MHM Magazine

A Changing Landscape of Substance Use When we think about substance use among doctors, the usual suspects come to mind: alcohol, tobacco, and maybe cannabis. But in recent years, something has shifted. In hospitals across Kenya, a new wave of substances is making its way into the lives of young doctors — vape pens, shisha, and even stimulants like the so-called “miraa juice” This is not just a Kenyan problem. Globally, early-career physicians — especially medical officer interns — are at risk. They’re often juggling long shifts, high patient loads, limited supervision, and the emotional strain of working with critically ill patients. Add the pressures of proving oneself in a demanding environment, and the stage is set for risky coping mechanisms. What We Found in Our Study From over 200 medical officer interns working across different hospitals here’s what stood out: • Alcohol was still the most common substance, with nearly two-thirds of interns reporting use. • Cannabis and tobacco use were high, with around four in ten reporting lifetime use. • Vaping and shisha were surprisingly common, with nearly a third saying they had strong urges to use these in the past three months. • Depression was alarmingly prevalent — two out of three interns screened positive. • Importantly, there was a strong link between high-risk substance use and depression. • Certain groups were more vulnerable: o Younger interns (20–24 years) were more likely to develop alcohol use disorders compared to older peers. o Having a family history of substance use significantly raised the risk. A Story That Stays With Me I remember one young intern — let’s call him David — who had just started his rotation in internal medicine. On the outside, he was the picture of confidence. But in our conversations, he admitted that most evenings after a stressful day, he would retreat to his room, pour himself a drink, and scroll through social media. “It helps me switch off,” he told me. “But when I wake up the next morning, I feel worse — the depression is heavier, and the cycle just continues.” David’s story isn’t unique. It illustrates how easily stress can push bright, hardworking young doctors toward coping mechanisms that, in the long run, only deepen their struggles. Why This Matters This is not just about doctors’ personal health. Substance use and untreated depression have ripple effects: • For patients: A doctor who is exhausted, hungover, or battling depression may be more prone to errors, which directly affects patient safety. • For health systems: Burnout and impaired doctors contribute to high turnover and reduced productivity. • For society: Doctors are role models. Their patterns of use influence how the community perceives these substances. What Can Be Done? We can’t ignore the fact that young doctors are silently struggling. A few steps could make a big By Dr. Litha Musili Consultant Psychiatrist and Researcher Nairobi, Kenya lithamusili@gmail.com EMERGING DRUG TRENDS AND THE HIDDEN MENTAL HEALTH STRUGGLES OF YOUNG DOCTORS IN KENYA MHM | 2025 | Volume 12 | Issue 4 | Emerging Drug Trends and the Hidden Mental Health Struggles of Young Doctors In Kenya MHM Issue 4 | 2025 | MENTAL HEALTH MATTERS | 23 MHM