Unearthing the underlying conditions of addiction in Uganda

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OPINION

By Dr Richard Lukandwa

Mental health remains a largely stigmatized and under-discussed issue in many African societies. A 2022 report by Lancet Psychiatry revealed that approximately 14 million Ugandans—about 32% of the population—suffer from mental illness. This figure represents a significant rise from previous national estimates of 24.2%.

The increase can be attributed to persistent social stigma around seeking mental health services, as well as challenges exacerbated by the COVID-19 pandemic, including lockdowns, job losses, and economic instability.

In response to these struggles, many individuals turn to substance abuse as a coping mechanism for conditions such as depression, anxiety, and trauma. According to studies published in Cognizance Journal (Sweden), substance addiction is particularly prevalent in Kampala’s suburbs and slums, where high population density and diverse demographics—including urban refugees—contribute to increased exposure and accessibility to drugs and alcohol.

The societal perception of addiction

Addiction is often viewed as a personal or moral failing rather than a complex health issue. Many societies judge those struggling with addiction harshly, blaming them for lacking the willpower to quit. This perception fosters stigma and prevents affected individuals from seeking help, even from friends and family members.

However, addiction is a growing crisis in Uganda, affecting individuals across all demographics, including street children, youth, men, and women. According to The Guardian, an estimated 5–10% of Uganda’s population regularly abuses substances, leading to addiction. This widespread issue underscores the need for a multi-faceted approach to treatment and prevention.

Addressing the challenge of addiction

Effectively combating addiction requires the collaboration of various stakeholders, including government agencies, community leaders, private sector players, civil society organizations, and healthcare professionals. Key strategies include:

• Public Awareness Campaigns – Educating communities on the risks of substance abuse and promoting responsible behavior.
• Prevention Programs – Targeting at-risk populations, particularly the youth, to reduce exposure and temptation.
• Improved Access to Treatment – Expanding addiction treatment facilities to ensure that individuals struggling with substance abuse receive proper care and rehabilitation.

Alcohol consumption in Uganda

The 2023 World Health Organization (WHO) report highlighted that Uganda’s per capita alcohol consumption stands at 12.2 liters per year—nearly double the African regional average of 6.3 liters and the global average of 6.18 liters.

Despite the alcohol industry contributing over sh1 trillion annually in taxes to the Ugandan government, it faces criticism due to alcohol-related harm. The issues of binge drinking and heavy episodic drinking contribute to high disease burdens, social consequences, and economic costs. According to a 2022 Ministry of Health report, some Ugandan communities traditionally brew alcohol at home, exposing individuals—often minors—to early and excessive consumption.

Furthermore, illicit alcohol, often cheaper and unregulated, dominates the market. The 2021 Euro Monitor study estimated that unregulated alcohol accounts for 65% of all alcohol consumed in Uganda, with an informal market valued at sh2 trillion. This illicit industry is neither monitored by the Uganda National Bureau of Standards (UNBS) nor subject to quality control measures.

The role of the regulated alcohol industry

Recognizing these challenges, formal alcohol industry players have implemented self-regulation measures to promote responsible consumption. Through public awareness campaigns, they educate consumers on the dangers of excessive drinking while advocating for moderate and responsible alcohol use. Additionally, the industry has developed the Alcoholic Beverages Responsible Code of Business Conduct, which ensures that marketing and sales practices discourage drinking in unsafe circumstances, such as before driving or operating heavy machinery.

Conclusion

It is time to shift our approach from merely addressing the symptoms of addiction to understanding and tackling its root causes. By prioritizing mental health, reducing stigma, expanding access to treatment, and promoting responsible drinking, Uganda can create a more supportive and effective framework to combat alcohol and substance abuse. A collective effort from the government, private sector, and civil society is essential in fostering a healthier society free from the devastating impact of addiction.

The author is an Independent Consultant Physician at the Medical Hub Kampala.

Email: lukandwa@doctors.org.uk