Thread by @BuzzFeedNews

Nigeria is on the brink of a catastrophic epidemic of addiction to a synthetic opioid named tramadol. Millions of Nigerians are hooked on the painkiller, and the government is powerless to stop it.
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People of all ages are popping millions of pills daily. How widespread is it?

• Aid workers say it circulates in refugee camps
• College students use it as an aphrodisiac
• Farmers say it keeps them going for hours on end
• Sex workers say they use it to keep working longer

It goes further: senior military officials told us that stashes of tramadol recovered from Islamist militants like Boko Haram often outnumber bullets found in their hideouts.

Here’s the thing about tramadol — unlike heroin or morphine, it’s not eye-wateringly powerful. It does not give extreme highs. Instead, the epidemic is being driven by its ready availability.

On its own tramadol is rarely fatal, even in overdose quantities. Mixed with other drugs, though, it can become a sedative powerful enough to stop the heart.

The epidemic happened quick. Less than 8 years ago, tramadol addiction were rare cases, almost entirely confined to young men doing hard labor or people who’d become addicted through medical prescriptions.

Nigeria’s struggle looks a lot like America’s battle with opioid addictions: after years of watching an epidemic grow, policy makers are looking for quick fixes.

There are other parallels, too: In the US, a lack of insurance leaves millions of impoverished people with addiction lacking access to care.
Nigeria’s bare-bones health care system means most people with addiction struggle to find the kind of ongoing support addiction requires.

What makes Nigeria’s problem especially challenging is that tramadol is an “unscheduled” drug — meaning there’s no limit on production and international drugs bodies can’t track its export.

Tramadol is the obvious choice for medics in Nigeria struggling to fill a gap in pain management medication — in particular for cancer and post-surgery patients.

Doctors Without Borders classifies the drug an “essential medicine,” arguing that pain relief shouldn’t be a luxury.

Right now, in Nigeria, 70% of all those in rehab for opiate abuse used tramadol as their drug of choice. It continues to flow freely into the country.
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