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Codeine: Combating menace of drug abuse in Nigeria

drug abuse


On February 28, I witnessed something that looked like a script straight out of a horror movie.

I was at one of the private hospitals on the Island in Lagos on this particular day to see a doctor friend.

A young boy of about 15 years was rushed to the emergency unit of the hospital. He was said to have been found at home hitting his head on his bedroom door despite the fact that the door was not shut.

Apparently, the boy was acting wild and kicking everyone in his way so the security men around had to pin him down. Even his parents could not hold him down.

He started pointing at those of us who had gathered around, threatening to kill and eat us while laughing hysterically. He kept on this bizarre display for quite some time.

From where I was peeping, I could see that the security men were able to restrain him. He looked so excited and his eyeballs were bulging.

I had seen people abuse drugs but I had never come across one as this before…Ever.

Upon further inquiry from my doctor friend, I learnt that the boy’s mother handed over empty bottles of codeine found in his room along with a small sachet of a stuff which looked like white powder with tiny crystals in it. Most likely cocaine and bath salt…who knows.

To say that I was scared would be saying the least. I was dumbfounded.

I could not fathom how and why a 15-year-old boy got himself involved in substance abuse. Who sold it to him and how did he get a hold of it?

Only last year, the National Agency for Food Drug Administration and Control (NAFDAC) issued a warning about the use of tramadol and codeine medicines.

Sadly, many Nigerian youths can no longer cope without indiscriminate use of these drugs. While many known abusers say it makes them ‘high’, experts say they are digging their graves.

In a recent documentary, the British Broadcasting Corporation (BBC) reported that thousands of young Nigerians were addicted to codeine syrup – a medicine that has become a street drug.

A research carried out by a non-governmental organisation, Development Initiative of West Africa (DIWA) estimates that up to 3 million bottles of the addictive syrup are drunk every day in just two northern states, while 30,000 codeine syrups are consumed daily in Niger state only.

Codeine is an addictive opioid that is often prescribed to treat pain and is mixed in with some cough syrups. Although legal in certain circumstances, codeine can cause psychosis and organ failure when taken in excess.

Less than 24hours after the film was screened by the BBC, the Nigerian government banned the import and manufacture of codeine-based syrup.

When the News Agency of Nigeria (NAN) interviewed drug abusers in the Federal Capital Territory, Abuja recently, the general consensus was that depression, financial instability and peer pressure were some of the reasons for their addiction to substances.

The young abusers stated that they took to the habit due to increased peer pressure, adding that it increased their level of acceptance by helping them blend into desired societal groups.

They listed marijuana, cocaine, Refnol, and codeine as constantly abused substances with alcohol, gins, soft drinks and spirits acting as mixers for the drugs.

Some of the drug abusers said that banning codeine would have minor effect on drug abuse prevalence; alleging that it would increase the ‘black market’ value of the drug substance.

Miss Angela Obuh, a 19-year-old undergraduate, admitted that drug and substance abuse has become a pre-requisite for acceptance in various peer groups.

“I don’t find anything wrong in taking Refnol or codeine because all my friends do it and you don’t want to be the odd one out,” she said.

Reflecting on the history of her drug abuse, Obuh said that it started about a year ago when she accompanied her friends to a party.

“I didn’t want to take anything because of all the stories that older people had told me about drugs and they (her friends) laughed at me. I tried it and the drugs really made me feel good.

“I don’t think I can hang out with people who don’t want to get ‘high’; they are boring. I am young and this is the time to do all these things,” Obuh added.

However, she confessed that her parents and relatives were not aware of her drug abuse habit as she dreads judgment from older people.

Similarly, Mr. Ifeanyi Akachukwu, a 28-year-old postgraduate student, said his drug abuse journey started during his early undergraduate years following depression after he lost his father.

“You know, it is difficult to drop a habit that gives you so much peace. When my father died during my undergraduate years, I picked up the habit of smoking.

“I started smoking cigarettes but as the pain and pressure I felt increased, I needed something stronger to numb the hurtful feelings and marijuana became an instant solution”, he said.

Akachukwu noted that there was so much stereo-type around drug and substance addicts as they were usually seen as ‘never-do-wells’.

He said, “I agree that the habit is bad and it has medical side effects but everybody has one (bad) habit or the other, moreover, depression is real.”

However, the government’s ban on codeine has been met with several reactions by Nigerians, especially, with the closure of some pharmaceutical companies.

Adeolu Ogurombi, a Project Coordinator at Youth RISE Nigeria, an organisation that researches drug policy reform, said that the ban might not do much to end Nigeria’s pharmaceutical addiction problem.

“The cough syrup challenge is just a symptom of a faulty system”, said Ogunrombi.

“If we are just banning the cough syrup to try to solve the problem, then we are actually missing the point.”

Ogunrombi blamed easy access to the medicine on corruption and loopholes in the Nigerian public-health system, including pharmacies that fail to ask for prescriptions.

He added that while codeine-based cough syrup was legal in Nigeria, it was supposed to be handed out only to patients with a valid prescription or to those with a pharmaceutical license.

“A ban has not eliminated the demand for the substance. There is still a huge demand, and a criminal market is going to spring up to meet the needs of the substances”, he said.

“Just like we see a lot of overdose from Fentanyl in the U.S, such things will begin to happen here now because a lot of people who have been using codeine syrup will maybe use a deadlier substance and begin to experience overdose.”

However, a social media user, Muhammed Adia, wrote, “Codeine is the new cocaine in Nigeria now; I think the government deserves thumbs up on this one.”

Meanwhile, in a chat with newsmen on May 3, Dr. Albert Kelong Akali, National Chairman of the Association of Community Pharmacists of Nigeria (ACPN), said that the ban imposed on the importation of codeine into Nigeria is not the answer to the problem of drug abuse bedeviling the country.

Dr. Albert called for an all-inclusive approach in tackling the problem of drug abuse.

He said, “We should be able to account for all the drugs that are manufactured and imported into this country, if we have such a tracking system in place, then the issue of drug abuse will be reduced to the barest minimum.

“So the drug distribution system channel must be structured and the new National Drug Distribution Guideline (NDDG) should be implemented.

“They should be able to know that there is a drug that is being abused, investigate to find out where the abuse is coming from,” adding that with the current development, every relevant stakeholder would sit up.”

However, Dr. Okon Akiba, the Chairman for the Society for Occupational and Environmental Health Physicians of Nigeria (SOEHPON) expressed his concern on the ban of codeine and how to curb drug abuse in Nigeria.

He noted that the ban on codeine is just a scratch in the surface until the government makes a move to identify the causes of drug abuse and review the drug distribution network.

He said, “For me I don’t think we should attend to this issue from a superficial point. I think we need to first answer the question ‘why are we in this mess that we are in?’

“It’s not only codeine that people are abusing; it may thrill you to know that people are sniffing gutter, gum and a whole lot of other things to get high.

“I think we have to look into the root cause why people abuse drugs, especially youths.

“Like it is said, drug abuse is any drug that you use above the recommended dose. So, for me this is a scratch on the surface, we have not touched the main issue.

“The drug distribution channel is already infested. Since these drugs are abused they should only be sold to patients with prescription.

“If we can tackle the distribution channel and close down pharmacists without license to deal, then we can say that a solution is in view.”