Codeine and the Criminal Enterprise
In my column titled “Catalogue of Made-in-Nigeria tragedies” published on 17th September 2015, I listed a myriad of issues which depict a near absence of safety standards in most areas of public administration in the country, after which I concluded: Whichever way we look at it, the string of untimely, and sometimes brutal deaths from preventable causes that have become our lot as a nation in recent times is a sad commentary on the value we place on human life in Nigeria.
One of the numerous examples I cited in the piece was the revelation by Mr. Ali Baba Mustapha, the Assistant Superintendent in charge of Exhibits at the Sokoto State Command, National Drug Law Enforcement Agency (NDLEA) about the increasing involvement of married women in drug abuse. According to Mustapha, many women now take cough syrups that contain codeine, believing that it would enhance their sexual appetite.
A week later, Daily Trust newspaper, which broke the initial story, did a lengthy feature titled, “Codeine abuse spikes in women, teens across North”. It was the first of several major stories on how cough syrups like Benylin, Emzolyn, and Asad as well as Rohypnol and Tramadol tablets are destroying several families, especially in the North. “There is the case of a new bride whose husband discovered under their bed, a carton of Tutolin, usually abused to induce intoxication and supposedly boost sexual drive. Even before then, during the wedding, the loss of a necklace had prompted a search that led to the astonishing discovery that women at the occasion, mostly housewives, had varieties of cough syrup containing codeine in their handbags” said the report.
Since then, there have been several other reports on the devastation that these drugs are wreaking, especially in the North. Two years ago, the NDLEA Commander for Gombe State, Mr Aliyu Adole, said between 20 to 30 percent of the young people in the country, including school children, were into substance abuse. “It’s the cartel, dealers and rings that supply drugs to the youths and the same cartel sells from South to the North”, said Aliyu who explained how the drugs are usually transported in heavy duty vehicles and stuffed between other commodities in what is clearly an organized crime.
While the authorities in the health sector pretended they were not aware of what has been going on, the first official response to the menace came last year when Borno Senator, Baba Kaka Bashir Garbai moved a motion on the “increasing abuse of cough and prescriptive drugs among the youth and women across the 19 northern states” which he argued “has devastated many upper and middle class families in the region. There are several reports about young girls in tertiary institutions, who have taken to an alarming abuse of the codeine cough syrup, which is often taken, mixed with soft drink.” The problem, Garbai added, “is destroying even mothers in homes, as they use same codeine and other drugs as an escape from their abusive relationships and invariably get hooked on them.”
Supporting the motion at the time, former Sokoto State governor, Senator Aliyu Wamakko said the challenge was not peculiar to the north; hence it should be treated as a national social problem since amphetamine-type stimulants and several dangerous over-the counter (OTC) drugs are being increasingly abused across the country. Wamakko was right. Indeed, if there is anything that the murder in 2002 of Miss Cynthia Osokogu in a Lagos hotel by her Facebook friends revealed, it is the ease with which one can procure any and every drug in our country without medical prescription. In the course of the trial, Cynthia’s killers confessed that they bought the Rohypnol—a prescription drug for the treatment of insomnia—which they injected into her drink, from an OTC store.
However, it would seem the landscape is changing following a chilling report last weekend by Ms Ruona Meyer for the British Broadcasting Corporation (BBC). Titled, ‘Secrets of Nigeria’s illicit codeine trade revealed’, the report has already forced one of the leading pharmaceutical companies in the country to dismiss a staff who was caught on camera selling 60 bottles of cough syrup. Now, everybody is talking about a problem that has been there for years. Even the Federal Ministry of Health has suddenly woken up by directing the National Agency for Food and Drug Administration and Control (NAFDAC) to ban further issuance of permits for the importation of codeine as an active ingredient for cough preparation.
The question is: Was this the tipping point?
In the BBC report, Ruona’s story went beyond the demand and consumption of codeine to the supply side and exposed the mindless corruption behind the whole trade. Two, by naming and shaming, the pharmaceutical companies feeding fat on the misery of others and their collaborators in the health sector can no longer sleep easy. Three, the medium is sometimes the message. With the BBC internationalising the story, there was no way the Nigerian authorities could continue to ignore what many people had been warning about.
We must commend Ruona who, by the way, is the daughter of Mr Godwin Agbroko, former chairman of THISDAY editorial board who was shot dead on his way home from work on the night of 22nd December 2006 by unknown assailants. What she has done is beyond journalism, it is public service. While there may not be any available statistics, there must be a correlation between substance abuse and most of the crimes that are now prevalent in the country today even if we discount the several families that have been destroyed by the problem that is evidently national.
Incidentally, I came across two positive developments on the issue yesterday, one from NAFDAC and the other from the Senate. The two institutions have come to the realization that at a time the nation is facing a serious economic challenge, the social problem of having our young people hooked on drug needs to be properly addressed. It is something the authorities must build upon if we are to effectively tackle this big challenge.
While NAFDAC, under its Act, has power to grant authorization for the import and export of narcotic drugs and other controlled substances, I understand that not much attention was paid to dealing with drug and substance abuse in the country until the recent appointment of Professor (Mrs) Mojisola Adeyeye as the Director General. The previous efforts were concentrated on the supply side by ensuring that the use of narcotic drugs and psychotropic substances were limited to medical and scientific purposes and prevent any diversion of these substances for illicit use. That the efforts have yielded little fruits can be glimpsed from the danger we now confront.
In recent months, Adeyeye has been vehement in her campaign that the sale of Tramadol, a medication used to treat pain (but capable of being abused and addicted to), should be controlled and never administered to children. According to Adeyeye, the US-FDA has discovered that the use of Tramadol in children below 18 years of age may result in a rare but serious case of slowed or difficulty in breathing. After identifying the various socioeconomic problems as major risks factors responsible for substance abuse in her recent presentation before the Senate Committee on Drugs and Narcotics, Adeyeye also confirmed that “codeine containing cough syrup has been a prescription-only-medicine since 2012” even when it is being sold massively by some unscrupulous people in the country.
Perhaps because he comes from the medical profession, the Senate President, Dr Bukola Saraki has also shown considerable interest on the issue. After a recent roundtable discussion in Kano by the Senate on the menace of drug and substance abuse with all the critical stakeholders gathered to proffer possible solutions, two bills have already been drafted. The first one, ‘National Drug Control Bill, 2018’, seeks “to provide for the effective response and regulation of the production, distribution and consumption of controlled substances in Nigeria and for related matters.”
Both NAFDAC and the Senate should be commended for being proactive on the menace but the second bill which seeks to create a National Council on the problem is for me unnecessary. What we need is not another bureaucracy but a new orientation. Apparently because we live a country where not much attention has ever been paid to healthcare aside the fact that self-medication is the vogue, even security guards openly prescribe and sell ‘malaria tablets’ in their kiosks, a multipurpose centre for trading anything and everything. That explains why these dangerous substances are readily available on the streets.
In her Senate presentation, Adeyeye argued that “drug traffickers usually target the weak institutional links in the control chain; hence the need for improved collaboration, coordination and information sharing between and among drug control and enforcement agencies in addressing the drug problem” while highlighting some of the challenges to include the absence of NAFDAC at the ports. The agency, according to Adeyeye, is also adversely affected by lack of adequate resources (including operational vehicle and staff), as well as “delay in prosecution of criminal offenders and imposition of mild punishment by the courts.”
Like in most cases, calamities like drugs, diseases and terrorism travel faster and more easily where borders are porous and institutions of control and regulation are weakest. Therefore, it is a matter for serious concern that NAFDAC lacks the enabling facilities to effectively control the influx and spread of dangerous drugs. A country that is ever in a hurry to appropriate funds for all manner of dubious expenditures ought to have the self-interest to see the codeine influx as a virtual emergency. Besides, it is the economic desperation of the times and the spread of a mass psychology of hopelessness that has created a ready market for the dangerous substances on which many of our young people are now hooked.