Psychoactive substances have been used by humans for various purposes, including traditional practices, therapeutics, and recreation. Different compositions and formulations of psychoactive substances exist, each producing varying effects.
The term opioids refers to psychoactive substances that are either natural derivatives of the opium poppy plant or synthetic compounds that mimic the action of opium-based substances. Many opioids are potent pain medications and are strictly regulated due to their highly addictive nature, especially with prolonged use.
Initially, opioid misuse was prevalent in the West, where increased availability and consumption led to a widespread crisis. However, this problem has now expanded into a global drug epidemic, with an estimated 60 million users worldwide.
West Africa has also been affected, with opioid abuse increasing significantly over the past 10 to 20 years. The patterns of use and addiction dynamics appear to be similar across different countries in the region, signaling a growing public health concern.
Recently, a documentary from BBC on how some opioid-based medications especially ones containing tramadol and tapentadol, are imported into the country and abused by mostly young people in low economic settings, made evident by the ‘Wonnim red’ trends on TikTok.
Although the misuse of opioids has been ongoing in our communities, recent events have brought attention to the larger issue at hand.
According to the Ghana Food and Drugs Authority (FDA), 400,000 out of 521,191 tramadol preparations seized contained potency levels far exceeding those approved for medical use. Interviews with non-medical tramadol consumers in Ghana, Benin, and Nigeria revealed that many users obtain their tramadol from itinerant hawkers or informal medicine traders, as pharmacists refuse to sell the drug without prescriptions due to ethical considerations.
Multiple factors have been linked to opioid misuse. Some studies indicate that users take opioids to suppress fatigue, stay awake, reduce hunger, and endure strenuous work. Others highlight peer pressure, curiosity, and escapism as the initial motivations for tramadol abuse among young people.
Prescription opioids have now become the second most commonly misused substance, partly due to the perception that they are legitimate medicines. This provides pharmaceutical cover in otherwise conservative societies like Ghana.
Regardless of the initial reasons for use, many individuals continue opioid abuse for various effects, including euphoria, attentiveness, high energy levels, pain relief, and enhanced sexual performance. However, tramadol misuse also causes severe side effects, such as vomiting, loss of appetite, seizures, emotional aloofness, and irritability.
The impact of the opioid crisis is multidimensional, affecting not only the users themselves but also their immediate communities and the nation as a whole.
Several institutions public, private, and informal have taken responsibility for curbing this menace in society. Efforts could be intensified to strictly regulate importation and reinforce narcotic control systems to prevent the smuggling of these medicines.
This would reduce accessibility for informal market holders and village hawkers, who contribute to the illegal distribution of prescription-only opioids. Additionally, severe punishments should be imposed on individuals involved in the smuggling and peddling of opioids to deter illicit activities.
It has also been suggested that a key solution to many of the opioid-related problems in West Africa involves expanding and improving formal healthcare delivery. This would significantly influence the types of medications people use for pain relief, as inadequate healthcare access has been identified as a major factor in opioid misuse.
The economic climate also plays a crucial role, as many individuals vulnerable to opioid abuse belong to low socioeconomic groups and work in the informal sector, which is poorly regulated. These individuals often work long hours to earn minimum wages, increasing their likelihood of resorting to opioids for fatigue relief.
Implementing measures such as increasing minimum wages, unionizing vulnerable workers, and introducing tailored interventions could help mitigate the risk of opioid abuse.
Additionally, public education on the harmful effects of opioids is essential to inform users and at-risk individuals about the consequences of opioid misuse. Some media houses, social media influencers, and concerned individuals have already initiated awareness campaigns, but more structured efforts are needed.
Ultimately, continuous dialogue among all stakeholders is crucial for developing effective, adaptive solutions to combat the opioid crisis. A strategic and iterative approach to implementing these solutions would maximize the impact of efforts to fight this growing menace.
In summary, whatever the factors fueling opioid misuse may be, their addictive nature and the destructive effects of opioid misuse far outweigh the transient benefits and all efforts must be pushed towards ridding our society of this menace for the betterment of Mother Ghana.
God bless our homeland Ghana.
The author, Dr (Med) Jessilyn Sulemana Stevenson is member of the Psychiatry Association of Ghana (PAG).
References:
https://onlinelibrary.wiley.com/doi/abs/10.1002/nop2.353
UNODC World Drug Report 2024: Harms of world drug problem continue to mount amid expansions in drug use and markets
Substance Abuse | WHO | Regional Office for Africa
Divergences and commonalities between the US opioid crisis and prescription medicine mis/use in West Africa – ScienceDirect
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