Some Stakeholders in the fight against illicit drug trafficking and abuse have raised concerns over the non-medicinal use of tramadol in the countries within the West African sub-region.
The stakeholders expressed their concerns in separate interviews with News Agency of Nigeria (NAN) in Abuja at the end of the inauguration of the West African Drug Report 2014 to 2017 by the United Nations Office on Drugs and Crime (UNODC).
Mr Cheikh Toure, the Regional Programme Coordinator on Support to ECOWAS Regional Action Plan on Illicit Drug Trafficking said that the causes of drug abuse were wide-ranging.
Toure said that the UNODC report linked drug abuse to unemployment.
He, therefore, called on governments to strike a balance in the use of tramadol considering its importance in the cure of diseases.
“But I think this is why we have to strike a balance to ensure that the state regulatory board take themselves seriously and control this type of medications coming into Africa to ensure that those drugs are used for what they are intended for,’’ Toure said.
Prof. Isidore Obot, the Director, Centre for Research and Information on Substance Abuse (CRISA) in Uyo said that the issue of illicit trafficking of drugs like Tramadol was becoming a global issue.
Citing the UNODC report, Obot said that those undergoing treatment for drug abuse were children from the age of 10 years old to 19 years old.
According to him, early prevention through advocacy at the primary school level was needed to tackle the menace.
Obot added that teachers and parent could play great roles in drug abuse prevention, noting that control measures were needed at this point for the consumption of tramadol.
“Cannabis remains a big problem in the region, we find large number of it with very young people from 10 years old smoking it.
“This is something we need to look into because Tramadol is a very important pharmaceutical substance used for severe pains.
“Tramadol for prescription is not usually abused, the one abused are usually manufactured from illicit market, a lot of enforcement is really needed,’’ he added.
He urged government to start prevention and awareness programme early, and to educate
parents and teachers on the need for them to “wake up”.
Mr Oliver Stolpe, UNODC Representative in Nigeria, said that the non-medical use of prescription such as tramadol appears to be growing most rapidly in the region.
He said that there had been a dramatic increase in tramadol seizures from 17 tonnes in 2014 to about 232 tonnes in 2017 .
According to him, the fact that more than 60 tonnes of tramadol seized in 2017 were in transit to other countries, there was need to call for increased cooperation and intelligence-sharing among countries in the region.
Mr Baba Oseni, Director, Drug Demand Reduction of National Drug Law Enforcement Agency (NDLEA), reiterated the agency’s commitment toward the fight against drug trafficking.
He said that when the agency visited most of its counselling centres for drug users, majority of those undergoing rehabilitation were youths.
According to him, management of the agency is planning to carry out an awareness campaign aimed at making the youth to see the negative on drugs.
“NDLEA has been committed to support all the efforts of the sub-region both in terms of supply reduction and demand reduction.
“We have seven counselling centres with the efforts and support of our friends we hope to increase the number as soon as possible so that we can have more data,’’ Oseni said.
Tramadol, sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain.
Abuse, dependence, and overdose of tramadol have become a serious public health concern in some African countries and parts of Western Asia.
Recognised risk factors for tramadol overdose include depression, addiction, and seizures.
Naloxone only partially reverses the toxic effects of tramadol overdose and may increase the risk of seizures.
Deaths with tramadol overdose have been reported and are increasing in frequency in Northern Ireland; the majority of these overdoses involves other drugs including alcohol.
There were 254 tramadol-related deaths in England and Wales in 2013, and 379 in Florida in 2011.
In 2011, 21,649 emergency room visits in the United States were related to tramadol.
According to the World Health Organisation (WHO) in its May 2018 World Report, tramadol is available as an unbranded product often containing supra-therapeutic doses (up to 500 mg in some cases), and as a counterfeit medicine.
In 2016, the International Narcotics Control Board (INCB) reported that more than 40 million pills of counterfeit tramadol had been seized at the port of Cotonou, Benin, West Africa.
Data provided by UNODC (July 2017) on global tramadol traffic showed a steady increase in seizures between 2007 and 2015.
In 2012, the Container Control Programme (CCP) led to the seizure of 19 containers with over 100 tons of fake tramadol, all originating in India and seized in West Africa.
At the end of 2017 the UNODC warned of the increase in trafficking and consumption of tramadol.
In the last 5 years seizures of the drug have risen from 300 kg to more than 3 tonnes. Benin, Nigeria, Ghana, Togo, Niger, Sierra Leone, Cameroon and Cote d’Ivoire were highlighted as the major transit or destination countries.
The involvement of criminal organisations, armed groups and terrorist organisations such as Boko Haram in Nigeria and the Islamic State of Iraq and the Levant in Libya have led to suggestions that the trafficking of tramadol plays a direct role in destabilising the region (WHO World Report, May 2018).