Nigeria: Sweet Codeine, Bitter Consequences

By Wale Sokunbi 

Nigeria is on the global hotspot on account of a crisis brought into bold relief by an investigative documentary trending in the media. The documentary entitled Sweet Sweet Codeine, made by the British Broadcasting Corporation (BBC) Africa Eye undercover reporters, featured some workers of three Nigerian pharmaceutical companies – Emzor Pharmaceutical Industries Ltd. Lagos; Bioraj Pharmaceuticals Ltd. and Peace Standard Pharmaceutical Ltd., in Ilorin, Kwara State.

One of the workers featured in the documentary openly admitted his company’s massive sales of codeine cough syrup in the country, and boasted that he could sell a million cartons of the syrup in a week. The sales representative has since been fired by the company concerned.

The BBC investigative report handled by a team led by Correspondent Ruona Meyer showed that there were ten million more prescriptions of codeine cough syrup this year than in 2017, which was said to be more than 27,000 packs of codeine cough syrup a day. It also brought home the serious effects of codeine addiction as persons who had become mentally challenged on account of abuse of the drug were shown in chains at local rehabilitation centres.

The federal drug regulatory agency, National Agency for Drug Administration and Control (NAFDAC) immediately shut down production in the three named pharmaceutical companies. And Emzor, which has been very much in the eye of the storm in this crisis, came out with a statement saying its daily production of codeine was less than 0.5 percent of the amount said to be consumed in the two Northern states featured in the documentary. Although the Federal Government has since ordered a re-opening of the three companies, and only ordered a ban on the issuance of permits for the importation and production of codeine syrups, the controversy over the codeine crisis is not about to die down.

There is no doubt that the opioid codeine cough syrup is being abused and used as a stimulant in some parts of the country. This abuse is responsible for the massive sales of the syrup, when the country is not having a cough epidemic.

It can also be safely said that the companies involved in the manufacturing of this dangerous drug are not totally unaware that it is being abused, with all the dangers that this poses to misguided young persons in the country. Yet, they continued its production and importation, because of the high profits that they make from it. Arguments are ongoing on the propriety or otherwise of shutting down the three companies’ codeine production lines, with some people insisting that it will only drive the sale of the drug into the black market, and make it more difficult and expensive for those who really need it to access it. Yet, others say an outright unavailability of the drug would automatically end its abuse and the addiction. I subscribe to this view.

Beyond all the arguments for and against the ban, however, is the need to determine the actual scope of the problem and to clean up the country’s chaotic drug distribution channels. The way drugs, including prescription only drugs, are sold in open markets in the country needs to be checked. Sale of prescription drugs should be handled only by pharmacists. It should not be an all-comers affair as we have it now. Considering the serious consequences of the abuse of codeine, as evidenced in the chaining of the drug addicts in the BBC documentary, it is necessary for the relevant government agencies to provide for rehabilitation and care for the addicts. There should also be public enlightenment programmes to educate the youths on the dangers of addiction to codeine. It is also necessary to look beyond codeine in tackling drug abuse in the country. Other drugs that are being widely abused in the country, such as Tramadol, should also be included in any programmes designed to tackle abuse of codeine in the country.

Codeine is said to produce several adverse side effects. It produces sedation, nausea, euphoria and many lead to schizophrenia and other mental problems. Even organ failure, and death.

Nigeria has to take a very serious view of the codeine addiction problem. Even before the current focus on the problem of codeine addiction, the Senate had decried its increasing abuse, with a claim that three million bottles of the drugs are consumed in two Northern states – Kano and Jigawa- every day. A committee had also been set up in January to look into the abuse of the drug, with a mandate to submit its report in six weeks, but the report was yet to be released by the Health Ministry at the time the BBC documentary was aired.

Now that the BBC documentary has brought the Nigerian codeine problem into global focus, it is time for the government to bring all hands on deck to tackle it. Religious leaders/institutions, governmental and non-governmental agencies, parents and schools should all be involved in the efforts to end the codeine crisis in the country.

*Wale Sokunbi, an editor at SUN newspaper could be reached with walesokunbi2010@yahoo.com