Africa's Opioid Crisis: Painkillers in Tea | Africa | '
This Wednesday, "World Drug Day", when the United Nations, as it does every year, is campaigning against drug abuse and illicit drug trafficking, many people think of heroin, cocaine, tobacco or alcohol. The world's most dramatic drug crisis is currently centered around substances that are actually contained in legal medications such as cough syrup or painkillers: the so-called opioids, which produce heroin-like noise effects and can quickly make them dependent.
Worldwide, non-medical use of opioids has increased dramatically over the past decade. Therefore, in the US, President Donald Trump proclaimed the national health emergency in 2017. But in many parts of Africa Opioide demand more and more victims. Tons of cheap, harmless-looking and cheap pills are smuggled onto the continent and sold to consumers on black markets – without any medical scrutiny.
UN: "We are in a crisis situation"
The United Nations Office on Drugs and Crime (UNODOC) in Vienna now speaks of a "crisis situation". "More and more people in Africa are dependent on opioids," says Matthew Nice, manager of the opioid program of UNODOC. For many countries, there are currently no precise figures, but the situation can be described as very serious. Especially in Ghana, Nigeria, Mali, Burkina Faso or Togo, non-medical opioid consumption is widespread, according to Matthew Nice in a ‘ interview. Tramadol is clearly the most consumed drug.
A market in Abidjan, Côte d'Ivoire: Trafficking in smuggled drugs is flourishing in many parts of Africa
Originally Tramadol was developed by the German pharmaceutical company Grünenthal GmbH and came in 1977 under the name Tramal on the market. When the patent expired in some parts of the world, Indian generic manufacturers were on the spot: they mass-produced the drug and also supplied to the African markets. Chinese, Nigerian and Ghanaian pills makers retreated.
Africa is particularly vulnerable
"The smuggling of pills is relatively easy, their transport is barely controlled, it's apparently not about drugs, but supposedly just a harmless drug," said Matthew Nice. Although the opioid problem also affects other regions of the world, such as North America. Africa is more vulnerable. Because in most African countries there are no effective control bodies. "Criminal organizations in Africa are particularly good at earning money," says Nice.
The consequence: More and more countries are being flooded with cheap tramadol pills. In Ghana, for example, the drug is reportedly known among consumers as a "tramore". The name is ambiguous: The opioid in Ghana also appeals as a sexual enhancer. In Gabon, where Tramadol is popularly called "Kobolo", the remedy is especially popular among students who want to improve their performance before exams. And in the Sudanese capital Khartoum, eyewitnesses say, you can have a Tramadol tablet thrown into your tea at some street stalls to recharge your batteries before hard physical work.
The opioid agent tramadol is omnipresent in Africa
"Tramadol can be bought virtually anywhere on the black market," confirms the Togolese psychiatrist Damega Wenkourama in a ‘ interview. And there the drug is often extremely high-dose and therefore becomes particularly fast dependent. "People mostly use the pills to work hard, they feel stronger, alert and more efficient, but they end up in dependence relatively quickly." The Kara hospital, where Wenkourama treats addicts, is now overwhelmed by the rising numbers of tablet addicts, the psychiatrist reports.
Drug smuggling: The role of terrorist networks
But opioid smuggling is a problem not only for public health in many African countries. "There are indications that some extremist groups and terrorist organizations are involved in, or are benefiting from, international trade in opioids," says Matthew Nice of the United Nations Opiate Program. In addition, there are reports that groups such as Boko Haram or Al Qaeda distribute opioids to their own members in order to increase their fearlessness and combat readiness.
Also, to undermine such organizations, Nice and his colleagues are advising African security agencies on the fight against smuggling networks. However, it is more important, according to Nice, to establish a functioning, legal market for medicines in the affected countries. "What we see most of all is that in many African countries, large amounts of opioids are sold completely unchecked." This is also because people who actually need painkillers would not be able to legally buy the medicines in good quality. "People are trying to use painkillers in other ways – and smuggled tramadol is one of those ways."
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