NIDA-Supported Mini-Grant Projects Featured at ICUDDR Annual Meeting

ICUDDR Mini Grant Updates
L to R: Dr. U. Ventakesh (India), Dr. Valentine Ucheagwu (Nigeria), Dr. Stephen Asasta (Kenya), Dr. Lindsey Friend, Dr. Gladys Bett (Kenya), Dr. Charles Orjiakor (Nigeria)

The NIDA International Program previously collaborated with the International Consortium of Universities for Drug Demand Reduction (ICUDDR) to support five mini-grant projects. International scholars led these research projects to advance substance use research in their local regions. The scholars presented their research at the ICUDDR Annual Meeting in Chiang Mai, Thailand, August 9-11, 2023. The following are summaries of the research activities:

Stephen Asatsa (Kenya) 
Title: COVID 19 Pandemic-Related Impacts and Addiction Severity Among Service Users in Selected Substance Use Treatment Facilities in Nairobi, Kenya 
Summary: The onset of COVID 19 brought about disruption in almost every sector globally. Among the affected places in Kenya were substance use treatment facilities where service users were discharged to avoid infection. This was accompanied by closure of bars and introduction of curfews, among other measures. Data on the possible impact of these disruptions on alcohol use disorders is still scant. This study aimed at examining the relationship between COVID 19 pandemic experiences and severity of substance use disorder (SUDs) symptoms. Methods: Data were collected from 176 residential service users in selected substance use treatment facilities in Nairobi using Epidemic–Pandemic Impacts Inventory (EPII) and the Modified Addiction Severity Index. Results: The study found weak positive and significant correlation between COVID 19 impacts and addiction severity. The study further found higher addiction severity among drug users during the COVID 19 pandemic period compared to pre-COVID 19 period.  Conclusion: The findings imply the need for substance use treatment facilities to include COVID 19 impact in their assessment and intake history. Future Direction: The researcher would like to do a bigger study in substitute behaviour as a treatment alternative in order to promote self-help during times of emergencies like COVID 19.

Gladys Mutai Bett (Kenya) 
Title: Role of Guidance and Counselling in Addressing Cannabis Use Among University Students in the South Rift Region of Kenya 
Summary: Mental illness is a substantial public health burden in Kenya. The World Health Organization’s 2017 report revealed that mental health cases are increasing and ranked Kenya fifth among the African countries with the highest number of depression cases. Research done by NACADA (2022) in Kenya found that use of narcotics, especially bhang, was very high among the youth and the problem was endemic across the country. The problem that this research was addressing was that many youth struggling with addiction, especially cannabis, which is illicit, are afraid to reach out for help due to the stigma that surrounds it. The rationale behind this is that research has shown that there are 1.4 million binge drinkers aged 12 to 17, who may be at higher risk for future substance use disorders and mental disorders because of their young age, and so early intervention is a necessity. This study was guided by the following research question: What is the role of guidance and counselling in managing cannabis use among university students in the South Rift Region of Kenya? Guidance and counselling is a professional field which has a broad range of activities and services aimed at assisting individuals to understand themselves, others, and the school environment to attain their potential. New scientific knowledge and effective, evidence-based interventions have provided health leaders and policymakers a remarkable paradigm to guide the development of addiction treatment services around the world. This research aimed at finding interventions that assist students to prevent and treat cannabis use and build a knowledge base of evidence-based programs that prevent and treat cannabis disorder. The findings of the study showed that guidance and counselling has played a significant role in addressing the use of cannabis (P = 0.013 p<0.05), that is, proper implementation and utilization of guidance and counselling services had a positive effect in the management of cannabis use. It was found that the most common method of prevention is through seminars or workshops and that rehabilitation is the most preferred method of treating cannabis use disorder. The study recommends a permanent multi-sectoral structure to deal with substance abuse in the learning institutions. In future, more research is needed on community-based interventions tailored to suit the needs of each institution. In addition, capacity building must be done to equip all counsellors on evidence-based treatment programs and procedures. Moreover, there was a need for an empirically defensible and a multi-sectoral approach to promote wellness through integrating psychosocial, clinical, and community-based interventions. Lastly, youth wellness centres that address drug and substance use must be established in each county.

Charles Orjiakor (Nigeria) 
Title: Community Response to Methamphetamine Use in Nigeria 
Summary: Methamphetamine recently rose to become a priority drug in Nigeria. The recent rise and widespread use of methamphetamine in the country has met an arguably weak policy response, as stakeholders struggle to react to the problem amidst low availability of drug-specific evidence. However, local communities have been observed to put up a dynamic response. The current study aimed to explore what has worked for other contexts and what actions were effective in Nigerian communities that have responded to the methamphetamine use problem. We found from the systematic review of studies on community actions to reduce methamphetamine use that galvanizing multidimensional local community resources was effective; while exclusively relying on law enforcement agents faltered (Orjiakor et al., 2023). From community stakeholders, we learnt that the rise of internet fraud is driving use amongst young people. Organized multistakeholder community response helped to ward off dealers and deployed local familial and community structures in educating and providing alternative opportunities to youths. Lessons can be drawn and shared with communities still grappling with the challenge.

Valentine Ucheagwu (Nigeria) 
Title: Mindfulness Oriented Recovery Enhancement (M.O.R.E.) in Reducing Cue Reactivity and Improving Cognition in Drug Addicted Persons From Nigeria: Preliminary Investigation 
Introduction: Due to growing use of illicit drugs in Nigeria, effort has doubled on drug demand reduction and lasting treatment for drug users. Very few randomized controlled clinical trials have been done in Nigeria with regards to non-pharmacological treatments of drug use. We conducted a pilot study on efficacy of M.O.R.E. in reducing craving and improving cognition in persons diagnosed with cocaine and opioid addiction in the Anambra state of Nigeria. We hypothesized that M.O.R.E. will reduce drug cue reactivity and improve executive function (working memory, inhibition, and set shifting) in treated participants. Method Participants: Twenty male participants (Age: 20-40 years; mean age: 27.25; SD age: 5.66) receiving rehabilitation in a government-owned drug treatment facility in Anambra state were recruited for the study. Instruments: Executive function was assessed at three domains: Inhibition (Stroop word-color test), set shifting (TMT A&B), and working memory (Number span test: forward and backward). Physiological responses to drug cues were measured with systolic and diastolic blood pressure, and pulse and salivary cortisol. Procedure: Participants were randomly assigned to two groups. Group 1 received M.O.R.E. (Mindful breathing) for 20 minutes once a week for 4 weeks in addition to treatment as usual (TAU). Group 2 received TAU. During M.O.R.E. sessions, group 2 was assigned to group discussion on the Union of European Football Associations premier league as all the boys had interest in football. Design/Statistics: The study was a randomized controlled trial. Mann-Whitney U and MANOVA statistics were used for data analysis. Result: No significant differences were found for domains of EF and cue reactivity between M.O.R.E. and TAU groups respectively. However, the M.O.R.E. group had better outcomes on inhibition and working, compared to the TAU group. There are significant interaction effects for M.O.R.E. and education on EF (working memory and set shifting). Discussion: The pilot study demonstrated indications for efficacy of M.O.R.E. in improving cognition using a small sample. There is need to further this study with a large sample population and add some level of experimental titrations to the baseline. Limitations: We only used one (mindful breathing) out of three full versions of the M.O.R.E. protocol in the study. Body scan and savoring techniques were not included in the intervention. We hope to do full M.O.R.E. interventions in the future. Also, the small number of participants limited the power of the study.

U. Venkatesh (India) 
Summary update not available at this time.