Using Technology to Treat Substance Use Disorder

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Addiction psychiatrist, Dr Sarah Kiburi was awarded a PhD for her important study on the use of digital interventions in treating opioid use disorder. This complex illness is characterised by compulsive use of opioid drugs even when the person wants to stop, or when using the drugs negatively affects the person’s physical and emotional well-being.

The study was piloted at a methadone clinic in Nairobi, Kenya. 

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. 

Kiburi said that her research was motivated by the fact that substance abuse is a significant challenge in Africa, particularly following the COVID-19 pandemic. Her study assessed the feasibility and acceptability of a mobile phone text message-based intervention with people attending the methadone clinic. The mixed methods study found that the intervention was well-received, paving the way for more robust controlled trials using technologies to assist people with addiction problems, particularly in low-resource settings. The study was co-supervised by the Head of Psychiatry at UKZN, Professor Bonginkosi Chiliza and Professor Saeeda Paruk, findings from which elicited how a digital approach can help improve access to care for those with substance use disorders, given the burden of disease that arises from these disorders. 

Kiburi said that while there are several evidence-based interventions for substance use disorder treatment, there are low levels of implementation in Kenya. ‘The challenges include the limited number of healthcare providers to deliver treatment.’ Shortly after completing her graduate training in psychiatry, she attended a short course on the use of information and communication technology in healthcare that sparked her interest in assessing digital technology use in mental health. The outbreak of the COVID-19 pandemic restricted access to treatment, further motivating her to explore digital treatment approaches. 

‘I am very happy and grateful to have completed my PhD. I gained many skills and my study highlights several areas that need to be addressed to improve care of individuals with substance use disorder and other psychiatric illness,’ Kiburi said.

Her immediate plans are to assess the application of the intervention she used in her study with a broader study population. ‘I hope to continue growing in practice, engaged in both clinical care of patients as well as academia and research. 

‘I always wanted to be a doctor and to help people. My first role model was my mother who was a nurse. During my undergraduate training, I enjoyed psychiatry rotations and became interested in specialising in psychiatry.’

Kiburi holds an MMed in Psychiatry and another in Addiction Studies. ‘My theses for the two degrees involved assessing the prevalence of adverse childhood experiences among individuals with substance use disorders and examining the associations between use of cannabis during adolescence and psychosis later in life, respectively.’ 

Chiliza said: ‘Sarah joined one of our research weeks, perhaps the last one before COVID-19 hit, very soon after losing a very close member of her family. She persevered despite numerous challenges and published three peer-reviewed articles, with two more under review. She also published other original research and systematic reviews in the area of addiction. 

Kiburi’s hobbies include working out at home, spending time with her family, listening to music and reading. 

Words and Photograph: Lunga Memela