Two-thirds of global drug deaths now come from opioids, according to a recent report by the UN. 53 million people worldwide use opioids today, coming second-place to cannabis, used by 188 million people globally.

A significant portion of opioid use is concentrated in West Africa. Codeine and tramadol, strong painkillers, are the main opioids used in the region, both recreationally and for mental alertness. In Nigeria, many workers use tramadol, because it allows them to work harder while ignoring pain and hunger.

“The market women use it here in Lagos. They use it to wake up very early and work long hours. They carry very heavy goods for hours when they use drugs,” a Nigerian businesswoman said.

“The men use it too. They can carry very heavy items like washing machines and fridges when they are on drugs, so they work as movers,” another retiree from Nigeria said.

Nigerian customs have intercepted many trucks bringing opioids into the country. In September 2018, The Nigerian Customs Service (NCS) intercepted a truck with concealed cartons of cough syrups with codeine, diazepam and tramadol injections and tablets.

Last month, the NCS intercepted containers of tramadol worth ₦5 billion ($14,000), in the capital, Lagos State. In July 2019, about ₦7 billion ($20,000) worth of tramadol was destroyed by the NCS. Almost 90% of the pharmaceutical opioids seized globally in 2016 were seized in Africa.

Why Opioids?

In West Africa, opioid usage is now a crisis. Opioids are cheap, widespread and highly accessible in many West African nations. Mainly manufactured in India and smuggled into West Africa, they offer mental release to a population living in poverty and facing mass unemployment, with no opportunities for social mobility.

West African nations top the world’s poorest nations list. In 2016, 79% of global suicide occurred in low- and middle-income countries. The rising rate of opioid abuse has directly led to an increase in mental health diseases in the region.

“In Kenya, Nigeria and South Africa triggers of mental illness such as unemployment and violent crime are at critically high levels. The mental health picture is far worse in poorer countries, especially those that have recently experienced civil wars and conflicts, including Liberia and Sierra Leone,” the UN explained.

Nigeria: Textbook Example

West Africa’s opioid crisis can be understood throughout Nigeria. 55% of youths in Nigeria are unemployed. A great cause of this unemployment is mass corruption within political institutions. Political elites have, for decades, stolen government funds for their personal pockets, refusing to invest in the country’s infrastructure and institutions.

Corruption among officials has led to very few prosecutions of drug dealers caught smuggling illegal opiates into the country. Although it is legal to buy tramadol from pharmacies in the country, many drug users opt for the illegal varieties which can go as high as 600mg, six times the recommended dosage for the synthetic opioid.

Nigeria has the fifteenth highest suicide rate in the world. Trauma caused by generational problems, such as poverty, economic and political instability, unemployment, lack of education, religious and tribal violence, along with a corrupt government, has led to 14% of the nation’s population abusing tramadol.

When taken in high doses, tramadol can produce the same high as heroin, giving users an euphoric experience. In Northern Nigeria, tramadol abuse is rampant among Boko Haram members, who take it before their violent attacks.

Mr Pierre Lapaque, the UNODC’s (United Nations Office on Drugs and Crime) Regional Representative in West and Central Africa confirmed in 2017 that: “Tramadol is regularly found in the pockets of suspects arrested for terrorism in the Sahel, or who have committed suicidal attacks. This raises the question of who provides the tablets to fighters from Boko Haram and Al Qaeda, including young boys and girls, preparing to commit suicide bombings”.

Many who have been internally displaced by Boko Haram also abuse tramadol for relief against PTSD as a result of their experiences, including loss of loved ones and being kidnapped to work as child soldiers.

In 2012, the Nigerian government banned over-the-counter codeine cough syrups after widespread abuse by the population. Tramadol, however, is a legitimate painkiller used in hospitals all over Nigeria. A nationwide ban of tramadol will cause patients dealing with pain to suffer, such as sickle cell anaemia patients.

The UNODC has pledged to “support governmental institutions in the region to strengthen the capacities of law enforcement and justice officials to fight illicit trafficking and terrorism.” Furthermore, it also promised to “deliver support on border control (land, aerial and maritime borders), and intelligence gathering and sharing.”

West Africa’s opioid problem, however, is a political one that wouldn’t benefit from simple government surveillance and crackdowns. Rather, West African governments must tackle youth, unemployment, civil unrest and war, and corruption. Once West Africa reaches social stability and financial mobility, mass demand for opioids will subside.