Prosecute illegal sale of Tramadol

It is curious that the Federal Government’s recent ban on sale of syrups containing codeine as one decisive step towards stemming the phenomenal and widespread abuse of that and many other drugs by Nigerians has not been effective. There were reports recently that 13 containers of Tramadol, another genre of painkillers being abused, were intercepted by the authorities despite the ban on such substances.

It has been revealed by health authorities that Codeine is not the only opioid scourge in the country. Another painkiller, Tramadol, has also been reported as fuelling widespread addiction. Tramadol is an opioid analgesic prescribed to treat severe pain and is considered a safer alternative to other narcotic analgesics like hydrocodone, and methadone. However, this opioid painkiller may also be at the heart of Nigeria’s drug problem, because it is the rave for recreational drug users and the reasons are not far-fetched.

Different studies suggest that the high levels of misuse of tramadol are as a result of its easy availability in pharmacies and on the illicit market (as it is trafficked in large quantities), its lower price compared with illicit drugs, perceptions among users that tramadol is safe as it is a prescription medication, and the ease with which it can be hidden.

The recent seizures of Tramadol are pointers that the opioid is available in the illicit market. Within a month, Nigeria has witnessed Tramadol ‘armada’. On November 16, Tin-Can Island Customs Command reportedly intercepted 13 containers of Tramadol and other items with Duty Paid Value (DPV) of N3.13 billion. It was reported that 10 of the 40ft containers contained tramadol, Ciprofloxacin capsules, Diclofenac Sodium tablets, Soffeathe, IV Cannula, Sidenfil Citrate tablets; one 40ft container had bleaching soaps; and two other containers of second-hand clothes.

Similarly, two containers of Tramadol had earlier been handed over to the National Agency for Food, Drugs Administration and Control (NAFDAC) on October 11 and October 20 while a container of Tramadol was also handed over to the National Drugs Law Enforcement Agency (NDLEA) on the November 2.

If these quantities of Tramadol had found their way into the markets, the effect on the lives of Nigerians, particularly the youths is better imagined because of the devastating effect on health and security.
The uncontrolled use of Tramadol is unhealthy and can tease its user into criminal acts. Some of the social consequences are also numerous: cultism, violence, armed robbery, lawlessness, cultural disorientation, rape, assassinations, loss of productivity and all sorts of anti-social misbehaviour. Hence, the safety concerns over the availability, use, misuse and abuse of Tramadol assuming a frightening dimension in Nigeria are not unfounded.

In fact, the UN Office on Drugs and Crime, (UNODC), late last year, warned that opioid Tramadol destabilises and fuels terror in parts of Africa. According to UNODC, it is regularly found in the pockets of suspects arrested for terrorism, or who have committed suicidal attacks; including young boys and girls, preparing to commit suicide bombings. This suggests that the availability of Tramadol may be fuelling insurgency in Nigeria. Apart from that, reports have revealed that in places like northern Nigeria and Cameroon, farmers are taking and also feeding it to their cattle while long-distance commercial drivers are known to favour the drug to give them an edge on their journeys.

So, this recurring seizure of Tramadol in the last few months should be a source of concern for all and sundry, especially duty bearers in both the public and private spheres, because the consequences of its abuse to the individual and society are humongous and the abuse can cause significant damage to life.

The matter came to the fore when a foreign news medium aired an investigative documentary on how a particular cough syrup turned into street drug and became popular and expensive in the black market.

Apart from Codeine and Tramadol, the National Drug Law Enforcement Agency (NDLEA), recently uncovered an illegal methamphetamine laboratory in Orlu, Imo state, making it the 15th Meth lab that has been uncovered in Nigeria between 2011 and 2018.

Besides, on Tuesday, December 10, the Nigeria Customs Service Federal Operations Unit, Zone A, Ikeja announced the seizure of 3792 kilogramme of cannabis (Indian Hemp) worth N379.2m

Considering the trend of insecurity in the country, which some experts have partly attributed to substance abuse, it is obvious that the desperation of unpatriotic importers willing to make money at the expense of human lives and circumvent the process by bringing in unwholesome items such as Tramadol, is a show of shame and moral bankruptcy.

While the vigilance of customs officers who intercepted the consignments of Tramadol should be noted, the seizure should only be treated as a first step in addressing the problem because detection alone will not deter those unpatriotic importers and users who have already developed Tramadol addiction. A comprehensive prevention strategy is one that seeks to tackle this problem from various angles that will yield both short- and long-term results. Essentially, effective Tramadol control requires evidence-based supply chain management from the source country and the destination country, public enlightenment, engagement and monitoring of dispensing outlets and withdrawal management and rehabilitation of addicts.

Therefore, there is the need to understand the basic reasons for people being drawn to Tramadol. As a result, it is important to have a baseline on the magnitude of Nigeria’s Tramadol problem, particularly the quantity and distribution. In addition, it is important to know the demographics and psychographics of Tramadol consumers; and outline the socio-economic impacts.

So, a better understanding of the magnitude of the crisis, backed by credible data, must be put in place to stop Tramadol abuse. Therefore, rather than focus on debates, there is the need for introspection on the deeper issues involved to find a solution to this growing crisis.

Also, beyond the seizure, the government should improve the regulation and enforcement of existing regulations on sales of medications, especially in the open markets in Nigeria while experts need to carefully assess patients’ legitimate clinical needs for opioids, to ensure that these drugs do not get into the wrong hands.

Again, given the low risk perception of the dangers of Tramadol abuse, the Health Ministry and the National Drug Law Enforcement Agency (NDLEA) should work in collaboration with the United Nations Office on Drugs and Crime (UNODC) to design a good communications strategy focusing on the dangers of Tramadol abuse. Authorities concerned should fill the airwaves and public spaces with anti-Tramadol abuse messages. At the family level, parents should create enough time to attend to the needs of their children and guide them properly to adulthood. In the same vein, at the community level, religious leaders should sermonise on the ills of Tramadol abuse.

Therefore, the Federal Ministry of Health, State Ministries of Health, NAFDAC, health-related non-governmental organisations (NGOs), the Pharmaceutical Society of Nigeria (PSN) should educate Nigerians on the dangers of Tramadol. Every pharmaceutical store should have resident pharmacists who should ask for prescription before dispensing drugs and educate patients about any drugs. But that measure should not prevent prosecution of illegal distribution and sale of the killer drugs.