Introduction

Globally, cannabis, also known as marijuana, is one of the most widely used psychoactive substances, ranking second only to alcohol in prevalence. In the United States, for instance, reported adult use more than doubled between 2013 and 2022. While this data often originates from Western nations, Kenya presents a unique and complex landscape shaped by its distinct urban-rural dynamics, a large youth population, potent socio-economic factors, and a stringent legal framework.

Understanding the patterns, effects, and legal status of cannabis—commonly called “bhang” in Kenya—is not just an academic exercise; it is a critical public health imperative. This comprehensive analysis delves into the latest data to explore the prevalence of cannabis use in Kenya, its legal standing, the specific health implications for Kenyans, the often-overlooked gender patterns, and the ongoing policy debate that will shape the nation’s future approach to this controversial plant.

Cannabis in Kenya: Prevalence and Use Patterns

National Prevalence and a Worrying Trend

In Kenya, the national prevalence of cannabis use is lower than that of other substances like alcohol or tobacco, but the trends point towards significant growth. According to the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA), approximately 518,807 Kenyans aged 15 to 65 were current cannabis users as of recent surveys. This represents about 1.9% of that demographic.

However, this seemingly modest figure masks a dramatic surge. Multiple reports, including those from NACADA, indicate a staggering 90% increase in consumption over a recent five-year period. While a study of patients in a Nairobi methadone-maintenance clinic found an extremely high prevalence (85.8%), this is not representative of the general population but highlights its common use among specific high-risk groups.

Demographic Profile: Age, Gender, and Geography

The face of cannabis use in Kenya is predominantly young, male, and urban.

• Age: Young adults, particularly those between 18 and 25 years, show the highest rates of use. Alarmingly, use is also seeping into secondary schools; a study in Teso South found about 3.1% of students reported marijuana use.
• Gender: The user demographic is overwhelmingly male. Data indicates that of the 518,807 current users, a staggering 475,770 are men, meaning men constitute over 90% of the user base.
• Geography: Urban centers, especially the Nairobi region, are hotspots. One study flagged Nairobi with a current cannabis use rate of 6.3%, significantly higher than the national average and other regions.
• Education: A lower level of education is strongly correlated with a higher likelihood of use. Research has shown that having a university education was associated with a 90% reduced risk of cannabis use among the populations studied.

Evolving Consumption Patterns

Beyond traditional smoking, new and more discreet forms of consumption are emerging in Kenya. Reports from various counties indicate the arrival of cannabis edibles (e.g., cookies, brownies) and infused beverages. This shift complicates public health monitoring and law enforcement efforts, as these products are easier to conceal and can appeal to a broader audience, including those who wish to avoid smoking.

The Legal Status of Cannabis in Kenya: A Strict Prohibition

Overview of the Law

In Kenya, cannabis remains strictly illegal for recreational use. The primary legislation governing it is the Narcotic Drugs and Psychotropic Substances (Control) Act of 1994. Under this act, the possession, cultivation, sale, and importation of cannabis are criminal offences.

The penalties are severe:

• Possession of any amount can lead to a prison sentence of up to 10 years.
• Trafficking (which can be broadly interpreted) can result in a life sentence and heavy fines.

The government, through NACADA, has consistently reaffirmed this position, maintaining that cannabis is an illegal narcotic despite shifting global perspectives.

Exceptions and the Medical/Industrial Debate

While recreational use is banned, there is a limited legal pathway for industrial hemp (defined as cannabis with less than 0.2% THC) for scientific, research, or industrial purposes under a special license. However, the landscape for medical cannabis remains largely theoretical. Despite ongoing conversations, there is currently no accessible, legal pathway for Kenyan patients to obtain cannabis for medical treatment.

The Current Policy Debate

The strict prohibition is facing increasing scrutiny. Prominent figures, such as former Law Society of Kenya President Nelson Havi, have announced intentions to file constitutional petitions challenging the criminalization of cannabis, arguing for decriminalization or legalization.

Conversely, the Office of the Attorney-General has strongly defended the existing laws, urging the courts not to lift the ban and citing the need to protect public health and regulate narcotics. This tension ensures that cannabis will remain a hot-button issue in Kenyan policy circles for the foreseeable future.

Health Effects of Cannabis: A Kenyan Perspective

Immediate and Short-Term Effects

The psychoactive component of cannabis, THC, produces well-documented short-term effects. These include:

• Altered perception of time and senses
• Impaired memory and difficulty with thinking
• Reduced coordination, increasing the risk of accidents
• Mood changes, including euphoria or, in some cases, anxiety and paranoia

In the Kenyan context, researchers have highlighted that these effects can directly impair learning and memory in adolescents and young adults, with immediate consequences for their academic and personal lives.

Long-Term and Chronic Health Risks

Chronic, heavy use of cannabis is associated with a range of serious long-term health issues, which are a growing concern for Kenyan public health officials:

1. Cognitive Impairment: Persistent use, especially when initiated young, can lead to lasting deficits in memory, attention, and decision-making.
2. Mental Health Risks: There is a strong link between cannabis use and an increased risk of psychotic disorders, such as schizophrenia, particularly with high-potency products. Kenyan articles have cited studies showing daily use of potent marijuana is associated with a three-fold higher risk of a first psychotic episode.
3. Respiratory and Cardiovascular Disease: Smoking cannabis over the long term damages the airways and can lead to chronic bronchitis. NACADA has also flagged an increased risk of heart attacks, strokes, and hypertension.
4. Addiction (Cannabis Use Disorder): Contrary to popular belief, cannabis can be addictive. Dependence leads to a recognized substance use disorder, with withdrawal symptoms including irritability, insomnia, nausea, and anxiety.

Gender and Behavioural Aspects in the Kenyan Setting

Patterns of Use by Gender

The gender gap in cannabis use is pronounced in Kenya, with men constituting the vast majority of users. This disparity is influenced by a combination of biological, social, and cultural factors. The strong stigma associated with drug use in Kenya may disproportionately discourage women from using or reporting use, leading to significant under-reporting.

Differences in Side-Effects and Behaviour

While Kenyan-specific data on gender differences in side-effects is limited, global research offers insights that are likely applicable:

• Men more frequently report effects like increased appetite (“munchies”) and an altered sense of time, and they tend to consume larger quantities per session.
• Women more often report dizziness, anxiety, and changes in appetite, and may be more likely to use non-smokable forms like edibles. They also appear to experience different withdrawal profiles, with higher rates of anxiety and nausea.

Implications for Public Health and Outreach

These differences necessitate a tailored approach to prevention and treatment in Kenya:

• Campaigns targeting men should be focused on areas with high male usage, such as urban informal settlements, and address motivations like peer pressure and unemployment.
• Women-specific messaging is crucial, even if numbers are lower, to address their unique health risks (e.g., during pregnancy) and to reduce stigma that may prevent them from seeking help.

Why These Differences Exist: Biology and the Kenyan Context

The variations in cannabis use and its effects stem from a complex interplay of factors:

• Biological/Physiological: Men and women metabolize THC differently due to variations in hormone levels, body fat distribution, and genetic factors. This leads to different experiences of side-effects and withdrawal.
• Socio-Economic Factors: In Kenya, unemployment and low education levels are key drivers. A study in a Nairobi clinic found 76% of cannabis users were unemployed. Peer pressure is another massive factor, cited by 90.1% of students in the Teso South study as a cause for drug use.
• Cultural Norms and Stigma: Deeply ingrained gender norms in Kenya make it more socially acceptable for men to engage in substance use, while women face greater social condemnation.

Kenya-Specific Risks and Public Health Implications

1. Impact on Youth and Education: With a massive youth population, cannabis use poses a direct threat to Kenya’s educational goals. The link between student drug use and poor academic performance is clear, with one study finding 89.6% of student users had poor grades.
2. Mental Health Burden: The association between cannabis and psychosis is particularly alarming in a country where mental health resources are already stretched thin.
3. Polysubstance Use: Cannabis is frequently used alongside other substances, such as opioids and alcohol, complicating treatment and increasing overall health risks.
4. Legal and Social Consequences: The severe legal penalties mean that a single arrest can derail a young person’s life, leading to imprisonment, a criminal record, and lasting social stigma.

Conclusion: Navigating a Complex Future

Cannabis use in Kenya is a multifaceted issue that cannot be ignored. While the current national prevalence rate is modest, the sharp upward trend, its concentration among the nation’s youth, and the severe health and legal risks make it a significant public health and social challenge.

The strict legal prohibition stands in stark contrast to the growing debate on reform. For Kenya to navigate this complex landscape effectively, a multi-pronged approach is essential. This includes investing in local research to understand Kenyan-specific patterns, strengthening youth-focused prevention and treatment programs, and ensuring that public health—not just criminal justice—is at the centre of any future policy discussions.

For Kenyan families, youth, and policymakers, the message is clear: informed, evidence-based, and context-aware strategies are the key to mitigating the risks associated with cannabis and safeguarding the well-being of the nation’s future.