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The cough syrup and painkiller that can kill you

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What category of people use it?

Adolescents and young adults usually, although some middle aged as well as elderly individuals have also been caught in this web.

With statistics, show the number of youths and women currently using drugs illegally.

There is paucity of local data regarding the true number of youths and women currently using drugs illegally in Nigeria however, according to data published by WHO and the World Heart Foundation in 2007, 22.1% of school youth aged between 12 to 17 years in Nigeria use tobacco. The National Drug Law Enforcement Agency (NDLEA) in 2016 announced that 30% of youths in Nigeria consume illicit drugs. The State Bureau for Substance Abuse Prevention and Treatment in November 26, 2016 through her Director General, Dr. Isa Baka in an exclusive interview with Channels Television reported that over fifty per cent of youths and women in Kaduna State are into drug abuse. According to the National Survey on Drug Use and Health (NSDUH), about one out of every six American young adults (between the ages of 18 and 25) battled a substance use disorder in 2014. This represents the highest percentage out of any age group at 16.3 percent. A study by Substance Abuse and Mental Health Services Administration (SAMHSA) in 2014 records 15.8 million women (or 12.9 percent) ages 18 or older have used illicit drugs in the past year, 4.6 million women (or 3.8 percent) ages 18 and older have misused prescription drugs in the past year.

Reasons why they take the drugs

There are many reasons why people indulge in drug abuse, some of which are, Peer influence, legality, gateway, self medication, fitting in,ignorance, lack of and/or bad parental and sibling mentoring, genetics, race, access to drugs, curiosity/experimenting, depression, temporal euphoria (highness), and sexual gratification,  among others.

Which one do they use the most?

This partly depends on the gender, environment and socioeconomic status. For example, the male folks tend to abuse more of Tramadol because of their likely tougher occupation and relatively high socioeconomic status. The female folks abuse more of the Tutolin because it is cheaper. It was reported in 2015 that there was a sudden spike in abuse of Tutolin and Codeine containing cough mixtures among women in the North (Katsina, Kebbi).

Where they get them from (source)?

Peers, illegal drug hawkers and vendors, Patent medical stores and Prescriptions (drug abuse/problematic use)

What is the price?

Prices are usually in ranges depending on the setting whether in rural/urban and the demand/supply of the drugs. The price of Tutolin ranges between N150 to N400 per bottle while Tramadol ranges between N300 to N500 per sachet of 10n capsules.

Apart from these two, what other drugs are being misused?

Other drugs being abused are Alcohol, codeine, amphetamines, benzodiazepine, cannabis, caffeine, nicotine, cocaine, heroin, chocolate, volatile substances, and ketamine among others

What are the side effects?

Habitual users who become tolerant to Tutolin and Tramadol need to increase the amount or frequency of the doses they ingest in order to achieve the previously euphoric effects, this eventually drags them to “accidental overdose”. Symptoms and signs include Miosis, difficulty with breathing, intense drowsiness, cold and clammy extremities, slow and/or irregular heart rate, collapsed or clogged blood vessels, nausea, vomiting, constipation, urinary retention, seizure, loss of consciousness, and coma among others.

What feeling or sensation does it give to them?

It generally causes a “high” or “euphoria”, this also enhances its addictive power, but what follows the initial high is depending on the class of drug, whether it is a stimulant or a depressant. A stimulant will give intense feeling of pleasure, power, self-confidence, increased energy. A depressant follows the initial high with feelings of relaxation and satisfaction.

Are they over the counter or they are being prescribed?

They are to be controlled drugs dispensed only on Doctor’s prescription  given the enormous reports regarding the abuse of these drugs, but because of the high handedness of some health workers who kyphose around on white coats, they let out these drugs once greeted by the slightest indication. A doctor is to entertain a lot of constraints before putting pen on paper especially with respect to these drugs weighing the risk to benefit of use. In addition, in Nigeria even without a doctor’s prescription, these drugs are readily available at pharmacies, patent medicine stores etc and some chemists and pharmacists just sell them to the public even without a prescription from the doctor. This is where our drug regulatory bodies/agencies can contribute hugely in curbing this social ill from ravaging our future.

Using the minimum wage of a house wife monthly allocation and youth, how much will they spend in a month?

The amount they spend is a function of the economic status of the individuals whether he or she earns the minimum wage or has to depend on the parents, husband, relatives, and peers for funds to procure drugs. The restlessness exhibited in seeking for funds by any means to get drugs is an important component of the definition of ‘Addiction’.

Thus how much spent monthly by drug users is not entirely a function of the minimum wage but of the economic status of individuals /friends, level of addiction and resources at ones disposal. However within the purview of the Nigerian minimum wage with consideration of other factors noted earlier, some persons may expend between 40-100% of the minimum wage.

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