Codeine.. the new Cocaine....

He looked at his watch. It was small on his wrist. Looking at him one would have thought he was gazing correctly at the watch. His mind was elsewhere and there his eyes followed. Everything around him had become small, except his own body. And his weak eyes not for the reason of an old age. He is just 20 but he has perfected the act of drug addiction in a new way. Gbade (not real name) sat in a small room apartment to tell his own story. He is the fifth respondent who spoke to the correspondent. Like the others, he has a tale of loss, fear and pain. It is a complex mix.

“I started using codeine as an experiment. I experienced it first when I took my first full bottle as a year one student and I have taken more than three bottles altogether at once. I lost my sense of focus as I grew with codeine every day. I stopped every other thing that will make me somebody in life. I truly relegated my priorities as a student to the background for the vain things like women, parties and fashion. I got involved to get high for a confidence to look at ladies, talk and have my way around them.” Gbade told his story at a rehab centre in South west, Nigeria.

Investigation revealed that more Nigerian youths are devising new ways of getting narcotic drugs into their system out of the prying eyes of illicit drug control agents and their parents.  The young people are clever and are going to such extent of by-passing the narcotic control agents who are more concerned about marijuana and cannabis.

For instance, investigation showed that young people; especially in tertiary institutions are approaching pharmaceutical shops without prescription to buy cough syrups containing codeine or in the family group of benzodiazepine. Once out of the shop, they soon purchase viju milk or malta drinks nearby and in a twinkling of an eye, three to five bottles of codeine syrups are mixed with a can of malta drink for immediate consumption.

“When they come here, they buy emzolyn as if they want to go and re-distribute. I mean they buy a large number of bottles. I can say sometimes some of them open one bottle before they leave here, put the bottle directly into the mouth without measurement and empty the content into their stomach,” said an attendant at a chemist store in Lagos.

Perhaps Mohammed Bello Adoke, the Nigeria’s Attorney-General of the Federation (AGF) and Minister of Justice has an idea. While inaugurating the Governing Board of the National Drug Law Enforcement Agency (NDLEA) recently in Abuja, he said, “it is worrisome especially as our country has regrettably progressed from a drug transit nation to a drug consuming nation with all its attendant negative consequences on our youths and active population.”

Dr. Ebiti Williams, the head of clinical services, Drug and Alcohol Treatment Education and Rehabilitation Unit at Federal Neuropsychiatric Hospital in Kaduna confirmed that, “over six million bottles of codeine are sold on a daily basis in the North-West part of the country.” 

National Drug Law Enforcement Agency (NDLEA) report of 2010 also put the figure at over 11 per cent of people in the North-West zone alone who abuse drugs in Nigeria.

Pressure to Succeed
Experts say substance abuse is usually precipitated by some psycho social issues that young people want to suppress. They argued such include emotional pains they are going through. According to Dr. Bola Olaore, the Director of Social Support Services at Babcock University, “ There are lots of pressure in the society today such as pressure to succeed, make quick money and belong to status cadre.”

She claimed, “Benylin is like an alcohol with sedative component that could be abused and that is why it has same warning effect. If there is any agitation going on in the life of these young people they look for that because there is easy access to them on the shelves of pharmaceutical shops.”

But, Dr. Kayode Taiwo of the Department of Psychology at the University of Ibadan blamed it on the society. “When people are in an environment that excessively put them into such habit as drug abuse what you find is young people going into any extent to satisfy that craving. The peer pressure, the socio-political, economic and educational system of Nigeria is a factor, where moral code is absent and ready option of substance abuse is available,” he said.

Rehabilitation
The Shock! it was gathered that a number of students between ages of 18 and 27 are being suspended or referred to rehab centres for drug abuse in Nigeria. In a letter from one of Nigeria’s best private university to a renowned psychiatric hospital known for its best psychotherapy in drug abuse patients, the university stated, “Above-named student who tested positive to marijuana use has been referred to your facility for residential drug treatment in rehabilitation services. A progress report in discharge summary will be required for his return to the university. He is presently on school disciplinary sanction.”

Any student who is referred usually spends four months at the Rehab. But, a source close to the rehabilitation center hinted that the letter may not have been appropriately worded. “The University will not use Codeine as an excuse for suspension, because it is not carrying so much weight that could make them to suspend or refer a student for rehabilitation and obviously because it is not one of illicit drugs, but when they come here and enter our emergency ward for our own drug screening, we usually found loads of codeine in their system.”

Mr. Adesola Abraham, a medical representative in Lagos said, unethical use of cough syrups such as Benylin with Codeine is like taking heroin or cocaine. “It may seem harmless at first glance. Some people may not understand its addictive properties and assume it is merely a net asset to society and legally distributed. Unfortunately, cough syrup is a substance of which people can become addicted. Cough syrup is appealing for addicts craving both highs and lows with its high risk. Cough syrup can be abused in many ways. Some addicts drink it straight out of the bottle, usually in quantities that are above suggested levels. Still other users soak marijuana joints in the cough syrup.”

Access to Drug
On accessibility of the drugs, he said, “many young people in higher institutions have enough money to move round. I can say that young people are now entrepreneurs with money coming into their wallets and that provides them with financial independence. The cough syrups are also readily available over-the-counter (OTC), relatively inexpensive.”

Psychoactive substance use, the World Health Organisation (WHO) warned, could lead to dependence syndrome - a collection of behavioral, cognitive, and physiological occurrence that develop after repeated substance use.

It is no lie. “It made me lose my dignity as a lady; responsible for my unwanted pregnancy, turned me to a single mother, unfocused and a shame to my family. It is a battle to overcome, but it has a hard grip on me,” said a 27-year-old codeine addict who graduated from one of the nation’s private university last year and is an outpatient drug abuse victim undergoing a talking medicine at a rehab center.

A few months back, a son of a deputy governor from Plateau State it was  reliably gathered had been taken into drug addiction and rehabilitation unit of another popular rehab far away from Plateau with the deputy governor visiting the rehab under cover to protect his name.

Checks revealed that top rated Nigeria private universities like Igbinedion University, Covenant University, Babcock University and others have partnership with rehab centers for treatment of substance abuse amongst their students.

Dr. Olaore, the Director of Social Support Services at Babcock University confirmed that her institution undertake routine substance abuse test on students. “We conduct random screening as well as at intake of new students. 

Also when our staff notice abnormal behaviours in  students, they refer them for screening. We have a drug screening process that is able to identify the prescription drugs that are being abused by the students. Once we are able to identify there was no medical condition that led to it, we usually refer them for intensive drug rehabilitation,” she said.

Though, the universities may be trying hard to check the growth rate of Codeine consumption as the crave for intoxicants amongst young Nigerians jumped to the high heaven, one of the psychiatric nurses who administer psychotherapy at a partner rehab center being used by the universities says success rate is not encouraging.

“The success rate for these people referred here by those universities is not encouraging because a larger part of them doesn’t see it as a limiting factor. They see it as observing punishment from their universities. So, it’s just to take the four months as it come. Their treatment is not very successful because they are compelled to come,” he stated.

Regulation
But, Olaore sees things differently. She said, “There may be initial resistance, but they will eventually cooperate,”she claimed. She said “being away from school for four months is a huge loss and those times away from campus will not be counted as time spent studying.”

Assuredly, Dr. Dokun Adedeji, whose organisation, Christ Against Drug Abuse Ministry (CADAM), has been involved in rehabilitation of drug abuse victims in the last 10 years stated that, “It is best for the society to be responsible and do something about it. If you see 10 young people today six to seven of them must have abuse substances. You can imagine that even NUTRI-C is now being abused as well. What we need to do as a society is to work together to curb some of these intoxicants that have become irresistible to the young people in the society. There is a huge cost in social, health and economic terms if we do not bring a halt to these substance abuse activities of our youths in the society. A lot of them are having psychosis already and the increase in crime is all from drug abuse.”

Akinbode Oluwafemi, a public health policy expert, argues that sound control policy will remedy the situation. “Policies sound enough to influence the levels and patterns of substance use and related harm can bring about a lot of changes.”

When  contacted the Zonal Chairman of Association of Community Pharmacists of Nigeria (ACPN) in Lagos, he claimed his organisation is aware of the problem, but incapacitated because of the chaotic distribution of drugs in the country.  Mr. Oduwole Fred said that Nigeria has sufficient law, but the political will to enforce it is absent.

“We have sufficient law in this country. Drug distribution in Nigeria is just too poor, porous and chaotic as a result of weakness in enforcement of the law. If you go to Idumota, you will understand how easy drug abuse is possible in Nigeria. There is no part of the world where they distribute drug in a chaotic way as Nigeria. In Idumota, you will see drugs being sold in cubicle at relatively cheap price and in an open market way. So why can’t young people get Codeine to abuse in such places where you don’t need prescription to buy drugs.”

But, Deputy Director of Public Relations and Protocols, National Agency for Food and Drug Administration and Control (NAFDAC) charged with control responsibility, Mr. Abubakah Jimoh said that NAFDAC is aware of abuse of cough syrups amongst young people, particularly in senior school and higher institutions.

According to Jimoh, “NAFDAC is torn between outright ban to make it a prescriptive drug or taking Codeine out of the syrups, but we have a country with large rural dwellers with huge medical issues and if we say those drugs should be sold only by prescription it will limit access.

We have therefore undertaken to use massive awareness campaign as well as encouraging manufacturers and our colleagues at neighborhood stores to do thorough reality checks before selling such drugs.”

And, with jail term for drug abuse and drug trafficking in Nigeria ranging from five to 25 years, the young people have become clever with cough syrups as a good alternative.

Source:ThisDay