Nakinti Nofuru, GPJ Cameroon
Chantal, who asked that her full name not be used, is a nurse, and she says she sells tramadol in her small medicine shop, even though it has been banned.
BAMENDA, CAMEROON – His classmates say he sleeps in class regularly. Time and again, he beats his desk like a drum and sings in his loudest voice. He threatens to pummel classmates who cross his path and he often skips lectures. Three times, he has failed a basic exam that would allow him to attend high school.
Known as Big Boy, the 19-year-old is addicted to tramadol, a powerful pain drug. He buys it with money his father gives him daily for his lunch, and says he takes up to five pills a day.
“I started taking tramadol not because I loved to take it,” he says. “The situation in my house caused me to take it. My mum and dad consider their work more important than me and my sister. Forget my mum, she is never there. I am not sure she is conscious of the fact that she has children.”
He says tramadol, which he’s been taking since a friend introduced him to it two years ago, helps him forget his problems. The drug makes him feel happy, he says, then sleepy.
“I’m happy I have found love in tramadol,” he says. “It is the only friend I have.”
Tramadol is only legally obtained via a prescription, health officials say, but it’s still being used and abused in the North West region of Cameroon, by everyone from school children to motorbike drivers. It’s cheap and easily found on the streets.
Recent years have seen increased international attention to abuse of the drug. The International Narcotics Control Board noted in 2012 and 2013 reports, among other publications, that tramadol was widely abused, especially in Asia and Africa, and illicitly distributed. Other countries have cracked down on use of the opioid. In 2014, the U.S. government classified the drug as a controlled substance, which placed it under tight distribution regulations.
But in Cameroon, the drug is still sold in pharmacies and other stores, as well as in roadside telephone stations.
“People sell it illegally and in hiding. We are yet to find those who are still selling the drug,” says Julius Sama, the regional chief in charge of immunization and drug control at the Regional Delegation of Public Health for the North West region.
Sama says most illegal drugs enter Cameroon through Nigeria and quite often, the smugglers use hidden footpaths to enter the country.
In most countries, tramadol is only available with a prescription, according to the World Health Organization. It’s considered to have a low potential for dependence, but addiction can occur if the drug is used for prolonged periods of time.
Ten tablets go for 200 Central African francs (34 cents) and users only need to take two tablets a day to get a narcotic-like effect, says Henry Fombad, a retired nurse and a lecturer at the Catholic School for Health Sciences at Shisong Hospital, northeast of Bamenda.
People who abuse the drug are at risk of depression, convulsions, euphoria, nervousness and dependence, says Fombad.
“A lot of young people have become addicted to tramadol, and that is not good for them,” he says.
Chantal, a nurse who owns a pharmacy in Bamenda, says demand for tramadol is high.
“The consumption of tramadol is higher than people can imagine,” she says. “The highest number of consumers are students between the ages of 13 and 19. I am alarmed at the rate at which school children have gotten into this.”
She asked that only one of her names be used to protect her identity.
She says public transport drivers and commercial motorbike riders also frequently buy the drug from her store. Once, she says, a motorbike rider threatened to beat her up because she didn’t have tramadol.
Chantal says she buys the drug from smugglers in Nigeria and hides it whenever health officials come to inspect her store. On some days, she says, tramadol sales bring in 40,000 francs ($68).
Solange Bih operates a roadside telephone station. She says tramadol sells out fast in her shop.
“Tramadol na quick business,” she says in pidgin English. “Okada people come and buy all the time.”
Okada is the local name for motorbike riders who earn a living carrying passengers around the city.
Bih sells tramadol worth as much as 20,000 francs ($34) in a day, she says.
Felix, a motorbike rider who asked that only his first name be used, says he and others need tramadol to navigate Bamenda’s pot-holed roads without feeling pain.
“When I take tramadol, I feel lighter,” Felix says. “I ride my bike all day in the bad roads of Bamenda without feeling any pain.”
Felix says he takes up to six tablets a day. The drug is readily available, he says, and cheap.
“With tramadol, the situation becomes see no gallop, dodge no gallop,” he says, laughing.
