A ray of hope: Fighting codeine and tramadol abuse in Kano state
“I would take two bottles of codeine in the morning and after like an hour follow up with 200mg of tramadol. At night I would take a bottle of codeine again. The feeling was… indescribable.”
Bello Yunusa Adali said he started taking tramadol and codeine in 1997. He was an okada rider and other drug users would ask him to go and buy the drugs for them. “One day, I sipped just a bottle cover full of codeine and that was how it started. Before I knew it, I was taking everything including alcohol.” He gave up on drug use three months ago thanks to the intervention of a women’s faith group, and today he leads an association of young drug abuse survivors called Jajircewa, which roughly translates to “persistence.”
It is a hot hazy afternoon in Nigeria’s second largest city of Kano, the kind of weather that signals the transition between the harsh harmattan and freezing rainy seasons. We are in Kwana Dala in Dala Local Government Area, a densely populated neighbourhood just off the major Jakara road. The neighbourhood is a typically northern setting where small markets and shops lie adjacent to houses. At its’ heart is a primary school, Damabazau Special Primary school. The school, which shares a wall with a large traditional building that houses the Sarkin Bai’s (Traditional ruler) residence, looks newly renovated. It is a surprising find in a community like this one.
We enter a classroom decorated with alphabets and numbers on the wall where a group of about 20 young men are seated. These youth, mostly in their late 20s and early 30s, share a common history; they have been victims of one of the most pressing and previously secretive challenges facing northern Nigeria today; codeine and tramadol abuse. They are here today to share their stories, not only of abuse, but also of recovery thanks to the work of the Federation of Muslim Women Association of Nigeria (FOMWAN), Kano State chapter.
FOMWAN Kano took it as a responsibility 11 years ago to fight the scourge of drug abuse in its communities, but wanted to do it without the traditional naming and shaming approach. Khadija Kabir Ayagi, the Amirah of FOMWAN in Dala Local Government Area, said it was not until June 2017 that the first set of addicts were engaged in her own domain. “The addicts were first approached in their usual base where they gathered, took drugs and made noise,” she said, adding, “We approached them during Ramadan when they usually broke their fast with drugs. We started bringing food to them, we bought mats for them and gradually they got comfortable with us. That was how we started talking to them about their lifestyles.”
Bello was one of the drug users they approached. He said he was convinced to give up drugs because of the way FOMWAN approached them. “They came to us and instead of chasing and insulting us like other people were doing, they embraced us and brought us close to them,” he said. “They showed us love and care like mothers.” Another motivation Bello said was his wife. “I never had time for my wife. She never saw my smile because I was always in ‘slow’. Whenever I went home I would go straight to bed. She wasn’t happy.” Bello said he was able to beat the addiction gradually. “As they kept talking to us, I began losing interest in the drugs,” he said, adding, “Instead of the 200mg I reduced to 100mg. Later I reduced to taking only a bottle of Codeine instead of two in the morning.” Bello said he continued that way, then he gave up on the night bottle and only took half a bottle in the morning. Eventually he was diluting just a cover of codeine with some coke, until he gave up on codeine and tramadol completely.
The FOMWAN team persisted despite the early reluctance they faced from the drug users and set up a weekly sensitization meeting which continues to hold till date. The youth association, Jajircewa, currently includes 53 young people who are recovering from drug abuse.
Tackling Northern Nigeria’s Substance Abuse Challenge
Northern Nigeria faces a host of challenges. From ravaging insurgency in the northeast, to communal clashes in north-central and an alarming poverty and unemployment rate in the northwest. Drug abuse, especially abuse of codeine and tramadol, is one challenge that threatens the future of the region and the country. The Nigerian senate in October 2017 estimated that about 3 million bottles of codeine is consumed daily in Kano and Jigawa States alone. In the same vein, the former Director General of NDLEA stressed that about 7 out of 10 youths in Kano state are involved in drug abuse. Though debatable, these figures point to the widely accepted fact that there is an alarming rate of drug abuse, particularly of codeine and tramadol, in Northern Nigeria, and it is destroying an entire generation. As the Amira of Kano state FOMWAN, Hajiya Sa’adatu Hashim grimly put it, “There is hardly any home in Kano state that you wouldn’t find a drug addict, that is how bad it is.”
The government has made proactive steps to deal with this problem from the standpoint of policy direction. A Senate roundtable in Kano in December 2017 resulted in the introduction of the Mental Health and Substance Abuse Bill. Minister of Health Prof. Isaac Adewole also set up the Codeine Control and other Related Matters Working Group in January this year.
Many concerned groups opine that placing a ban on the manufacture, importation, distribution and use of codeine in Nigeria is the surest way to go to reduce the access to these substances especially by young people. Pharm. Ahmad Yakasai, President of the Pharmaceutical Society of Nigeria, believes that this won’t do justice to the few who genuinely need codeine containing cough syrups. “It is not only Codeine that is abused,” he said, adding, “If you ban codeine are you going to also ban Rohypnol and Lexotan?”
Local Solutions to a challenging problem
FOMWAN Kano’s success in getting youths off drugs can be traced to their innovative approach, which they explain is a three-step process; embrace, sensitize, and rehabilitate. By first embracing drug users and providing meals for them, rather than insulting or naming and shaming them, they are able to gain their trust, which is essential if they are to listen to reasons they should stop using drugs during the sensitization process. Creating an association where those recovering from drug abuse can find community and accountability also goes a long way to ensure that rehabilitation is sustainable.
Further east of Kano is another organization, the Youth Awareness Forum Against Drug Addiction (YAFODA). Founded in June 2012 by a former drug addict, Mr. Abubakar Shuaibu Maitumaki, the organization was set up to share with addicts the steps Maitumaki followed to quit drug addiction. Over six years, YAFODA has expanded into all the 44 local government areas of the state with executives in every LGA and a coordinator in every ward. YAFODA has six cardinal programs they use in executing their activities;
The one on one campaign: They hold counselling sessions with individual drug addicts. These sessions take place weekly at YAFODA’s offices across the state or other designated places.
The “Catch Them Young” program: This involves visits to secondary schools across the state to create awareness among the students about the dangers of drug abuse.
The Teen care program: This focuses on teenagers on the streets that are either vulnerable to drug abuse or are already engaged in it.
The road awareness campaign: Members of the Association march through the streets of Kano sensitizing and creating awareness about drug abuse with stop overs at markets, worship centers and other public places.
Women drug reduction program: This targets young women that are into drug abuse. It is driven by female members of YAFODA and takes place in three metropolitan local government areas of Kano which have the highest prevalence of drug abuse among women, according to YAFODA’s research. These local governments are Fagge, Nasarawa and Tarauni. According to Mr. Maitumaki, in one of these LGAs, they found about 500 young women who are into codeine abuse.
The Kano Metropolitan program: This focuses solely on Kano city. In this programme they carry out visits to the densely populated and cosmopolitan areas of Kano city and traditional houses, government institutions and social gatherings.
From 2015, YAFODA has successfully rehabilitated 252 drug addicts, mostly codeine and tramadol abusers. They have their state headquarters in a small office at Kawo Bus Stop, along Lamido Crescent in Nasarawa area of Kano.
FOMWAN and YAFODA are two small organizations taking the fight against prescription substance abuse right into the heart of the most affected parts of Kano state using strong community-based approaches. The question arises therefore as to why their efforts haven’t been heard by substance-abuse interveners and regulatory bodies especially outside Kano.
This may be due to the two groups’ reluctance to have media engagements. In the case of FOMWAN, a track record of rehabilitated addicts has not been established. Funding is also a challenge that both groups are facing. Right now they tax themselves to provide the funds they need to rehabilitate drug abusers.
Both groups however seem to have clear plans for the future; FOMWAN is in the process of establishing a standard counselling Centre in the Kano in the second quarter of 2018 and YAFODA plans to expand their activities to the 19 northern states by the year 2020. Despite the challenges these two organizations face, they are providing effective local alternatives in the persistent fight against drug abuse in Nigeria through their community-focused approaches that identify, engage, counsel and rehabilitate those suffering from drug addiction.
For more information, contact FOMWAN at email@example.com or call 08023664488, 08032744978.