Acceso usuarios
Micheal O. Ezenwa, Tochukwu C. Orjiakor, Michael C. Ukwuma, Henry I. Oraetue, Eze N. Ude, Tochukwu Nweze
Tramadol and codeine-containing mixtures are the pharmaceutical opioids with adverse health consequences most used in Nigeria. Widespread use has provoked stricter State control of these drugs, yet trafficking and availability remain a challenge. Knowledge of the trafficking routes of these substances may provide insight into how to control them better and reduce demand. The present study was aimed at investigating the routes through which tramadol and codeine get to illicit users in Nigeria. The profile and characteristics of those users, as well as their willingness to receive treatment in Enugu State, were also explored. A mixed-method approach was used, and 119 pharmacists and patent medicine dealers participated in focus group discussions, while 70 tramadol and codeine users completed the drug use assessment scale and participated in in-depth interviews. We found that tramadol and codeine had complex but well-developed traffic routes, making them easily accessible to users, in spite of restrictions. Established networks of corrupt customs and other security officials aid and abet the passage of the drugs to the markets. The open drug market system in Nigeria exploited by profit-seeking business persons facilitates an illegal flow of these opioids. Supplies from the open markets feed pharmacy and patent medicine dealers through whom users acquire the drugs. Users have dealers supply the drugs to “safe centres” for easy access. The drugs are also peddled by hawkers and sold at roadside kiosks. Findings also showed that tramadol and codeine use was spread among people from diverse walks of life, though young men, students and artisans were perceived to be particularly at risk. A total of 47.4 per cent of users of tramadol and 30 per cent of users of codeine-containing mixtures expressed the desire to receive treatment. However, many users of tramadol (47.5 per cent) and codeine (50 per cent) did not know where to go for help. The authors of the study recommend easy and free access to treatment, youth-targeted drug abuse awareness campaigns and the removal of restrictions on codeine and tramadol as critical to demand reduction.
