Codeine: Effectively defusing the time bomb

Codeine is seemingly harmless and relatively less habit-forming than other opiates such as heroin and cocaine, but overuse can result in dependence, psychiatric disorders, and fatalities. Experts in this interview by Sade Oguntola say its strict control like other drugs rather than criminalisation will check its abuse.

Michael Ubom, a graduate of the University of Technology, Minna started smoking at the age of nine. He was introduced to it by a friend in the church but later graduated to taking alcohol, hemp, and other drugs.

With a 25-year-old history of drug use, Michael recounted his experience on the street, drug business and now a drug user counsellor.

“I use to be locked in the house, but my friends will come and put the cigarette in my mouth through the window. I have been to prison because of drug use. Even after the mandatory Nigerian Youth Service Corps, and could not find a job, went into selling drugs, “recounted Michael.

Sherrif Alli’s entry into drug use started when he tested pentazocine, a pain medication prescribed for his friend with sickle cell disease.

“Since I tested it, I started to take it once a day, but later graduated to using it thrice a day to get high, “said Sherrif. “Even when I changed to ketamine and codeine, they were was not as effective as pentazocine.”

Unlike Sheriff, Fati Hammed, a mother of a three-year-old girl started smoking cannabis when she was in Primary Six.

Fati, then, the black sheep of the family, who was later introduced to pentazocine by Sherrif, could not stop the habit despite her mother’s corrective measures.

Even when Fati got pregnant, with her first baby, and wanted to stop because of it, it was difficult. And when she had a miscarriage, it became more difficult for her to stop because the drug use became her solace.

Like Sheriff, Fati, and Micheal, many youths are now turning to drugs for different reasons- dysfunctional families, frustration, peer pressure, curiosity, homelessness and wrong social perception of a drug.

In fact, from cannabis, tramadol, codeine syrups, cocaine, sedatives like valium, to alcohol, many youths are able to point out their friends that use them.

Michael Ubom, the regional North Central coordinator for People that Use drugs, declared, “almost 70 to 80 per cent of youths use drugs. It is everywhere, cutting across all social classes both in the rural and urban communities.

He added, “Even in primary schools, some pupils now use drugs like tramadol. The odour of drugs like cigarette and hemp is easily picked, so they tend to use drugs that do not shout but still act on their psychosocial system.”

Unfortunately, more varieties of drugs are getting into Nigeria and youths been experimental in nature, are trying them out. According to Micheal, “Before, we only have Indian hemp, but now, there is the chemicalised Indian hemp called Arizona or Colorado.”

Mr Nonso Maduka, Executive director, Bensther Development Foundation, Enugu, and secretary of the Network of CSOs working on drugs declared that an equal number of women and men now use drugs.

He declared that hospital data indicate that cannabis is mostly used in Southern Nigeria, more people in Northern Nigeria use opioids like tramadol and codeine-containing drugs. But the use of other drugs like skunk is on the rise in Northern Nigeria.

Unfortunately, he said the increasing number of people using drugs suggest the need for a change in government’s policy on drug control.

Unfortunately, Mr Adeolu Adebiyi, team lead for YouthRise Nigeria and Commissioner on West African Commission on Drugs said banning the use of drugs, including codeine-containing drugs that are commonly abused by many youths is not the solution.

According to him “there will be an emergence of another substance and which can be more dangerous. That is the case we are seeing in the opioids crisis in the US. Heroine has been used and then the level of control was heightened, so they turned to phentermine. Now people are dying from its overdose.”

In banning codeine use, Mr Adebiyi said “we need to look at it from the angle of the level of harm. Yes, it is being abused, but if today we ban codeine, it is still going to be available on the black market.

“Secondly, it will lead to substance displacement. Another substance will emerge and we do not know how dangerous that will be. So, what we need is a strict regulation of codeine.”

Mr Adebiyi, remarking that many youths take codeine-containing drugs without knowing its health implications, said it is a wrong perception to think a drug user looks different from any other person on the street.

“Often times, we are deceived by the fact that a drug user is somebody with a black mouth, red eyes and looking unkempt. Those are manifestations that come after a long period of use. There are so many people in a suit who use a drug.”

Paradoxically, the way Nigeria has been dealing with drugs for many years had made it look like a war although it is not so, said Professor Isiodore Obot, the Director, Centre for Research and Information on Substance Abuse.

According to him, “there has not been any substantial change in the number of people who used drugs in the world. All the interventions deployed have not been effective in eliminating drug use.

“The situation we will like to see is that where using a drug or being in possession of a drug is not seen as committing a crime. This does not, however, extend to drug traffickers.

“A drug user should be seen as somebody who needs help and requires treatment. There is a growing acceptance that we should treat drug use a public health issue rather than a criminal issue. Drugs have destroyed many people. By continuing to depend on wrong policies, we will continue to destroy more lives.”

Mr Mame Bougouma-Diene, Africa Programme Officer, for Open Society Global Drug Policy programme, said many countries like Portugal had decriminalised drug use.

“They realised that from the time people were allowed to carry a small amount, people tend to purchase less and also suddenly, the police can start focusing on people who are dealers rather than users.

“With any kind of substance, the closer you move towards regulation, the better it is. Once drugs are regulated, children will not have access to it anymore. Once they do not have access to it on the street anymore, they do not fall into the trap of choosing other drugs.”

Mr Bougouma-Diene stated that decriminalised drug use will not promote the drug use just as it did not promote the use of alcohol, but rather will ensure a huge economic boom in terms of taxes while taking all the power away from organised crime and street-level crime.

Moreover, Wilson Ighodalo, President, The Drug Salvation Foundation, Lagos, however, said decriminalised drug use will prevent stigmatisation that further worsens the condition of a drug user and preventing them from seeking help and getting integrated back into the society.

Mr Ighodalo said such a change in perception will ensure drug users can be separated from those that trade in it, and reduce the harm that comes either directly or indirectly from drug use.

In recent times in Nigeria, there has been a surge in crime and shocking incidences of suicide and murders. These may not be unconnected with the rise in drug abuse. The Senate of the Federal Republic of Nigeria raised the alarm in 2017 of the menace of codeine abuse particularly in the Northern part of Nigeria.

Those suffering from dependence on codeine are said to include young girls and married women and by some estimates, an average addict takes some three to eight bottles of codeine-containing syrup daily.

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