Nigeria is on the precipice of a fatal epidemic. According to Buzzfeed, there are millions of Nigerians dealing with addiction to tramadol- a synthetic opiod and powerful prescription painkiller like morphone, oxycodone, and fentanyl. The number of those addicted to the drug is set to soar in the most populous nation in Africa.  

Nigerians of all ages are popping pills daily. The drug is vastly used as an aphrodisiac amongst college students in hopes of improving their sexual performance. However, it has been recovered that tramadol has been used amongst Boko Haram members and refugees in refugee camps.

In Nigeria, 70% of all those in rehab for opioid abuse used tramadol as their drug of choice. Less than a decade ago, beds at the National Drug Law Enforcement Agency (NDLEA) facilities were filled almost exclusively with working-class people struggling to wean themselves off alcohol, heroin, and/or marijuana, but now more and more patients abusing tramadol are finding their way through their doors. 

The reason that tramadol is so commonly abused isn't in its effects, but in its ready availability. Unlike morphine, heroin, or cocaine, tramadol is easier to obtain and can be distributed in large quantities due to an international loophole that allows Southeast Asisa to legally produce vast and unregulated amounts of the drug which is then imported to Nigeria. 

Though the International Narcoctics Control Board regulates how much opiod or synthetic opiod products each country can produce or purchase, tramadol can't be regulated because scientists designated it an "unscheduled drug". Therefore, there is no limit to its production or distribution. 

Tramadol's "unscheduled" immunity made the drug an obvious choice amongst Nigerian medics trying to manage pain medication for cancer and post-surgery patients. 

Tramadol relieves pain, but also has calming effects. However, tramadol is not exclusively abused on its own. It has been discovered that tramadol is being taken in conjuction with codeine or with Rohypnol, also known as the date rape drug.

Codeine is another opium based drug that is being highly abused amongst Nigerian youths. Codeine can be taken to wash down tramadol, or can be taken as cocktail with sprite or some type of drink. Nigerian artist Falz even touched on this topic in his viral video, "This Is Nigeria".

Taken on its own, tramadol is rarely fatal, but when it is mixed with other drugs, it can become a sedative powerful enough to stop the heart. Pharmacists in Nigeria have been lobbying for years to reduce codeine subscriptions, but prescribers don't want to lose their profit margins who continue to prescribe cough syrup. 

Just like the US, Nigerian officials caught on too late to the epedemic and are now scrambling to find solutions to the problem. In May of 2018, in response to codeine abuse, lawmakers announced a ban on the importation and production of cough syrup hoping that the ban on codeine would also have adverse effects on the use of tramadol. 

Also like in the US, where a lack of insurance and access leaves millions of people without proper care, most people with addiction in Nigeria struggle to find the kind of ongoing support and resources necessary amid the country’s flawed health care system.

According to studies, it takes around two years for the brain to adjust to coming off opioids, but those coming out of detox have a lowered tolerance, meaning relapsing is  potentially fatal. With Nigeria's few clinics unable to provide adequate means of support for addicts, many turn to churches and mosques in search of help. 

When the NDLEA was set up in 1990, it had included rehabilitation centers run under its “drug demand reduction” units, which was a way of curbing drug smuggling and abuse. 

But just like the majority of institutions in Nigeria, corruption seeped into the agency. Mismanagement and a lack of resources left it hobbled and usueless in almost every aspect. Training is almost nonexistent or outdated. 

Still, those who end up in one of the NDLEA’s handful of beds nationwide are, technically, the lucky ones. For all the other rehab center’s failings, the misconception about drug abuse and  mental health that Nigeria's society projects that it is that its the patient's fault, still reigns supreme.  

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