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In Sangha forest in Central African Republic, young people of the Ba’aka community, who have few opportunities, often take refuge in the opiate tramadol.
Reports are rife of tramadol use among young people of the Ba’aka community, in the Sangha forest of Central African Republic. Photograph: Susan Schulman
Reports are rife of tramadol use among young people of the Ba’aka community, in the Sangha forest of Central African Republic. Photograph: Susan Schulman

Misuse of opioids such as tramadol and fentanyl is 'global epidemic', report finds

This article is more than 5 years old

UN figures reveal deepening opioid crisis in Africa, with cocaine and opium production at records levels worldwide

The misuse of pharmaceutical opioids is fast becoming a “global epidemic”, with the largest quantities being seized in African countries for the second year in a row, according to a UN report.

While huge attention has been paid to the opioid crisis in the US – where the misuse of prescription drugs like fentanyl dominates – figures released by the United Nations Office on Drugs and Crime has revealed seizures in Africa of opioids now account for 87% of the global total.

Unlike in the US, the seizures – concentrated in west, central and north Africa – have largely consisted of the drug tramadol, followed by codeine.

The figures were disclosed in the latest UN world drug report, which noted that opioids were the most harmful global drug trend, accounting for 76% of deaths where drug-use disorders were implicated.

The report said that while fentanyl and its analogues remain a problem in North America, tramadol – used to treat moderate and moderate-to-severe pain – has become a growing concern in parts of Africa and Asia.

The report added that the global seizure of pharmaceutical opioids in 2016 was 87 tonnes, roughly the same as the quantities of heroin impounded that year.

The figures on pharmaceutical opioids were rivalled by global cocaine manufacture, which the agency said had reached the highest level ever reported in 2016, with an estimated 1,410 tonnes produced.

Most of the world’s cocaine comes from Colombia, but the report also showed Africa and Asia emerging as cocaine trafficking and consumption hubs.

From 2016-17, global opium production also jumped by 65% to 10,500 tonnes, the highest estimate recorded by the agency since it started monitoring global opium production nearly 20 years ago.

“The findings of this year’s world drug report show that drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts,” said the UNODC’s executive director, Yury Fedotov.

“Non-medical use of prescription drugs has reached epidemic proportions in parts of the world,” he added. “The opioid crisis in North America is rightly getting attention, and the international community has taken action.

“However ... the problems go far beyond the headlines. We need to raise the alarm about addiction to tramadol, rates of which are soaring in parts of Africa. Non-medical use of this opioid painkiller, which is not under international control, is also expanding in Asia. The impact on vulnerable populations is cause for serious concern, putting pressure on already strained healthcare systems.”

Despite the increase in availability and production, the report disclosed that the number of people worldwide using drugs at least once a year remained stable in 2016 at around 275 million people – or roughly 5.6% of the global population aged 15-64 years. Drug use among the older generation (aged 40 years and above) has been increasing at a faster rate than among those who are younger.

Despite that, global deaths directly caused by drugs use increased by 60% from 2000 to 2015, with mortality among people over the age of 50 increasing from 27% of these deaths in 2000 to 39% in 2015. About three-quarters of deaths from drug-use disorders among those aged 50 and older were among opioid users.

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