BBC Africa feature on abuse of Codeine Syrup in Nigeria; power of the media & role of the government + society

May 14, 2018

Update: I edited this blog post into an opinion piece that was published by The Daily Nation in Kenya

I recently watched a BBC Africa feature on the use of codeine in Nigeria. I had heard about codeine also known (and 'praised' in the hiphop -  or is it trap now...i am old - space) as purple drink or lean. The first time I heard about it was when Lil Wayne had seizures, one year or two ago, and people started saying he has epilepsy...of course those of us in the epilepsy advocacy space were waiting for him to become the next artist advocating for an illness that gets so much stigma. As the days and weeks went by, reports said his seizures might be due to the drink he always has in most of his videos -  a mix of cough syrup and other things. I did not understand why someone would want to drink cough syrup - and so much of it - so I began digging and that is when I learnt about 'the world of codeine'

Flash forward to this year and boom, I am not reading about famous artists having seizures and hoping we will have a famous advocate but I am watching people in chains, with flies all around them...I am watching senior sales executives from big medicine manufacturing companies in Nigeria striking deals with people posing as business men looking to sell codeine to students...I am listening to them share how once the students get hooked they will keep coming for more with is more money for the 'businessmen' and the companies...I am watching pharmacies that are trying to be ethical selling their products through the spaces in their burglar proof doors to protect their staff from 'codeine hungry' youth.

I am watching the investigative piece by Ruona Meyer titled Sweet Sweet Codeine. 

Ruone got interested in the abuse of codeine syrup in her home country, Nigeria, after her brother's addiction and struggle. 

(I definitely recommend the feature - though I had a problem with her use of the word mad among other labels when referring to those who had been affected by the drug. It is also unfortunate that rehabilitation and mental health facilities across Africa are scenes of people chained to trees, sleeping on floors with flies all around them, something that through the mental health academy we are trying to change - for we would like to make mental health sexy not just through increase in conversations but also through the types of services that people with substance induced mental health conditions and any other forms of mental health conditions -  'mild' to 'severe'. It is also important to note that despite the unfortunate and regularly shown face of mental health in Africa, there are human centred, acceptable, accessible, affordable and available services)

Power of the media
Following the feature, the government of Nigeria put a ban on codeine. This goes to show the power of the media as a tool for advocacy and awareness creation. I do not know how much the advocacy groups in Nigeria had done with regards to codeine, if anything at all...I do not know if they had done a lot of lobbying and the feature came at a perfect time to push the government to act...I do not know if the comments on social media and other forms of media in and out of Nigeria after the feature did the pushing but what I can say is that the feature showed the power of the media in advocacy and awareness.

I am however not sure if the ban in and of itself is the best response to the codeine and larger drug and substance abuse situation not only in Nigeria but across the continent (In Kenya, the government banned getting it over the counter without a doctor's prescription). Yes cutting off the supply is good but what is even better to is to cut of the need for the supply. Why is it that young people -  male and female -  are taking codeine syrup? Reports from Nigeria state that the price of codeine in the black market has gone up since the ban. Beside 'cold turkeying' everyone on codeine in the country, the governement there and in other African countries, need to have complimentary ways of dealing with the problem.

Role of government and society
There are definitely an array of reasons as to why people - especially the youth - get into any form of drug/substance abuse. Alongside the ban and dealing with the supply chains from manufacturers to the cartels both in the underground and otherwise, the government needs to look into the why, if they do not address it, chances are robberies and kidnappings might increase as these young people look for ways to get the additional money needed to afford the now more expensive codeine or get alternatives.

The governement also needs to think about those who were already addicted, what will happen to them?  What rehabilitation and reintegration options have been put in place for them. In Kenya, the use of MAT (Medically Assisted Therapy) in Kenya's main mental health referral and training hospital and in Malindi has gone a long way in assisting those who were previously dependant on heroine. The program offers methadone and counselling through outpatient services.

Such services as well as forming patnerships with the media to do a sequel that gives information to the society and especially families affects on how to take care of those affected, where to take them and how to assist them in their rehabilitation will go a long way in improving the lives of those previous dependant.

Establishment of champion programs where those who have recovered can be part of the awareness campaigns and participate in exploring 'the why' and 'the what next' will also help in reducing the chances of more young people getting into drug/substance abuse or looking for alternatives.

Matters like unemployment, access to skills, capital and tools to create own jobs and market for the services and products by young people need to be discussed, ministries of labour, trade and education need to be present during such deliberations to explore how to make African countries 

Youth friendly health and most imprtantly mental health services need to be prioritized alongside continuous awareness programs that make young people and the next generation comfortable enough to seek help and not look for alternative ways of solving their issues.

I am curious to know if we have this problem in other African countries...if you would like to know more about the side effects of codeine, read through this BBC write up based on the feature.

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