The Relationship Between Childhood Trauma and Opioid Addiction Among Clients at Saptas Harm Reduction Program, Nairobi County, Kenya.

Abstract

Childhood traumas have been linked to different forms of psychopathology such mood, substance use and anxiety disorders. Until recently, studies have focused on the impact of adverse childhood experiences on children and adolescents without a focus on their adult addictive behaviours. In consequence, most addiction treatment protocols do not explicitly provide the need to provide trauma-informed interventions for persons with substance use disorders. This research was carried out to establish the relationship between childhood trauma and opioid addiction among clients at the SAPTA harm reduction program, in Nairobi County, Kenya. The specific objectives of the study were; to establish whether childhood emotional abuse, parental neglect, and parental separation and divorce result in adult opioid use disorder and to advocate for trauma-informed interventions for clients with opioid use disorders (OUD). A total of 332 clients receiving services at the SAPTA‘s harm reduction program participated in the study; 267 male and 63 female. A combination of stratified and purposive sampling methods was used for the study with data collected through self-reported and interviewer-guided questionnaires. SPSS software was used to analyze data which was presented using descriptive statistics and content analysis using quantitative and qualitative techniques and the use of Pearson correlation and regression analysis. 89% of the respondents presented with severe OUD, 62% were currently on methadone with 43% had been on the program for more than 3 years. The study found a strong positive correlation (+1) between the studied childhood trauma experiences and adult OUD Out of the 332 respondents, 92 % had been exposed to emotional abuse, 96% to parental neglect, and 72% to parental separation. Significant associations between childhood trauma and OUD were revealed. Emotional abuse emerged as a significant predictor of adult OUD, with individuals reporting emotional abuse during childhood being three times more likely to develop OUD. Parental neglect was also found to significantly increase the likelihood of OUD, with neglected individuals twice as likely to develop OUD. Parental separation exhibited a profound association with adult OUD, with affected individuals being eight times more likely to develop OUD. The study found that even though counselling services were available, 72% attended at least one counselling session, out of those only 51% explored adverse childhood experiences during the sessions. This study confirmed severe OUD and a high prevalence of childhood trauma among clients receiving harm reduction services. This espouses the need to screen, assess, and develop trauma-informed treatment plans for every client. The severity of OUD identified warrants the need for medication-assisted treatment complimented by well-outlined behavioural expectations when one is on methadone. Additionally, trauma-informed interventions for the clients and their families, addressing environmental risk factors, providing recovery support services, safe spaces for men to speak out, love, protection, and supervision of children and adolescents are recommended. The study provides valuable insights for clinical practice and policy development in preventing and addressing OUD among vulnerable populations.