Nigeria recalls 2.4 million bottles of cough syrup containing codeine to fight abuse

Man pouring cough mixture onto plastic spoon. Universal Images Group/Getty Images

Lagos, Nigeria (CNN)More than two million bottles of cough syrup containing codeine are being recalled to stop widespread abuse of the drug, the Nigerian health ministry has said.

The recall is based on recommendations from a recent committee report from anti-drug abuse agencies in the country, Christiana Adeyeye, Director- General, National Agency for Food and Drug Administration and Control told CNN Monday.
"We asked all pharmaceutical companies producing codeine-cough syrups to recall the drugs. It was painstaking process that took six weeks but it is part of the steps we are taking to tackle codeine abuse in the country," Adeyeye said.
    Codeine, an opioid pain reliever, is the second most commonly abused prescription drug in Nigeria, a 2016 report Nigerian Epidemiological Network on Drug Use found.
    Analysis of opioid users in 12 treatment centers in the country showed that 69% had used tramadol, 21% had used codeine and heroin accounted for only 2% of admissions, the survey found.
    The drug came under scrutiny last year after Nigeria's Senate claimed around three million bottles of codeine-based cough syrup were consumed daily in two states in the north of the country.
    In March, Nigeria's anti-drug agency said its officials had intercepted 24,000 bottles of unregistered cough syrup in a single raid in Katsina, a state in northern Nigeria, local media reported.

    Young addicts

    Codeine-based cough syrups are commonly abused alongside prescription drugs like tramadol by young Nigerians, according to health officials in Nigeria.
    "Even teenagers and young adults are abusing prescription drugs like tramadol, rophynol, codeine-cough syrups. Some are smuggled into the country as unregistered products," Adeyeye said, while calling for stricter punishment for drug smuggling in the country.
    Marcus Odiegwu, a 19-year-old student, told CNN he combines several bottles of codeine-based cough syrups with crushed tramadol tablets to get high.
    "I had friends that were taking codeine at that time. I saw the aftermath, and I liked it," Odiegwu said. "They will go off and on just like that. So I decided to try it one night, it felt cool, and I continued," he told CNN.
    "I can do some crazy things when I am angry, but I don't take things personally when I take codeine. You might offend me, but I am too relaxed to bother," the student added.
    Opioids such as morphine and codeine are naturally derived from opium poppy plants more commonly grown in Asia, Central America and South America, according to the United States Centers for Disease Control and Prevention.
    They bind to receptors in the brain and spinal cord, disrupting pain signals. They also activate the reward areas of the brain by releasing the hormone dopamine, creating a feeling of euphoria or a "high."
    People who become dependent on opioids may experience withdrawal symptoms when they stop and may need to take higher doses leading to addiction.
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    Odiegwu told CNN though he knows the health implications of codeine addiction, he is more bothered about its impact on his academics.
    "I actually want to stop because I am having issues in school," said Odiegwu who said he was suspended after he was caught using drugs in school.
    Nigeria banned the sale of over-the-counter sale of codeine in 2012 because of widespread abuse in the country. But that has not stopped easy access to the drug, according to users like Odiegwu.
    "It's easy to get codeine or any drug in this present situation. Whether it is a pharmacy or not, you can get your drugs if you know who is selling them," he said.
    "Some people buy in bulk with evidence that they want to use it for legal things or health purpose, but those are the people who sell it around," he added.

    Broader link to crime

    Glen Prichard is the coordinator for the United Nations Office on Drugs and Crime Nigeria Response to Drugs and Related Organised Crime.
    Prichard told CNN Nigeria's law enforcement responses to illicit drugs has improved in recent years.
    However, the country remains a target because its population and market size make it an attractive destination for criminal networks trafficking pharmaceuticals in West Africa.
    It is not just Nigeria, the UNODC warned illegal trade and growing abuse of synthetic opioids, are destabilizing parts of West Africa, especially in the Sahel region.
    Prichard said there are two potentially worrying aspects to the drug issue in West Africa.
    First, is the health complications that arise from the abuse of prescription drugs which leads to dependency, another is its potential to undermine national security, especially in countries facing terrorism in the region.
      "The effects of drug trafficking contribute to criminalization in society and weakening of institutions which in turn has an effect of stability," Prichard said.
      "Drug trafficking is not just of pharmaceuticals, it is also about other illicit substances and that is an issue that Nigeria and the region should be aware of," he added.