How Tramadol Abuse Is Silently Creeping Into Homes With Its Destructive Effects In Nigeria

Tramadol Abuse

Tramadol came to Nigeria in the 90’s. It was an over the counter (O.T.C) drug. It is in the same class with opioid painkillers.

The reason why it was grouped with them is that they have a similar mechanism of action (M.O.A). When all other opioids have similar chemical structures and same MOA, Tramadol has a different chemical structure. This was the reason drug regulatory bodies place it as an over the counter (O.T.C) drug as it was believed to be relatively safer than the other opioids.

Tramadol just like opioids is prescribed for mild to severe pains. It is available in the form of a capsule of various strengths from 50 mg, 100 mg, and 200 mg in a sachet of 10. The price is usually from 100 to 300 naira when it is OTC, which depends on location and brand. Presently, it is well above a thousand naira.

Some years down the lane, it is becoming the most abused drug in Nigeria. It is more abused in tertiary institutions for some funny reasons than any other area. There are two sets of people that abuse it. Those that abuse it deliberately for some reasons and those who started it for treating medical conditions.

Some deliberately abuse it because it;

1. Enhance sex drive and performance

2. Gives some level of highness

3. Prevent sleep during night time              Note that it does not encourage reading at night. Students who take it to stay awake do so for reasons other than that. They cannot read but feel a terrible headache. It is mostly abused by online scammers when they want to stay active while doing their thing their own way.

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For those who were innocent, it usually starts from a normal prescription. From there, drug abuse and misuse sets in which includes taking it more frequently or at high instant doses. This leads to dependence unknowingly. The normal dose no longer satisfies the craving hence a move for an increase. It continues until the person notices the effect of signs of addiction.

The side effects of abuse include:

i. Dizziness

ii. Weakness

iii. Sleepiness

iv. Insomnia

v. Headache

vi. Shaking hands

vii. Dry mouth

viii. Sweating

ix. Constipation

x. Euphoria

xi. Mellowness

xii. The sense of well-being and lack of inhibition

xiii. Fear

xiv. Etc.

It is cheap and easily accessible to all as it is not an illegal drug. This is the main reason it is gaining ground more than hard drugs like cocaine, marijuana and the likes. Whereas, it has almost similar effects like them. It took some years before drug regulatory bodies made it a prescription only medicine and control drug. This means that pharmacists must dispense it only with prescription with strict precaution.

The drive to control it has not removed the dependence of people on it hence they try every available means to get it. To get their desired Tramadol, students have device means of forming that they have pains all over their body to their doctor. This has led to it being prescribed and abused. The drug is illegally sold by roadside chemists without prescriptions. This is making the fight to curb the menace a difficult one for the government.

The people who abuse this drug range from students to workers, old and young, male and female of all categories. Everybody is a suspect until proven otherwise. The normal lies such ones tell when the effect is telling on them is that they are just waking up or have health issues with their eyes.

Method Of Abuse Of Tramadol

1. Tramadol is taken orally but this is not always the case with abusers. They have device means to send the maximum amount that they can achieve to their system by designing methods that make the drug more powerful.

2. Adding it to soft drinks is the most common method of abuse. Much more quantity can be gulped without the fear of bitter taste when the drug is mixed with sweet soft drinks. This method has also been used on date rape. When some girls visit a guy who is drinking a bottle of soft drink, they just jump at the bottle and down they go with it.

3. Chewing is a little means of abuse since the taste is a turn off for many. It is still practice. The chewed drug is more potent than taking it whole.

4. Snuffing grinded Tramadol powder can send all the active ingredients into the system giving the feel they want.

5. Smoking it in a wrapped paper is another unpopular means used by addicts.

6. The last most potent method is injecting it into their blood. It is grinded and mixed with water and the resulting solution injected into the bloodstream using syringes.

Tramadol Mechanism Of Action (M.O.A)

Oral Tramadol goes to the liver where it is metabolized before hitting the circulatory system. It then enters the blood brain barrier where it attaches itself to opioids receptors. This alters the body pain pathway production and increases the release of norepinephrine and serotonin in the brain with mild anti-depressant effects. Abuse mostly leads to serotonin syndrome.

Effects Of Tramadol Overdose

1. Seizures

2. Accelerated heart rate

3. High blood pressure

4. High blood temperature

5. Delirium

6. Hallucination

7. Loss of motor coordination

It must be noted that no case has been recorded yet that an abuse of the drug led to violent behavior.

Quitting Tramadol Addiction

Most people want to quit when they notice they are addicted to it. It is usually like a cycle for most attempts: you stop cold, blank, after a while, you feel withdrawal syndrome like running nose, insomnia, restlessness. You rush down to your closet and it is in your system again. You feel relieved.

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Here is a story of a guy I read somewhere around. He took a whole sachet of 100 mg of Tramadol only to wake up and found himself tied to the hospital bed. The story he was told by those around him when it happened was that he suddenly stopped breathing, and after a while woke up like a mad man without recognising anybody.

All effects even of the same dose are different for different persons. The dose that will have effects on a person may be different from the one for the other person. Dependence normally starts from 200 mg/day dosing.

Treatment Of Tramadol Dependence

There are specialized hospitals that deal with addiction. Since addiction is for different drugs, one cannot say how many Tramadol addicts make themselves available in Nigeria. However, for those who attend such programmes, the methods of treatment are similar.

Reducing dosage over time has produced a more fine result than stopping all together one day. Clonidine and benzodiazepines might be used for acute withdrawal. Non-Steroidal Anti-inflammatory Drugs (N.S.A.I.D) also help during treatment. Antidepressants such as selective serotonin reuptake inhibition is used to treat serotonin syndrome in patients that demonstrated such activities during withdrawal. Trigger factors are analyzed and are worked on.

The following are the general pharmacological and non-pharmacological approach of treatment:

1. Benzodiazepines

2. Clonidine

3. Methadone

4. Naltrexone

5. Mirtazapine

6. And abstinence

The process normally follows this route:

Day 1-3: Feelings of pins and needles piercing the body is common. Sweating, anxiety, nervousness, nausea, palpitation, insomnia, and drug craving

Day 4-7: Blurred vision, confusion, insomnia, and disorientation with craving

Day 8-14: All symptoms should be mild by now.

Treating individual symptoms is used sometimes for treating anxiety and insomnia with valium 5.

The effect of this drug is more significant with women than men. Most women who become addicted to it find it difficult to quit when they are pregnant. Taking the drug when pregnant exposes the child to addiction. Such children will have the same effects of withdrawal symptoms which cannot be quenched with gradual reduction of Tramadol since they are younger than the age that can tolerate Tramadol. This will eventually make the child suffer for a long time.

This menace ought to be tackled headlong by all hands. The drive for profit is hindering the willpower to do it. However, I know one day, what is right will be done and will see an improvement in the availability of the drug with proper monitoring.

Updated: the federal government of Nigeria has classified Tramadol as a controlled drug (CD). It cannot be sold without prescription like other CDs. Tramadol sales is now an illegal business with some people selling it at black market at higher prices.