT) services, particularly opioid substitution therapy (OST), in counties like Kiambu, which ranks fifth nationally in the number of people who use drugs.

Risks and Implications for Kenya

The emergence of highly potent synthetic opioids like fentanyl and nitazenes in Africa poses a significant public health threat. These drugs are often mixed with other substances, increasing the risk of accidental overdose for unsuspecting users. The illicit drug trade also fuels corruption and can be linked to financing terrorism, as highlighted by Inspector General Kanja.

What to Watch

The results of NACADA's investigations into fentanyl in coastal counties are keenly awaited. Continued collaboration between Kenyan law enforcement agencies, health authorities, and international partners will be crucial in preventing a full-blown fentanyl crisis. The expansion of affordable and accessible rehabilitation services and public awareness campaigns will also be vital in mitigating the impact of substance abuse across the country.