June 26 was International Drug Abuse Awareness Day. It was a day of reflection because of the epidemic of drug abuse facing Nigeria today as a nation, especially among our youths.
According to the Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Professor Mojisola Adeyeye, she joined the Senate Roundtable Conference on “Substance Abuse Epidemic In Nigeria”, in Kano, 2017. Since then, she has had opportunities to speak on the same issue in Kebbi (February 2018), a conference organised by the Office of the National Security Adviser (March 2018), etc.
Then, on April 30, a BBC documentary was aired and this jolted the whole nation into an awareness that was not as heightened before that time. The exposure of abuse of codeine implicated many stakeholders including manufacturers, NAFDAC, Pharmacists Council of Nigeria, the Federal Ministry of Health, Parents and the general public.
The abuse of drugs in Nigeria is caused by many factors including love for money by peddlers, disobedience to the laws of the country, proliferation of the market with individuals who sell medicines, lack of control of prescription in the healthcare facilities and lack of control of dispensing among dispensers. Other reasons for abuse of drugs include smuggling substances of abuse through our porous seaports and land borders, corruption and compromises at the point of entries, diversion of legitimate exports to illicit use, weakness in inspections and weak penalties for the sellers and traffickers.
There are many social factors that have resulted in abuse of drugs. These include decline of family value systems, parents not playing their roles properly, children and youth therefore not receiving proper guidance, peer pressure, social media influence, poverty and unemployment.
The most commonly abused drugs in the country are tramadol and codeine. Tramadol is a synthetic opioid analgesic used to treat moderate to severe pain and is the most abused medicine among addicts. It has no effects on the respiratory system but overdose causes arrhythmias, cramps, coma and death.
In Nigeria, it is regulated as the 50 and 100mg dosage strengths but very high dosage forms of 200 and 225mg have infiltrated the market. There is also noticeable increase in smuggling of Tramadol capsules. Tramadol use disorder is associated with physical withdrawal symptoms and compulsive behaviour.
In order to address the public health, and social problems resulting from abuse of drugs, the three arms of government – the executive, the legislature and the judiciary, Ministries, Departments and Agencies (MDAs) of Health, health, educational and religious institutions, parents must address the issues with vigour and holistically through these approaches:
- Collaboration among strategic agencies (Nigeria Custom Services, National Drug Law Enforcement Agency and NAFDAC) responsible for importation and regulation of controlled medicines and/or prevent the importation, distribution and use of illicit drugs .
- Heightened regulatory alertness, diligence and control of importation of drugs and food, now that NAFDAC has been returned back to our ports and borders
- The Federal Ministry of Health should develop National Prescription Policy
- Enforcement of the prescription policy by the Federal Ministry of Health
- Advocacy, and public awareness campaign through the print, social and electronic media should be carried out. Ministry of information and agencies directly responsible for the end users and consumers such as the Pharmacists Council of Nigeria (PCN), Pharmaceutical Society of Nigeria (PSN), NAFDAC, Medical and Dental Council of Nigeria (MDCN), etc should play active role in these. Additional funding of these should be provided by the government
- Stricter issuance of permits and registration of controlled medicines by NAFDAC
- Greater collaboration through use of task forces among regulatory bodies responsible for drugs and controlled substances – NDLEA,NAFDAC and PCN
- Extra-territorial enforcement to identify, disrupt and dismantle organised criminal groups operating across borders.
- Review of the drug laws to enable the judiciary apply penalties that are commensurate to the offences.
- Provision of more rehabiliation centers and workers to assist those that are addicted to controlled drugs
- Provision of educational and employment opportunities to the youth