This article is part of our #FirstWord series to provide context on trending news.
An undercover investigation conducted by BBC Africa Eye, has revealed how much of an epidemic cough syrup, especially the ones with codeine, is among young Nigerians. The documentary, which is almost an hour long, disclosed that over 3 million bottles of codeine are consumed every single day in Kano and Jigawa alone by addicted youths with the aim of getting high. It also exposes the leakages in Nigeria’s pharmaceutical industry aiding the spread of codeine intake.
What is Codeine?
Codeine is classified as narcotics with high potential for addiction. The substance is proved to have similar pharmacological effects as cocaine and heroin, though to a lesser degree.
When used appropriately, it can act as a mild sedative, pain reliever and cough suppressant. However, the use of codeine in Nigeria, particularly in the North, has become dangerous and subject to abuse. Young people have now turned to the drug get high.
Why is it dangerous?
There are quite a number of health issues associated with excessive use of codeine. For instance, it can cause respiratory and mental depression, excessive sedation and drowsiness. In the blood vessels, codeine overdose can easily lead to heart block, hypotension, irregular heartbeat etc.
In addition to getting seizures and kidney damage, abuse of codeine cough syrup can result in mental psychosis with symptoms like delusions, hallucinations and schizophrenia. Codeine abuse can develop into a full-blown addiction which is potentially deadly.
Like similar drugs, the withdrawal symptoms from codeine can be hazardous, keeping the abuser in a cycle of use they struggle to stop. In the BBC Africa Eye documentary, codeine abusers in a rehab centre in Kano suffering from withdrawal symptoms were seen to be chained, violent, in pain and some displaying signs of insanity.
How is the drug distributed?
The most interesting part of codeine syrup is not the addiction but the ease of access in large quantities by those abusing it. Codeine is supposedly regulated and can only be bought across the counter with a doctor’s prescription, yet millions of bottles get into the hands of young Nigerians every day.
The syrup is a favourite for many drug addicts because it is easy to obtain at big stores without a prescription. According to BBC Africa Eye’s investigation, pharmaceutical company employees illegally sell syrup on the black market aiding the widespread abuse.
Among them is Chukwunonye Madubuike, a business development executive with Emzor pharmaceuticals, who illegally sold BBC 60 bottles of codeine (he thought they were drug dealers).
“When somebody is addicted to something - you get me? - and he needs it, the price is not an issue. This is a product that I know that if I have one million cartons, I can sell it in a week”
Across the country, pharmacies and rogue employees offer backdoor services for the sales of these syrups. In Ilorin, for example, the BBC found that buying cough syrup with codeine was as easy as walking into a store and purchasing it over the counter.
What is being done about it?
A lot, but not enough.
Before now, in December 2017, Nigeria's Senate had a roundtable discussion on the drug problem in the North, the idea behind the meeting was to reform the country's response to substance abuse. In addressing the issue, 2 bills were proposed. The first bill, the Drug Control Bill, seeks to criminalise the diversion and distribution of controlled substances like codeine without a license or prescription. It also restricts all drugs that have a high potential for abuse.
The second bill which is the Mental Health Bill recognises that psychosocial issues are key drivers for the abuse of cough syrup. It, therefore, seeks to ensure that there are standard facilities in every state to provide mental health and substance abuse services. Both bills are now receiving input from CSOs and MDAs, and according to the Senate will be introduced and fast-tracked.
After the BBC report broke the news, Emzor Pharmaceuticals fired Chukwunonye Madubuike, who apparently was on suspension at the time he was distributing the drugs to fuel the addicts. They also announced the halt of distribution of syrups with codeine. In a statement issued on the 1st May 2018, the company denied its involvement in direct sales to members of the public and said they were going to do a “full and thorough internal investigation” around the distribution of codeine-laced cough syrup.
The FG has also banned the production and importation of codeine in the country. The Minister of Health, Isaac Adewole, on 1st May 2018, directed NAFDAC (National Agency for Food and Drug Administration and Control) to stop issuance of permits for the importation of the substance. The syrups are now to be replaced with dextromethorphan, which is apparently less addictive.
There is also currently a ban on the sale of codeine-containing cough syrup without prescription across the country. PCN (Pharmaceutical Council of Nigeria) has been directed to supervise the recall for audit trailing of all codeine containing syrups in the country.
Finally, as a way of discouraging youths to shun the drugs, the Federal Ministry of Health is partnering with the National Orientation Agency (NOA), the Nigerian Football Association (NFF), celebrities, performing musicians and members of the actors guild of Nigeria to drive a national campaign against the abuse of drugs.
It is hard to predict what comes next but If history is anything to go by, the process of curbing codeine abuse may be stalled. Nonetheless, the Federal Government seems to be making moves to control the growing menace, which is a welcome development.