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TRAMADOL: The Bad, The Ugly and The Nasty!

About a year ago, when I heard about the opioid drug called Tramadol for the first time, it had already found its way into the underworld and its abuse was on the ascendency! Victims of all ages including minors had been pushed into the crowded space of addiction with no escape route in sight. Call it stampede; that has people constantly knocking their heads against each other. Well, they call it ‘nadding’ (nodding) in the ghettos. I personally saw youngsters losing control of themselves, with eyes partially shut, and the nodding of head on repeat. That got me curious. I wanted to know more. And I did.

My preliminary conversations with some youth around Bubiashie, Adabraka and Ashiaman, who have had a brush with tramadol shook me to the marrow. Their reasons for swallowing the high doses of tramol tablets and capsules frequently were mind boggling. For some, it was to enhance sexual performance. For Esther, a young lady who washes clothes for a living, tramadol gives her the ‘power’ she needs to wash for more people without feeling tired. And then she gets into deep sleep on her ‘off day’ which is Monday. Others take it to gather ‘dutch courage’, confidence (‘confi’ as they put it), or ‘ambition’ to do whatever they want to. For others, the hard-to-explain state of ecstasy is enough motivation. I was told how some commercial vehicle drivers abuse tramadol too. The list is endless.

As if the tramadol sermons were not enough, I was told how the “stuff” is mixed. My jaws dropped in astonishment when I got to learn from the ghettos, the ingredients of this “cherished stuff”. It’s a wild combination of strong caffeine energy drink, codeine cough syrup and tramadol. They quaff this “stuff” while they smoke marijuana. In the words of Ebo, an itinerant rubbish collector, who was literally sleep walking, “it makes me forget my sorrows and I work hard”. He demonstrated this by quickly jumping onto the heap of refuse in the bucket of his tricycle, to compress it to create space for more refuse. At this point, my heart was broken. And then a few cold beads of tears rolled down my cheeks as my mind struggled to come to terms with what I was seeing and hearing. I thought of Ebo as a brother. A brother who didn’t know what he had gotten himself into.

The first question that hit me while I listened to the harrowing accounts from those obvious innocent lives who had been tricked and lured into this mess was: “How did we get here?”  And then, I thought to myself, who do we hold responsible for this? And how do we get out of this quick sand and mud combined?

Later events revealed a systemic failure and breakdown, and how some unscrupulous people continue to take undue advantage of the lapses to greedily profiteer their enterprises while lives get ruined. Today, most pharmacies are trading large quantities of this prescription drug with careless abandon. The Pharmaceutical Council couldn’t have been aware of this. Could they? Well, prior to this alarming stage, no education was done. Yet, the country continues to pay salaries to thousands of community and public health nurses who are expected to interact with the people to guide them and gather intelligence as well. The national security and bureau of national investigations hadn’t caught a wind of this. Or maybe they didn’t think it necessary to follow up. The Food and Drugs Authority and the Narcotics Control Board were in a league of ‘business as usual’. The pores of the borders continue to widen daily. In short, the system had been broken, and we are excited to run it that way. Nobody seems to care and gradually, a whole generation is being knocked out on a speedy schedule.

Earlier in April, psychiatrist specialist, Dr. Yao Mfodwo, had told the media that “Tramadol is a dangerous narcotic substance which is even restricted in medical use, due to its addictive nature.” The question then is, why is its use not regulated? Where is the honesty, professionalism,  and sense of ethical responsibility of our pharmaceutical companies? Why is tramadol now being sold without prescription and even to children? How long has this been going on? The borders are porous, no doubt, but where raw illegality is perpetrated on the supposed sacred platforms of the pharmacies and chemical shops, it wipes away all hope. Does this feed into the theory that not all buildings labelled ‘pharmacy’ actually have qualified pharmacists? My checks proved that some of the people often found manning pharmacies are either medicines counter assistants or children of pharmacists who end up consulting Google to serve your pressing health demands. The repercussions? You tell me!

I also discovered that tramadol some addicts space up and alternate their patronage of pharmacies and chemical shops. So for example, if they buy from pharmacy ‘A’ today, the will buy from pharmacy ‘G’ tomorrow and then ‘C’ in that order.

The fact is, the addiction has severe financial implications and to satisfy that urge, the addict pays dearly for it. Where they get the money from is another question that must engage your mind. Will they do anything just to satisfy their ‘turkey’? YES! Does it put you, a non-user, at risk in terms of your valuables and security? ABSOLUTELY! Now, here’s the trick, the drug is sold cheaply to draw in addicts and then once they are hooked on, the market becomes fertile to rake in more cash from regular sales for suppliers and distributors.

The Food and Drugs Authority (FDA) confirmed to me on TV3 NewDay, that the drug has been abused by the youth, manual workers and even drivers, mainly because of its accessibility at chemical stores and street drug peddlers. They have also confirmed that tramadol is addictive and can result in epilepsy, multiple organ damage, seizures, excessive sweat as well as hallucination. The dosage of tramadol approved by the FDA to be sold on the market is 50mg and 100mg. Surprisingly, one can easily find 250mg volumes being sold in the open. The question is, how and why?

Just yesterday, I interacted with BBC Pidgin Service’s Adejuwon Soyinka about a thick-dark-shattering codeine cough syrup cloud hovering over Nigeria currently. Honestly speaking, i believe we are under intense attack. The cocaine and heroin kind that started small and has become uncontrollable. The bitter truth is, some people just want to make money, damn the consequences. And, I believe the time has come for West African countries to make good use of the ECOWAS grouping to put up some workable preventive measures. We could use some really good collaboration at this point.

For example, how well is the FDA collaborating with other government agencies and their external counterparts to police the various borders to close any loose end to stop the influx of the drug? What about the Pharmacy Council? Are they interested in conducting their own investigations to fish out and punish the bad nuts within their front? And the security agencies and NACOB? What does their schedule look like? The Ghana Health Service and Ministry of Health?

First of all, we must accept that there is a cartel fueling this drug menace. And then we must know that the cartel is huge; encompassing many players – overt and covert. Perhaps, bigger than the war being waged at the moment by just a few good persons including my friend Kwame Sarpong Asiedu and his team who have had to endure many threats. Could it be a case of big bucks, big pharma? And then we must read between the lines to judge for ourselves whether the authorities have really been compromised with money as we have heard being alleged over and over again. When we answer these questions, it will give us a clear indication of which approach to employ in this fight. The experts have spoken about a combination of Behavioral change communication and strict enforcement. But I say, we are bleeding and we need to stop the bleeding now! How? Let’s target the entry and supply points as well as the itinerant drug peddlers and stop the tablets and capsules from being piped in.

Let us spread the word: from the classrooms to the church, the markets through to the streets right into the offices. Every Tom, Dick and Harry must get involved. We must name and shame.

As a nation and a sub-region, we are sitting on a ticking time-bomb and something needs to be done fast. History has it that, in the late 60’s and late 70’s, that generation combined Mantrax, LSD, Indian hemp and other things. Those didn’t ruin them because of how it was tackled. Today, the population had ballooned to a staggering 29.6 million with crime, unemployment and other societal ills on the front burner. The challenges are real. But as seasoned pharmacist Kwame Sarpong Asiedu, a fore-runner in this fight says “The size of the problem may seem enormous, but the process to eliminating or mitigating the problem is in bits. – he says “Impossible is nothing” and I strongly share his view. Do You?

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By Johnnie Hughes

The writer is the award-winning host of #CommunityConnect on 3FM 92.7 on Fridays at 3:00 pm and TV3 NewDay.

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