Getting high: why tramadol users should be worried

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Unknown to most people who abuse drugs, including women, young men and ladies there is need for worry, since the effects could be very grave and physically damaging to the body. Chairperson, Committee on the Codeine Control and other related Matters Working Group (CCRWG), Professor Oluwatoyin Odeku while speaking on the problem of abuse of Tramadol in Nigeria has said that it was due to its chaotic drug distribution system which allows open drug markets in Nigeria.

Odeku, who is the Dean, Faculty of Pharmacy, University of Ibadan, said drugs, including prescription-only medicines, go from hand to hand, stating that tramadol is a narcotic drug whose importation was supposed to be approved by National Food and Drug law Administration and Control. Apart from approving the drug, NAFDAC is also to determine the quantity to be imported based on the needs of the country. 

Professor Odeku


“Until recently, NAFDAC was not at the port, so they were not given the opportunity to inspect containers before they were brought in. So, large quantities of controlled substances got into the wrong hands,” she said adding that tramadol, like other banned codeine-containing cough syrups is sold without a prescription and usually, sometimes, the labels on their containers are removed so as to prevent easy identification of their source.

Odeku, however, said tramadol is not a new drug nor is it the only abused drug, adding that “you know codeine containing syrups are sold in bottles; it is easy for you to see because of its volume and bulk but tramadol is sold in capsules and tablets in sachets and as such can be easily concealed in bags and pockets.”

Professor Odeku, who described tramadol as a pain reliever for moderate to moderately severe pain, said what the drug does is to alter the brain’s perception and response to pain, noting that all drugs are poisonous and that its implications on the body will be determined by the amount and frequency taken.

However, according to Odeku, when tramadol is abused, it could cause failure of important organs in the body such as the liver and the kidney, while its side effects include drowsiness, dizziness, hallucination and difficulty in concentration. The addictive tendency also leaves its users exposed to withdrawal effects and yearning for more to achieve the same euphoria feeling it gives.

Also speaking on the drug, Professor Isidore Obot, Director, Centre for Research and Information on Substance Abuse, Uyo, Akwa Ibom State said the frequent seizure of tramadol consignments is an indication of a big market for it in the country.

Professor Obot, who is also a lecturer at the Department of Psychology, University of Uyo, stated that tramadol use has become an issue in Nigeria because many young people continue to use the drug, develop problems and showing up in treatment facilities. He said banning its importation would only further drive its market underground, advising that what could be done by the authorities is to strictly regulate its importation and usage.

Lamenting the abuse of the drug across all ages, social classes and gender, Prof. Obot said “many of the people who end up abusing the drug start by taking it for legitimate things like pain.” The don said that common drugs abused by different age groups and social classes vary from one region in Nigeria to another, adding that no abuser uses only one hard drug.

“Many people who use drugs use more than one drug. It is a standard feature of drug users, not just in Nigeria, but across the world. They can move from using codeine to tramadol and back, depending on their availability,” he said noting that “the use of tramadol in its early stages started in the northern part of Nigeria.”

However, he added that on January 29th 2019, the Nigerian government launched its first report of drug use in the country based on data collected in three major projects which did make clear the number of drug abusers; what part of Nigeria is using what kinds of drugs and other information.

Dr Jibril Abdulmalik, a consultant psychiatrist, at University College Hospital, lending his voice to the tramadol debate, said apart from its side effects, it can cause death when an overdose of it is taken and it could also lead to increase in crime rate.

Dr Abdulmalik


 Nonetheless, Dr Abdulmalik said there has been an increase in cases of mental health problem, especially among youths because of drug use, lamenting that most time, people adduce spiritual colouration to its complications and as such resort to seeking help from prayer houses rather than seeking medical treatment.

“We do not accept the responsibility of drugs’ side effects, we push it to enemies ‘who are using spiritual control to affect the boy’ and so this is not useful. All over the world, young people abuse drugs if it is available. That is constant. So the issue is to make it less available and then educate the young people about the danger and harm so that fewer of them will fall into that trap,” he said.

What is more, Professor Adetunji Adeniji, a consultant obstetric and gynecologist, at Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State warned that the abuse of tramadol and codeine could be toxic to unborn babies, and cause miscarriage and birth defects in their babies.

Professor Adeniji


Professor Adeniji stated that these drugs can pass through the placenta, especially at the early stages of pregnancy, to affect the growth of the unborn baby. According to him, “it can cause narrowing of the blood vessels, so blood supplies to the baby get reduced, thereby causing growth restriction. Such a baby is therefore born with a low birth weight.

“Some of these drugs have sedative effects and can cause respiratory depression, in which case, the baby does not breathe normally. If such a baby stops breathing such can die. Some of these babies can come down with congenital abnormalities depending on whether the woman had been addicted before pregnancy or after she got pregnant. So, its effect is actually multi-various.”

Professor Adeniji, however, said that the effects of two illicit drugs are not the same, adding that tramadol is less sedative to the baby than say codeine, cocaine, and pentazocine. He said that far back in April 2017, FDA had also warned about the use of codeine and tramadol in children and nursing mothers because of possible harm to their infants, which can include excess sleepiness, difficulty breastfeeding, or serious breathing problems that could result in death.

Small amounts of tramadol and its metabolite are found in breast milk when taken by the mother. The amounts of tramadol and its metabolite are usually too low to cause a problem for the baby. However, there is a risk that the baby’s breathing may be affected or that the baby may be allergic to tramadol or its metabolite.

Taking into consideration the position of the experts spoken to, not only should the users be worried about possible effects of abusing tramadol on themselves, the government of the nation itself should be worried  of having a huge chunk of its population that is seriously dependent on drug.

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