Waking up to addiction: Life’s daily struggle in informal settlements

While many people wake up thinking about breakfast or preparing for work, a very different reality unfolds each morning in countless informal settlements across Kenya.

In these communities, many young people start their day already intoxicated, trapped in a daily cycle of substance dependence.

For years, the approach to tackling drug abuse in these areas has largely focused on arresting street-level dealers and rounding up idle youth in groups. Yet, these reactive efforts have done little to stem the tide of addiction.

If anything, substance abuse has surged, with users growing younger and more vulnerable. Many remain unaware of the long-term dangers, while others believe the health consequences only affect “other people” - not them.

Kevin Musyoka, 20, has never known a life free from drugs and alcohol. Born and raised in an informal settlement on the outskirts of Nairobi, he grew up in an environment where drugs are not just available - they are part of everyday life.

From a young age, Musyoka was surrounded by homemade brews like chang’aa, cannabis, cigarettes, and increasingly, harder synthetic drugs. Access to substances has never been a challenge. The only limitation, he says, is whether someone is willing to experiment.

“I started using it just to pass the time. Everyone else around me was doing it, so I joined in. It’s what people do here.”

Now, Musyoka’s drug of choice is something he calls 'GM', a potent substance that costs around Sh250 per dose. But getting it isn’t guaranteed - he only buys it when he can scrounge up the money through odd jobs or small hustles. When broke, he takes whatever he can find, regardless of the risk.

“I don’t take chang’aa - that’s for the zuzu,” he says, using a slang term for reckless people. “But everything else? I’m in.”

Recently, the government announced plans to raise the minimum legal age for drug and alcohol consumption to 21. While it may appear a step in the right direction, Musyoka is sceptical. To him, the policy feels disconnected from the reality of life in the settlements.

“What difference does it make?” he asks. “These things have always been here. Since I was a kid, they’ve been sold in broad daylight, sometimes by people I know. Even our friends sell them.”

In Musyoka’s neighbourhood, drugs aren’t hidden behind closed doors - they are openly distributed. Dealers are embedded in the community, often extending credit to users and feeding a cycle of dependency that becomes almost impossible to break.

At one point, he made a genuine attempt to break free. He joined a small community-led rehabilitation initiative and managed to stay sober for a short while. But the program lacked resources, and there was no long-term support or follow-up care. As soon as he returned to his old environment - still surrounded by drugs, old friends, and temptations - he relapsed.



“It’s not that I didn’t want to stop,” he says. “But when you live here and you’ve got no money or any way out, it’s hard.”

Asked whether he understands the health risks of prolonged drug use, he simply shrugged. His response is laced with a mix of disbelief and denial:

“They say you’ll get liver disease or cancer. But those are diseases for rich people. I’ve never seen anyone around here suffer from those things. Until I do, I won’t believe it.”

For many like Musyoka, the threat of disease feels distant and abstract. The more immediate concern is surviving the day, numbing the boredom, and finding a sense of belonging.

Brian Omondi, another young man from the same area, paints a grim picture of how deep the roots of addiction run. Joblessness, hopelessness, and peer influence all collide in a perfect storm that drives substance abuse.

“Most of us are unemployed, and drugs become the only escape; we don’t choose based on what’s safe - we choose based on what we can afford. Sometimes it’s chang’aa, sometimes it’s pills.”

Chang’aa, a highly potent and dangerous homemade liquor, is one of the most accessible substances in these communities. A small serving can cost as little as Sh10, while a larger cup may go for just Sh20 or Sh40. Its affordability makes it an obvious choice for jobless youth seeking a quick and strong high.

The danger, however, is immense. The alcohol is often brewed without regulation, sometimes mixed with toxic chemicals to increase its strength. Many cases of blindness, organ failure, and even death have been linked to chang’aa consumption, but the low price keeps users coming back.

The production of illicit alcohol is no secret. Walking through the settlement, one can easily spot millet spread out in open areas, drying in preparation for brewing. To an outsider, it might look like preparation for porridge or food. But to locals, it’s clear what’s going on.

That millet is destined for busaa, another traditional brew central in the local drinking culture. To make it, the millet is soaked in water until it ferments, producing a sour base that is then brewed into an alcoholic drink.

“Busaa is part of the culture here,” one resident remarks. “It’s cheaper than the stuff in stores, and it gets the job done.”

For many families, brewing has even become a source of income. In the absence of formal employment or economic opportunities, some have turned to alcohol production as a survival tactic. But with it comes increased access, especially for young people, and a normalisation of substance use that makes prevention nearly impossible.

In July 2025, NACADA proposed raising Kenya’s legal drinking age from 18 to 21 to curb youth addiction. The policy also aims to ban alcohol sales within 300 meters of schools, homes, and churches, restrict online sales and deliveries, and limit youth-targeted advertising. It includes mandatory health warnings and expanded rehab services.

The National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) has proposed to increase the legal drinking age from 18 to 21 years, barring anyone under 21 from accessing alcohol-selling outlets, even when accompanied by an adult.

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Alcohol consumption in Kenya has been a growing public health concern, particularly due to its association with a range of physical and mental health problems. One of the most serious long-term health effects of excessive alcohol use is liver damage.

A recent study conducted in rehabilitation centres located in Murang’a and Uasin Gishu counties explored the extent of alcohol-induced liver damage among individuals undergoing treatment for alcohol use disorders.

The research focused on analysing liver biomarkers such as ALT (alanine transaminase), AST (aspartate transaminase), and GGT (gamma-glutamyl transferase) - key indicators of liver function and damage.

The findings suggested that a significant number of patients admitted to these centres already had abnormal liver enzyme levels, indicating possible liver injury due to chronic alcohol consumption. This study, although not yet peer-reviewed, provides early evidence of liver health being compromised among Kenyan alcohol users, especially those in rehabilitation settings.

More broadly, global medical literature establishes a clear link between heavy alcohol use and liver disease.

It is known that over 90 per cent of heavy drinkers develop fatty liver disease (steatosis), which can progress to alcoholic hepatitis and eventually to cirrhosis in about 10–20 per cent of cases. Cirrhosis, a late-stage liver disease marked by scarring and loss of liver function, is a major cause of alcohol-related deaths worldwide.

Although Kenya does not yet have nationally representative data on the prevalence of alcohol-related liver disease, the patterns observed in rehabilitation centres and global risk profiles strongly suggest that many Kenyan drinkers, especially long-term, heavy consumers, are at serious risk of liver complications.

According to NACADA, about 25.9 per cent of men and 5.4 per cent of women aged between 15 and 49 reported drinking alcohol in the previous month. Among those with problematic use, some studies show alarming levels of binge drinking, with reports of individuals consuming up to 23 drinks per day. Early initiation of alcohol use - sometimes as young as 11 years - further increases the risk of long-term liver damage, especially when drinking is sustained over decades without medical intervention.

Despite these risks, alcohol-related liver disease remains underdiagnosed and underreported in Kenya. The lack of widespread liver screening programs and the stigma surrounding both alcoholism and liver disease contribute to late detection, often when symptoms have already become severe.

In 2022, Kenya recorded 833 new liver cancer cases and 819 deaths, figures expected to rise significantly in the coming decades.

A new report by The Lancet Commission projects that liver cancer deaths will double by 2050, as rising alcohol consumption fuels an impending public health crisis.