The federal government’s recent ban on codeine and tramadol due to their destructive nature and widespread abuse in the country has been undermined by smugglers who have switched to the illegal importation and smuggling of the product and other equally addictive substances. In this report, SAMSON BENJAMIN examines the issues arising from the ban.
The misuse and abuse of, and overindulgence in drugs have become a common occurrence in all age groups and gender but more prevalent in adolescents and adults.
Blueprint Weekend recalls that the federal government had on May 1, this year, banned the importation, manufacturing and distribution of codeine cough syrup due to its devastating effects on those addicted to it.
Codeine and tramadol are reported to be highly addictive and, if verindulged, over time they could cause kidney damage, liver damage, seizures and all kinds of mental disorder. Also, experts have associated the use of tramadol, a synthetic analgesic, with physical withdrawal symptoms and compulsive behaviour.
Dealers resort to smuggling
However, after the ban, smugglers and drug users who are bent on eating the federal government’s effort to check the menace of substance abuse have shifted their interest to smuggling of the banned substances and consumption of other substances which is said to produce similar effects to codeine and tramadol. According Nkechi Agu, a psychologist, “smugglers now find a way of smuggling the medicine into the country through Nigeria’s porous borders, making it difficult for regulatory and security agencies to clamp down on the abuse of codeine tramadol among the youth.”
Blueprint Weekend’s checks revealed that in the last one month, over 0 containers of tramadol worth billions of naira had been impounded by drug enforcement agencies and the Nigeria Customs Service (NCS). Similarly, Last week, The National Agency for Food and Drug Administration and Control (NAFDAC), says it has destroyed substandard and falsified medicines, unsafe drugs and unwholesome food and chemicals worth N3 billion in the last one year.
The agency also revealed that it had seized tramadol with a street value of N198 billion and would set the products ablaze soon. Apart from tramadol, other products destroyed are codeine, illegally imported unwholesome sugar and some counterfeit medicines.
The Director-General NAFDAC, Prof Mojisola Christianah Adeyeye, disclosed this recently in Abuja while presenting her one year anniversary speech. Prof Adeyeye, said three persons involved in the distribution of the banned tramadol have been arraigned at the Federal High Court, Lagos, even as plans are underway to destroy more than 30 additional containers of tramadol and other unregistered products worth more than N198 billion in the streets.
Adeyeye said: “Little did I know that aside from substandard and falsified medicines issue, the unsafe and illicit drugs would become a significant part of my role as the Director-General of NAFDAC in safeguarding the health of the nation.
“Since my assumption of duty, the new Director of Ports Inspection Directorate and his team have intercepted 86 containers containing tramadol and other unregulated drug products. These include 23 40-foot containers recently examined and found to have been loaded with tramadol of various strengths from 120mg to 250mg.
“Tramadol and other unregistered pharmaceutical products that are known to be injurious to the health of the public, most importantly our youth. The tramadol is estimated to be 6,446,100,000 tablets. The worth of tramadol alone on the street is estimated to be at about N193,383,000,000 on an average cost of N1,500,000.”
“In addition, 321,146 cartons of other unregistered pharmaceutical products that could be worth hundreds of millions of naira. Prevention of these dangerous drugs from entering into the Nigerian markets would protect millions of youths from hazards of drug addiction that can pose threat to families, Nigerian workforce and the security of the nation at large. This would have increased the number of casualties from insurgency, armed robbery and other social vices that are known to be the aftermath effect of use of illicit drugs,” he added.
Further, the DG said: “The Agency secured the conviction of one of the distributors and the court ordered the destruction of the seized consignment. To further protect the health of consumers, the Agency destroyed fake, adulterated, counterfeit, banned and unwholesome NAFDAC regulated products worth N4 billion in exercises across the nation, while also clearing its Apapa warehouses that had been filled to the brim since 2013.
“This is the crux of our regulatory activities and involves almost all the technical directorates. It starts from the Ports Inspection through Laboratory Services to pharmaco-vigilance and to Investigation and Enforcement.
“Removal of NAFDAC from the Ports from 2011 to 2018 worsened the problem of substandard and falsified medicines, illicit drugs and unwholesome foods in the country and portended real danger to the populace.
“Through the support of the Presidency, Office of the National Security Adviser and my incessant awareness campaign about the implications of absence of NAFDAC at the Ports, NAFDAC was returned to the Ports in May 2018 and was also included on the inspecting MDAs in the Kaduna dry port in August 2018.”
Substance still on sale
Blueprint Weekend investigation revealed that despite NAFDAC efforts on the banned tramadol and cough syrups containing codeine, its sellers are still in business. In some of the medicine stores visited by our correspondent in Masaka, a settlement in Nasarawa state, about 20 kilometres from the Federal Capital Territory (FCT0, young men in their early twenties were seen patronising the banned substance. Although, the medicine stores do not display the banned substances inside their shops; rather, they are kept in other hidden stores, from where it is supplied to customers.
A medical shop owner told Blueprint Weekend that unless the supply chain is completely cut off, the sales will not stop because the business is lucrative. “Ordinarily, a bottle of syrup is supposed to sell at N300, but now, it sells at N900 because of the high demand.
The sellers deliberately hiked its price, bearing in mind that buyers will still patronise them,” he said.
Blueprint Weekend further learnt that drug dealers in Mararaba, a settlement on the ever-busy Abuja – Keffi road, renowned for substance abuse now sell to their customers through third parties or agents. According to our findings, they had to resort to that method because they have been having a running battle with personnel of the National Drug Law Enforcement
Interestingly, an officer of NDLEA, Mr. Abdullah Umar said that from the day that codeine and tramadol was banned in the country, the product disappeared on the shelves of chemist shops and pharmaceutical stores in the area. He, however, added that the dealers might have removed them from shelves in order to feel the pulse of the government over the announcement.
“When we carry out raids, in every five arrested, drug will be found on four. Unfortunately, we don’t have a rehabilitation centre in this area; therefore, we only engage them in counselling. And parents don’t cooperate with the agency to carry out effective counselling. “The ban is a right step in the right direction, but the fight against drug abuse needs to be given a holistic approach. The NDLEA, being the agency to enforce the ban, needs to be properly equipped,” Umar said.
Ban not enough
According to Mr. Adeolu Ogunrombi, a project coordinator at Youth RISE Nigeria, an organisation that researches drug-policy reform, the ban did not do much to end Nigeria’s pharmaceutical-addiction problem.
He said: “The cough syrup challenge is just a symptom of a faulty system, if we banned the cough syrup to try to solve the problem, then we have actually missed the point. I blame easy access to the medicine on corruption and loopholes in the Nigerian public-health system, including pharmacies that fail to ask for prescriptions. 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 licence.
“The outright ban on the syrup only confirmed fears in many quarters that it will only let the government step back from responsibility for widespread addiction and open the door to unregulated and potentially more dangerous replacements. A ban has not eliminated the demand for the substance. There is still a huge demand, and a criminal market has sprung up to meet the needs of the users who are in need of the substances. 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 have started using deadlier substance.”
Speaking to Blueprint Weekend, Buba Mohammed, a pharmacist who was involved in the move that culminated in the ban of codeine because his advocacy and campaign led to a motion for the ban of codeine and other prescription drugs abuse by youth on the floor of the Senate, said: “Nigerian government needs to move beyond the ban of codeine to solve the abuse of drugs among the youths of the country.
“Many youths who are enmeshed in drug abuse are disoriented today and fragmented tomorrow. The ban of codeine was commendable but the federal government needs to know that there are many other drugs out there that are still abused and are equally dangerous as codeine.
“The government should not stop at codeine and tramadol ban, but equally outlaw other prescription drugs still being abused.”
He lamented that drug abuse especially cannabis and cocaine had for long been a problem among northern male youth, but codeine cough syrup and other drugs along the line became the new cancer ravaging the women and girls in the North.
“The increasing abuse of cough syrups and other prescribed drugs among the youth and women across the 19 northern states in the country has resulted in meaningless deaths, rendered them largely unproductive and has devastated many upper and middle class families in Northern Nigeria,” he said.
Similarly, the Association of Resident Doctors (ARD), Federal Neuro-Psychiatric Hospitals has called on the government to go beyond mere ban. Speaking to journalists during mental health education in commemoration of the International War Against Drug Abuse and Illicit Trafficking Day (IWADAITD) held annually recently at the Ojuelegba Motor Park, which is notorious for drug abuse in Lagos state. The President of the association, Dr Raliat Akerele, said that the association chose the park to educate people on the dangers of drug abuse because it reportedly harboured people who abused drugs.
NAN reports that the theme for the 2018 IWADAITD was: “Listening to Children and Youths is the First Step to Help Them Grow Healthy and Safe.”
Akerele said: “Anecdotal reports from passers- by and people boarding buses at the park show that a lot of drivers and conductors take and abuse substances.
“We feel it is a good ground to educate people about the effects and where they can get help. Based on my assessment, a lot of them are using substances; some of them have it in their possession and many of them are not aware of the harm that substances do to them.
“Many of them also do not believe that substance abuse can lead to mental illness, as they say that those who are suffering from mental illness are different.”
The president identified affordability, accessibility and availability as factors contributing to abuse of substances at such a park.
According to her, federal government’s ban on the importation of Codeine and Tramadol is not enough to stop substance abuse.
She said that the government would need to tackle drug abuse at every stage of the distribution chain and also ensure that people selling substances should have a license.
“If everyone has a licence, and drugs are not cheap, it is not everybody who will be able to sell the substances; the price will be regulated, then it will not be that affordable anymore. Also, if people are licensed, they will want to check the identities of those who come to buy the substances.
“Why do people use these drugs? These are analgesics that are used or pains; we can have alternative pain medications that are not addictive. Now that the government has banned the substance, the production and prices will increase because they will become scarce,” she said.
The psychiatrist expressed worry that some users could resort to crime in a desperate search for the scarce substances.
Similarly, the vice-president of ARD, Dr Moruf Mustapha, said there has been significant increase in the use of multi-psychoactive substances among Nigerians in the past 12 months.
According to him, motor parks are among the places people congregate including bus drivers, conductors, and jobless people to use the substances.
He said: “We find it very important, as part of our community outreach, to reach out to our co – citizens and educate them on the hazards of drug abuse.
“We pointed out the dangers to some of them and engaged more rational ones among them; we hope to keep doing this. Continuity of education is very important when meeting these people; we have to keep emphasising and re -emphasising the dangers of drug abuse.
“The next steps are to make them to come for treatment, rehabilitate those who need it and attain harm reduction in the community; we aim to achieve this in a big scale.”
