Friday, July 15, 2016

Rising Incidence Of Tramadol Abuse Amongst Nigerian Youths — GRAPHITTI NEWS Investigation

Even taxi drivers are aware of this craze for what is euphemistically called "Cough Syrup" amongst the initiates. It is a high like never before, as an insider describes the feeling from using the concoction containing the opiate.

GRAPHITTI NEWS report continues:
The only thing is that they would not reveal the full content of the mixture. Our Health Correspondent who is a qualified Pharmacist could only guess from his training what else thy may include in the concoction. However, the reporter is certain that Tramadol is not the only drug they are using, they know the names of several others.

Tramadol use is exploding all over the place. It is hugely popular. While some regular users prefer swallowing the ‘pills,’ others rather would drop them inside alcoholic drinks, and even the fizzy drink, La Casera.

The die-hard users bypass all of this and snort the drug!

Some people abuse pain medications such as Tramadol by snorting the crushed tablets. This may be done by those seeking a rapid initial burst of euphoria by bypassing the steady release of medication that would otherwise follow its intended oral administration.
GRAPHITTI NEWS findings indicate that abuse of the drug in this manner can result in a relatively rapid delivery of this drug to the brain, but can also cause serious side effects.

Why is tramadol abused?
The findings reinforces the findings of The Nation which carried the story "The Use and Abuse of Tramadol" on March 2016.

Apart from its pain relieving effects, Tramadol has been discovered to give a feeling of euphoric high when taken in large quantity. When opiods like Tramadol are mixed with alcohol, it increases the effects of the alcohol.

Toyosi Ogunjobi, a 19-year-old public secondary school student in Lagos, who is into the abuse of the drug told The Nation that he mixes Tramadol with alcohol when he wants to engage in manual labour. He claims it allows him to work harder and longer but that if he takes the mixture without working, it weakens him.

Gabriel Oladoye, a 21 year-old undergraduate of the University of Agriculture, Abeokuta also admits to abusing Tramadol. To him, Tramadol serves as an aphrodisiac. He says he normally takes the drug few minutes before sex and it enables him last longer and perform better in bed.

Bode, a 27 year-old liquor seller says mixing Tramadol with 'Bullet' alcohol drink helps him last longer during intercourse, since he normally suffers from premature ejaculation. He shared an experience in which he engaged in intercourse all night with a commercial sex worker after taking Tramadol with 'Bullet'. He said they had marathon sex all night, but confessed that he had to visit the clinic during the day, when he began experiencing pains on his manhood.

The doctor, after checking him up for infections, warned him to desist from such medications and marathon sex, as he was lucky not to have ruptured his tissues.

In a medication guide listed on Drugs.com, there contains a strict warning about Tramadol as follows:

“You should not take Tramadol if you have used alcohol, sedatives, tranquilizers, or narcotic medications within the past few hours.” 

“Tramadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take Tramadol in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill.

“Seizures (convulsions) have occurred in some people taking this medicine. Tramadol may be more likely to cause a seizure if you have a history of seizures or head injury, a metabolic disorder or if you are taking certain medicines such as antidepressants, muscle relaxers, narcotic, or medicine for nausea and vomiting.”

Now Tramadol is not supposed to be available OTC (Over the Counter). The question therefore arises, how are youths getting such a powerful prescription drug so readily?

Pharmacists are fingered, that is, rogue Pharmacists.

This drug is meant to be scarce in pharmacies, because it is usually required on special cases. But the reverse is the case these days, as pharmacists who are supposed to educate the ignorant youths are now the secret suppliers.

Drug abuse, any drug all, is not desirable, especially among the youths—the leaders of tomorrow.

In a candid viewpoint, Dr. Martin Agwogie, a Drug Demand Reduction expert with NDLEA, wrote "Drug Abuse and Nigerian Youth" in Vanguard of June 23, 2016:

The use of mind altering substances of natural origin has been known since the prehistoric times. For centuries, man has tried to either complement some pleasant features of life or escape from the unpleasantness of life, whether real or imaginary, by using fermented liquor and different plant products.

For example, drinking of palm wine and locally brewed alcohol such as “ogogoro”, “burukutu” as well as chewing of different stimulating plants and their products in Nigeria have been known for ages. Reports have it that the use of these substances was more of occasional and in moderation with few exceptions.

This was the trend of substance use in Nigeria until after the Second World War in the 40s when cannabis (hemp) was introduced through the war veterans who brought back the cannabis seed from India. The 70s and 80s witnessed the introduction of other drugs like cocaine, heroin, amphetamines and pharmaceutical opioids (codeine, morphine etc).

This trend changed dramatically in the 90s to include the abuse of non-conventional drugs such as volatile solvents or inhalants (gasoline, correction fluid, rubber solution, aerosol, nail polish removal, kerosene, petrol, and bytul nitrate). These volatile solvents produce psychoactive vapour which when inhaled goes straight from the nose to the brain, heart and lungs with instant intoxication and diverse consequences.

Today, ingenuity has been introduced into drug abuse with complex mixtures, experimentations and new discoveries. This has resorted to the abuse of lizard dung (especially the whitish part), pit toilet/soak away fumes (bio generic gas), “goskolo” a concoction of unimaginable substances, robin blue powder cocktail, “gadagi” (a substance resembling tea leaves), pharmaceutical products (Tramadol, Rohypnol) and many more. Codeine containing cough syrup mixed with soft drinks is gradually taking over alcohol in youth parties.

Due to new technologies which have improved the mass production of some of these drugs, many of them have become very cheap and therefore affordable. Unfortunately, the presence of new substances of abuse are usually not detected until someone suffering from the consequences visits the hospital for treatment or law enforcement personnel intercept or seize a supply of suspected substances.

Substance abuse in Nigeria and the new trend is becoming a significant medical, psychological, social and economic problem facing the nation. More worrisome is the increasing number of secondary school and tertiary institution students who are getting involved in drug abuse. These are the future leaders of Nigeria. What will the future of the nation be if it’s supposedly future leaders are drug addicts?

Five major predisposing factors to drug abuse among students are peer pressure, curiosity, ignorance, academic induced frustration and lack of parental care. Adolescence and young adult are characterized by new identities/peer selection, adventurism, curiosity, excitement and role confusion. Where students are not well guided, either by the home or school, they choose wrong peers which will lead to experimenting with drugs.

Also, the storm and stress of life such as academic workload, learning to be independent from parents put them under pressure to find solace in drugs. In some cases, they take drugs to have momentary relief and out of ignorance of the consequences. Some have been initiated by peers without knowing what they took. They would probably notice that they felt differently and would want to have a similar feel. Before they realize what they are taking, they would have been addicted to a particular substance of abuse. That is why some cannot tell you exactly the name of the substance they took until they go for drug test.

In some cases, they mention a substance of abuse whose effect is a contrast to their behaviour. The consequences of drug abuse by students include extreme violence, gang rape, drug induced suicide, paranoia, poor academic performance, larceny (to feed the habit), school dropout, poor health condition, indebtedness and waste of resources (money and material). Drug abuse is also associated with anti-social vices among students such as cultism, thuggery, racketeering, and armed robbery. This means that the problem of drug abuse among students is the problem of everyone – the parents, the school, other students and the general public.

Addressing drug problem among youths in institutions of learning therefore, requires collective efforts. Some institutions have put in place policies against drug abuse by students. Most of these policies are however penal such as suspension and in some cases rustication from school for students who test positive to substances of abuse. Some Institutions refer offending students for drug treatment and rehabilitation as a condition for re-admission into the school. As commendable as these policies may be, they need to be implemented with extreme caution. Otherwise, penal measures will become counterproductive with a good number of the students frustrated, not return back to school and would become additional burden to both the family and become security threat to the society.

Beyond referral for rehabilitation, counseling units in institutions of learning should be resuscitated with capacity to provide drug counseling, referral for more complex cases and follow up services after discharge from treatment and rehabilitation centers. Drug education, including drug refusal skills, should be incorporated into students’ orientation programmes. Alumni Associations should incorporate drug education and parenting skills in their programmes to help parents, institutions of learning and the government to collectively address the emerging threat to the future leaders of tomorrow.

Parents should be more involved in the educational progress of their children through effective collaboration with the school. In addition, parents/guardians should regularly monitor the activities of their children/wards at home in terms of the kinds of friends they keep, their late night activities as well as their consumption of the Internet as much as humanly possible. Schools should urgently establish a tripartite communication between parents, schools and students more for the overall welfare of the students, rather than for the business interests of the schools.

What Is Tramadol?
Sold under a variety of commercial names – including Kingadol, ConZip, Ultram and Ultram ER – this analgesic medication is prescribed to manage moderate to moderately severe pain.

Tramadol is a narcotic-like pain reliever. It is used to treat moderate to severe pain. The extended-release form of Tramadol is for around-the-clock treatment of pain.

Tramadol is a synthetic opioid agonist that interacts with certain opioid receptors within the brain – modifying sensations of physical pain and discomfort. It is often prescribed for people with nerve damage, arthritis or other painful chronic conditions.

Tramadol is sold in immediate-release and extended-release tablets, and it is meant to be taken orally. The extended-release version is intended to control symptoms for a longer period of time and is prescribed to adults who need around-the-clock pain control.

When Tramadol is abused for recreational purposes, it can create a near-immediate sense of pleasure and happiness that’s often been compared to a morphine high. But this man-made opiate agonist can be addictive, and snorting the drug increases the risk of dependence.

What Happens When You Snort Tramadol?
When Tramadol is taken orally as prescribed by a doctor, the drug is a generally safe alternative to other pain medications. Tramadol has more powerful painkiller properties than non-steroidal anti-inflammatory medications, and it was designed with the intention of providing a less addictive alternative to the stronger opiate analgesics.

Crushing the medication, however, is unsafe. People who misuse Tramadol may crush multiple tablets in order to snort the drug and get a euphoric high. While some side effects of snorting Tramadol may be shorter-term and less harmful than others, other side effects – such as seizures and overdose – can be much more risky and even lethal.

How Tramadol Enters Your System
When Tramadol is ingested orally, it is first processed through the liver before its effects are felt throughout your body. When Tramadol is snorted, however, the drug dodges this intended “first-pass” process of liver metabolism. Instead, the mucus membrane of your nasal passage absorbs the drug and delivers it across the blood-brain barrier directly to your brain.

How Tramadol Works in the Brain
Tramadol is a synthetic opioid – meaning that its chemical makeup has been man-made, rather than having been developed directly from opium poppy plant derivatives. Nonetheless, it works in the brain very similarly to natural opiates, as it attaches to opioid receptors and alters signaling throughout the body’s pain pathways. As a result, you perceive less pain in your body when there is Tramadol in your system.

Tramadol is a somewhat unusual opioid analgesic in that it also increases the availability of norepinephine and serotonin in your brain. The drug’s actions on these neurotransmitters may serve to bolster its pain relieving capabilities, but is thought to also provide a mild antidepressant effect – elevating good feelings throughout the body.

How Quickly You Feel Tramadol’s Effects
Orally administered Tramadol pills (immediate release) are processed through the liver, and drug levels peak in the body in about 2 hours. Since snorting Tramadol skips this liver metabolism process – delivering the drug directly to the neural circulation – the effects of Tramadol are experienced even faster than 2 hours.

What Are the Side Effects of Snorting Tramadol?
When Tramadol powder is snorted, the medication can cause severe irritation of the mucous lining of the nose. Some users report a painful burning sensation. In addition to causing discomfort and pain, snorting Tramadol increases the risk of taking too much of this medication.

Snorting Tramadol can have serious consequences, such as: Agitation, Panic, Shaking and tremors, Nausea and vomiting, Diarrhea, Dizziness, Weakness, Overdose and Seizures.

When you snort Tramadol while you’re drinking or taking other drugs that suppress breathing and heart rate (such as opiate pain relievers methadone or heroin), the risk of central nervous system depression increases — as does the risk of accidental death.

Tramadol and Serotonin Syndrome
A 2010 study of Tramadol overdose published in Clinical Toxicology indicates that 1.2 percent of all poisoning episodes in 2006 to 2007 were related to Tramadol. Taking too much of this drug can result in what’s known as serotonin syndrome – a severe drug reaction that can occur when you take medications that alter the brain’s production of the neurotransmitter serotonin. Dangerous side effects of serotonin syndrome may include: Seizures, Accelerated heart rate, Elevated blood pressure, Elevated body temperature, Delusions and hallucinations and Loss of motor coordination.

Getting Treatment for Tramadol Addiction
If you feel that your Tramadol abuse has taken over your life, you may have a physical or psychological dependence on this drug.

Getting help for Tramadol addiction may require intensive, professional substance abuse treatment – potentially one that specifically promotes recovery from Tramadol addiction or other form of prescription drug abuse.

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