Alarm as Heroin Use Spreads Beyond Traditional Hotspots

Concerns have emerged over the spread of heroin use beyond Kenya’s traditional hotspots after a new report revealed that access to the narcotic has penetrated counties previously considered low-risk, including Nakuru, Uasin Gishu, Kisumu, Nyeri and Isiolo.

According to a study by the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA), cannabis, heroin and cocaine remain among the most commonly abused illicit drugs in the country, with heroin emerging as the second most widely used narcotic substance after cannabis.

For years, heroin abuse in Kenya has largely been concentrated in the Coastal region and Nairobi. However, findings from the latest wastewater analysis indicate a shift in usage patterns, raising concern among authorities over the drug’s spread into non-traditional counties.

The report, titled Wastewater Analysis Study by NACADA to Assess Emerging New Psychoactive Substances and Illicit Drug Use in Kenya, also identified an emerging trend in cocaine use, particularly in Nairobi and Nakuru.

“Monitoring adulterants and cutting agents in heroin and cocaine via wastewater analysis or other methods is essential for protecting public health, understanding drug market dynamics, enhancing epidemiological surveillance, informing policy, and supporting forensic efforts,” the report states.

Laboratory analysis found that caffeine, dextromethorphan, chloroquine and diazepam were the most commonly used adulterants or cutting agents in heroin samples.

For cocaine, the study identified levamisole, dextromethorphan, racemethorphan, caffeine and ketamine as the most frequently detected adulterants.

The report warned that such substances can significantly alter the potency, toxicity and health risks associated with illicit drugs, increasing the likelihood of severe health complications among users.

Researchers further flagged diazepam and ketamine as emerging cutting agents in heroin and cocaine respectively in Kenya, raising fresh concerns over evolving drug formulations in the illegal market.

According to the report, diazepam — a sedative — may be mixed with heroin to intensify euphoric effects or compensate for poor-quality narcotics, a trend previously documented in global drug markets during supply disruptions.

Feedback collected through Focus Group Discussions (FGDs) also showed that cannabis, heroin, cocaine, khat, mandrax, methamphetamine, hashish, MDMA/ecstasy and prescription drugs were among the most commonly abused psychoactive substances.

The most frequently cited prescription drugs included diazepam, flunitrazepam, amitriptyline, tramadol, chlorpromazine, morphine and cetirizine.

The wastewater analysis study covered all eight regions of Kenya, with suspected samples collected and subjected to laboratory testing at the Government Chemist for analysis and identification.

A total of 152 samples were collected during the study, which sought to assess the prevalence of new psychoactive substances and illicit drug use across the country.