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Cannabis and Tramadol: The Raging Scourge

The 2021 World Drug Report of the United Nations Office on Drugs and Crime (UNODC) estimates that 275 million (5.5%) of the global population, aged between 15 and 64 years, had used hard drugs habitually in the previous year. It has also been projected that 36 million individuals will be experiencing drug use disorders. Furthermore, the Global Burden of Disease Study estimated that between 2017 and 2020, there were 1,755,000 deaths due to drug usage and drug-related crimes, globally. 

The burden of drug abuse (usage, abuse, and trafficking) has also been related to the four areas of international concern, viz-a-viz organised crime, illicit financial flows, corruption, and terrorism/insurgency. Therefore, global interventions for preventing drug abuse including its impact on health, governance, and security, have maintained steady advocacy over the years.

In Nigeria, the menace of drug abuse is on the rise and has assumed the dimension of a public health concern. Nigeria, which is the most populous country in Africa, has developed a reputation as a centre for drug trafficking and usage, mostly among the youth population. According to the UNODC report, ‘Drug Use in Nigeria’, the first large-scale, national drug use survey in Nigeria, one in seven persons (aged 15–64 years) had used a drug in the past year. Also, one in five individuals who had used drugs in the past year is suffering from drug-related disorders. Drug abuse has been a cause of many criminal offences such as theft, burglary, sex work, hooliganism, social disorders, shoplifting, amongst others.
 
BBC Africa famously released an investigation into drug abuse in Nigeria through an exclusive documentary titled ‘Sweet Sweet Codeine’ in May 2018. The documentary exposed the mystery behind the wide circulation of codeine among young persons in the country.  It also revealed that thousands of young Nigerians are addicted to codeine cough syrup – an expectorant that has become an abused street drug. The investigation estimated that up to 3 million bottles of the addictive syrup are drunk every day in just two northern states. Taken in excess, codeine can cause psychosis and organ failure. An effective painkiller, codeine is also capable of giving euphoric intoxication if consumed in large quantities. It is highly addictive and if taken in excess, it can have a devastating impact on the mind and body. The investigation revealed how some corrupt officials of big pharmaceutical companies have been conspiring with distributors, who violate the standard procedure by making the cough syrup available in the open market, thereby giving the public uncontrolled access to it. The discovery and extent of the cough syrup abuse in Nigeria was mind-boggling and appalling. Equally disturbing was the sheer size of the criminal network involved in the illicit trade.

Nigeria is an enormously diverse country, with over 250 ethnicities and many religious groups. Drug abuse is therefore viewed within a broader context, due to its multicultural nature. For instance, some societies do not consider the use of some drugs which do not produce overt behavioural changes as drug abuse. However, despite this multicultural nature of the Nigerian population, there is a consistent outcry from both the public, law enforcement agencies, preachers, health professionals, teachers, non-governmental organisations, regulatory agencies, and parents on the growing burden of drug abuse in the country.

The campaign against drug abuse in Nigeria is led by the National Drug Law Enforcement Agency (NDLEA), which is charged with eliminating the growing, processing, manufacturing, selling, exporting, and trafficking of hard drugs. The agency was established by Decree Number 48 of 1989 and is present nationwide, as well as in the nation’s international airports, seaports, and border points. The agency tries to eradicate hard drugs by disrupting supply, confiscating drugs, apprehending distributors and end-users, destroying drug warehouses and plantations, amongst other strategies. The NDLEA also targets the leaders of narcotics and money laundering organisations.

Recently, the Chairman of the Agency, Brig-Gen. Mohammed Buba Marwa, disclosed that in the last six months (January-June 2021), the agency has arrested over 2,180 drug traffickers, seized over two million kilogrammes of assorted illicit drugs, and destroyed over 200 hectares of cannabis farms, with some methamphetamine laboratories. During this period, the agency has also seized over N90 billion in drugs and cash. He further stated that the agency has filed at least 2,100 drug cases in court, recording over 500 convictions, with 1,549 cases pending in court. 

A prevalence of 20–40% and 20.9% of drug abuse was reported among students and youths, respectively. Commonly abused drugs include cannabis, cocaine, amphetamine, heroin, diazepam, codeine, cough syrup, and tramadol. Sources where abusers obtained drugs include pharmacies/patent medicine shops, open drug markets, drug hawkers, fellow drug abusers, friends, and drug pushers. Drug abuse is common among undergraduates and secondary school students, youths, commercial bus drivers, farmers, and sex workers. Reasons for use include the desire to increase physical performance, to relieve stress, and to derive pleasure. Poor socioeconomic factors and low educational background are the common risk factors associated with drug abuse.

Some common classifications of drugs include depressants (alcohol, cannabis, barbiturates, benzodiazepines etc.); hallucinogens, inhalants, narcotics/opioids (morphine, heroin, Codeine, tramadol, etc.), steroids, and stimulants (e.g., cocaine, meth, heroin). These classifications may vary, depending on who is doing the classification. Illicit drugs can also be classified according to how they are controlled, such as Schedule I, Schedule II, and Schedule III etc., as spelt out in the three UN Conventions of 1961, 1971, and 1988.

In Nigeria, cannabis rank as the No. 1 most abused substance, by 10.6 million Nigerians, followed by prescription opioids such as tramadol, codeine and morphine, used by at least 4.6 million people. Other dangerous mixtures, such as Rophynol, are also widely abused, especially by young people. According to research, cannabis is mostly used by those between ages 25 and 39, but most of them got introduced to the substance in their teenage years. So, youths generally, from age 13, are susceptible to drug use.

Relying on statistics from the most recent research, the Nigeria Drug Survey 2020 or Global Drug Survey 2020, it is apparent that the use/abuse of illicit drugs is rampant and spreading exponentially, both in the urban centres and in the rural areas of the country. While taking into consideration the country’s drug abuse prevalence which is at 14.4%, a statistic almost three times the average global prevalence of 5.5%, it becomes unarguable that drug abuse has become a major epidemic in the country.

What is pertinent to this situation is that illicit drugs are mainly psychoactive substances, in as such, they affect the mental state of the user, and a user under the influence of any of such substances cannot take full responsibility for his/her action. Psychoactive drugs induce psychosis, a condition whereby the way the brain processes information becomes warped and the user loses touch with reality to the point that s/he begins to see, hear or believe things that are not real.

The outward signs may include anxiety, panic, impaired attention and memory. All of these lead to an inability to think clearly, and an increased risk of accidents. Under such conditions, a user can become violent and kill others, inflict self-harm, or even commit suicide. For example, a 400-level student of Abia State University reportedly jumped to his death from a three-storey building after using Colorado, a narcotic which is a variant of cannabis. Fresh in the mind is also the case of a young undergraduate girl, Chidinma Ojukwu, who was recently charged with homicide in the unfortunate death of Michael Usifo Ataga, the CEO of Super TV. She alluded to being under the influence of hard drugs in the chain of events that led to the ill-fated murder. The other things people under the influence of drugs range from prostitution to stealing to the worst of crimes, such as murder, banditry, terrorism, cultism, kidnapping, and armed robbery.

Most rescued victims of kidnapping have attested that their abductors consumed a lot of cannabis and opioids such as tramadol, and captured Boko Haram insurgents have confessed to the addictive use of illicit drugs. Cultists apprehended have confessed to hardening their feelings and emotions by using illicit drugs. A whole lot of atrocities are committed by those who ingest or abuse illicit drugs.  

Two suspects were recently arrested in Abeokuta, Ogun State, including a security operative who was a purveyor of illicit substances and was the supplier to students and cultists on the campus of a federal university. This scenario depicts a clear instance of the chain of drug abuse in the country, as the security operative was caught with different types of illicit drugs including 17 bottles of codeine, 22 grams of cannabis, 98 grams of tramadol, 61 tablets of flunitrazepam, 48 grams of marijuana (113 tablets), and 44 grams of sex-drops that was intended to be transmitted to the students of this institution.

Statistics on drug abuse in Nigeria have demonstrated that the burden of drug abuse is still high, despite the existing drug laws, policies, and strategies for prevention. Measures to reduce the burden should actively involve the community, educational groups, mass media, government, and religious bodies. Preventive measures should target youths, students, identified sources of the drugs, and the reasons and risk factors associated with drug abuse in Nigeria.

It is against the backdrop of this renewed war against illicit drug activities in the country that every opportunity must be availed to drive the message home to Nigerians about the importance of having a drug-free country. Drug abuse as an enabler of all forms of criminality is a hydra-headed monster that must be crushed, if we must move forward as a nation. The solution lies in having an efficient anti-drug machinery at all levels of the society. 

Abuse of narcotics has incapacitated the workforce of organisations and ruined communities and societies. It has brought about family disintegration, decimated the capacities of our youths, and given rise to all types of crimes such as insurgency, terrorism, banditry, kidnapping, rape, and violent extremism, which have befallen nations including ours with attendant health and damaging consequences on the users.

The sanction on drug usage depends on the degree of the drug offence. The NDLEA Act stipulates that “any person who, without lawful authority, knowingly possesses or uses the drugs popularly known as cocaine, heroin or any other similar drugs by smoking, inhaling, or injecting the said drugs shall be guilty of an offence on conviction to imprisonment for a term not less than 15 years but not exceeding 25 years.”

As highlighted earlier, the NDLEA in response to the declaration of a state of emergency on drug abuse in Nigeria has been making remarkable progress in the battle against drug epidemic and there is a need to sustain the enforcement efforts with the launch of community-assisted non-stop offensive actions.

The Federal Government has also launched a new National Drug Control Master Plan (NDCMP) for the period between 2021 and 2025.   The NDCMP 2021-2025 is the outcome of two years of coordinated, collaborative, and multi-agency effort comprising experts from all the relevant Ministries, Department and Agencies (MDAs) as well as Civil Society Organizations (CSOs).  Developed with the technical support from UNODC, the NDCMP is a result-based strategic planning tool for coordinating interventions against illicit drug use and trafficking and related organised crime in Nigeria.  The plan contains four strategic pillars: Supply Reduction; Drug Demand Reduction; Access to Controlled Medicines for Medical and Scientific Purposes; and Governance and Coordination.

Each of the strategic pillars is anchored on one or two MDAs of the government that will be responsible for achieving desired outcomes.  The main goal of the NDCMP 2021-25 is to contribute to improving health and security for all Nigerians. It acknowledges that the problems arising with drug supply and consumption are not restricted only to people who use drugs, but have wider health, social and economic consequences on the family, community, and the nation at large. Based on this, the NDCMP adopts a broad-based, comprehensive, and inclusive approach for addressing drug-related issues. The framework should be effectively monitored for strategic implementation and sustainable success.

There is also a need to intensify advocacy campaigns aimed at orientating communities about the danger of the use and abuse of illicit drugs as a preventive measure that will help to keep young people away from controlled substances, while the NDLEA should also speed up the conviction and prosecution of drug-related offenders to serve as a deterrent to others.

Additionally, collaborations with a lot of Faith-Based Organisations (FBOs), Community-Based Organisations (CBOs), Non-Governmental Organisations (NGOs), donor organisations, primary schools, secondary schools, universities and other academic institutions of learning should be embarked upon and actively sustained on grassroots and national levels, with the key participation of press and media organisations. At the same time, it is equally important to make the message unmistakably clear to those involved in the proliferation, distribution, and trafficking and uses of illicit substances – the cartels, barons, traffickers, and addicts; that it is time for them quit or face the inevitable consequences.