The scourge of opium-based drugs and cocaine have become a bigger global threat to public health and law enforcement than ever before, according to the latest World Drug Report, released on Tuesday 26 June 2018, by the United Nations Office on Drugs and Crime (UNODC).
The findings… “show that drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts,” said UNODC Executive Director, Yury Fedotov.
The 2018 Report provides an overview of the supply and demand of drugs as well as their impact on health.
The UN drug and crime fighting chief said the annual report was “a key pillar of our support, along with assistance to translate international obligations into action and capacity building on the ground to enable effective responses,” he added, in order to “protect the health and welfare of humankind.”
Beyond the production of the opium-based street drug heroin, pharmaceutically-produced opioids account for 76% of non-medical, prescription drug deaths worldwide, with the powerful synthetic opioid Fentanyl an increasing problem in North America, and Tramadol a growing concern in parts of Africa and Asia.
Opiate addiction has become increasingly common in Sierra Leone, where there are few avenues for drug rehabilitation.
Propelled by a black market network of importers and sold cheaply and under the table by private pharmacies, the problem has become so bad that in August 2016, Sierra Leone’s overwhelmed pharmaceutical regulators declared Tramadol abuse a public health emergency.
“The danger is that Tramadol isn’t listed internationally with popular narcotics such as morphine or Oxycontin,” said Ethelbert Tejan, President of Sierra Leone’s Pharmaceutical Business Owners Association.
To Tejan, the solution is a matter of political willpower. “If it was listed, it would force governments’ hands to try to solve the problem in their own countries, but as of now it’s not listed with other harmful narcotics and psychotropics.”
“Right now our biggest problem is people having access to the illegal Tramadol, either through peddlers on the streets or pharmacies abusing their privileges,” said Wilshire Johnson, the President of Sierra Leone’s pharmacy board.
“And it’s sold cheap; 10 capsules for often less than a pint of beer. We’ve tried to put in place stronger regulatory mechanisms, which have
worked in certain areas, but there are also a lot of hard-to-reach places, and [the pharmacy board just doesn’t have the capacity to identify everyone going around the system.” He stated.
Johnson believes the rapid expanse in illegal Tramadol use over the past two years is rooted in an increase in youth gang activity, accrediting the problem’s ongoing nature to a “general attitude and disposition” towards illegal activity.
He believes Sierra Leone’s legal Tramadol is imported at a significantly higher rate than it is prescribed and that efforts to sensitise affected communities about Tramadol’s addictive qualities, such as a recent radio campaign, tend to fall short of expectations, often targeting people like college students who have been shown to be less prone to abuse than members of poorer communities.
“Sierra Leone has around seven million people with about two thirds relying on traditional herbal remedies and only a third or less even making use of pharmaceutical retailers,” Tejan said. “If you have 10 importers for a product that is not widely prescribed medically, you have to start asking questions. It’s not a safety risk to limit a product that is not fast moving, so if we can begin to control the importers I believe we will have gone 75% of the way.”
“We have to limit the accessibility options to just private hospitals and specialty clinics, and try to engage medical professionals in finding an alternative to Tramadol that can be imported instead,” she pointed out.
Even if the flow of Tramadol into Sierra Leone can be limited, treatment availability remains poor. The country doesn’t have any drug rehabilitation centres, and with the average Sierra Leonean making less than $2 a day, most addicts opt to deal with their illness independently before risking money on personalised treatment in the countries overworked and understaffed government hospitals.
Tramadol is only legally available in Sierra Leone with a doctor’s prescription and only a small handful of pharmacies are permitted to carry it at all. Yet Tejan and others describe a thriving parallel market for illegal Tramadol – pills that are smuggled into Sierra Leone across the country’s highly unregulated borders or sold under the table without prescriptions by street hawkers and in neighbourhood pharmacies.
Accessibility of both for medical use is vital for treating pain, but traffickers manufacture them illegally, causing considerable harm to health.
UNODC revealed that global seizures of pharmaceutical opioids in 2016 was 87 tons with West, Central and North Africa accounting for the vast majority and Asian countries reporting just 7% of the global total.
From 2016-2017, global opium production jumped by 65% the highest estimate recorded by UNODC since it started monitoring the drug’s production at the start of this century.
Turning to vulnerable age groups, the Report finds that drug use is highest among young people with research suggesting that 12 to 17-year-olds are at critical risk.
While the majority of people who misuse drugs are men, women have specific drug use patterns. The prevalence of non-medical opioids and tranquillizers is common to both, but women often begin abusing drugs at a later stage than men.
SV/27/6/18
By Sylvia Villa
Thursday June 28, 2018.
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