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Trading one addiction for another

By Denrele Animasaun

Behaviour of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope’.—Russell Brand

There is a drug problem in Nigeria, and it has been kept under wraps for far too long complicity and prolonged denial  has played a significant role in breeding this pernicious addiction. Sticking heads in the sand does not make it go away nor because it is not one’s immediate problem, will not do that either. What affects one, also affects the other. In a country, that is ill-equipped to deal with such epidemic, this is tragic. In a country that has inadequate or hardly any rehabilitation centres or specialists to run it, this makes it doubly tragic.

Codeine is no standardised drug. It is very deceptive, cheap and accessible and that is what makes it problematic. Addiction does not occur over night and according to the definition in the Diagnostic and Statistical Manual of Mental Disorders, drug use transforms into addiction when habitual drug use begins hurting someone’s function by, for example, leading them to steal or commit other crimes to obtain heroin or, in the worst case scenario, resulting in death.

This is not a victimless problem. It becomes never ending cycle, they take drugs to feel good and numb their problems and do more and until, they can no longer exist without a hit. The more addicted they become, the more removed from normal day to day they become; they cannot hold down a job or a relationship; they lie, steal and put their lives in danger if it means they get a hit.

The Nigerian customs officers have made a number of seizures of codeine in the last couple of  months, after a UN Office on Drugs and Crime warning that non-medical use of the synthetic opioid was rising.

Increased use of codeine-laced cough syrups and other more unconventional drugs such as solvents has been attributed to poverty and other social issues, including high unemployment.

As early as 2015, the cough syrup laced with codeine overtook tramadol as drug of choice for addicts. Tramadol is very addictive and long use of tramadol is counterproductive from a therapeutic perspective and it is not very accessible. Codeine, on the other hand, is easily accessible and has become the opiates of choice; it is shocking that thousands and thousands of young people in Nigeria use it. In the North alone, over three million bottles of codeine cough syrup are consumed daily. The BBC documentary highlighted this epidemic to the world and it is shocking to see young men huddling together and chugging cough mixtures down their throats and are positively high.

The government have said that they are acting to ban the sale of the cough mixtures for inappropriate use. It is a little too late because, this  horse has bolted. Nigeria does not need this but sadly this is the sign of the times. Our young have casted up the river without a pedal, no jobs, no education or training.

A family member of a codeine addict has said: “I call on all security agencies, lawmakers, judiciary, drug manufacturers, civil society, regulators, teachers, parents, neighbours and you to take this as a personal war and halt the menace.”  The need to act swiftly and decisively to arrest this epidemic before it visits every home, up and down the country.

Right now, it is said that it recorded that far too many pharmaceutical companies are selling the drug illegally and up to  70 % of codeine cough syrup, is  produced and imported to Nigeria  and shockingly into the hands of the insurgents according to Senator Leadehmed Lawan.

So the Federal Government on May 1st  has ordered an immediate ban on issuance of permits for the importation of codeine as active pharmaceutical ingredient for cough preparation. And the Minister of Health, Isaac Adewole, in the directive said the move became necessary due to the gross abuse of Codeine in the country.

“Today in Nigeria there is hardly one single family that does not have an addict of some sort. This is the most destructive phenomenon in Nigeria after the killings by Boko Haram and the bandits,” he said.

“I believe that today between the Executive and Legislature we have found a common ground. We debated and took resolutions. The Executive have found enough reasons and grounds to ban the importation of this deadly syrup.  Let us hope that is not all talk and no action.

If the government is serious about eradicating codeine abuse, they have to look at the lack of infrastructure and facilities to support and treat addicts. Chaining them to trees and applying concoction of herbs is not going to cut it. It is important to deal with the core problem why these addicts got in to taking codeine in the first place. Unless, the government understands the uncomfortable truth and are committed to help and invest in all areas, then unfortunately, this epidemic would not go away. Addiction is a mental health problem and it needs specialists that are scarce resources in Nigeria.

Mission Impossible– Doctor M.I.A

Nubi Peter, a psychiatrist admitted that the country’s mental health system is heavily reliant on the whims of the politicians: “take for an example in Nigeria, we, as Psychiatrists have been clamouring for a National suicide prevention policy… We submitted letters and had series of meetings with the government. Nothing”

What is clear is that mental health services has always been ignored for so long and it does not get enough resources as general hospital. Psychiatry has always being the Cinderella services to general medicine. It simply does not make sense, because there is no physical health, without mental health.

And to make matters worse, psychiatric treatments and facilities are so expensive in Nigeria, scarce and inaccessible to almost all who need it. There is a need to urgently overhaul the mental health system in Nigeria.  Nigeria is at a crossroads of an addiction and suicide epidemic and definitely, more needs to be done to prevent further loss of promising young lives.

It is a scandal that in this day and age, in Nigeria, there is a paltry one Psychiatrist to 740,000 Nigerians! Let that sink in. In the whole of Nigeria, there are less than 250 active psychiatrists in the country and some thirty of them are unemployed and unable to get suitable postings after spending almost a decade of training and specialisation.

So no wonder those that can, have left Nigeria to pasture new and on quest for a better paid job; a promising future and a better chance of becoming a specialist in the chosen field. Sadly, it does not seem that the government is doing anything to prevent their departure nor offer those incentives: by improving working conditions, better paid, given opportunity to update skills, research and knowledge, a determined drive to recruit and retain the scarce and precious commodity-doctors.


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