The need to find instant relief from bouts of headache hooked a 19-year-old university student to an unforeseen addiction he is failing to come to terms with two years later. The student joins a number of youths in the country on the edge of addiction following their escapades with off-counter drugs.
As Drug Fight Malawi would testify, youths drug addiction is attaining a crisis level as it easier for tthem to walk into a pharmacy and buy off the counter drugs.
Prescription-only medicines, especially opioids such as tramadol, are the most abused. Tramadol is used to alleviate moderate to severe pain in patients, including after surgery.
Other opioids include codeine found in stopayne and cough syrups; morphine and oxycodone, including propofol, dextromethorphan and fentanyl.
World Health Organisation (WHO) classifies fentanyl as a potentially lethal dose that has so far caused 60 million deaths globally.
But while tramadol was initially a huge relief for 19-year-old Noel (preferred to be called by first name) who suffered spells of headaches in 2023, it has now become an addiction.
“I no longer take other painkillers,” he said.
Noel, a student at one of the private universities in Blantyre where he resides with his parents, said in an interview with Nation on Sunday he was introduced to the drug in 2023 when he went for treatment at a private health facility.
He was prescribed the drug which he wrote in his phone.
Thereafter, whenever he had a headache, he could go to any private pharmacy to buy the drug until some pharmacies started requesting prescriptions from a certified medical doctor.
He said: “But I am still able to buy from some.”
Noel said he also ingests the drug even when not in pain, because his body is just used to it.
In a week, he said he uses at least three strips of 10 capsules each. This means in a month, Noel ingests 120 capsules of tramadol.
He said he finds it difficult to stop using the drug because he gets irritated as part of the withdraw symptoms. Noel is open to any remedy and help to stop his addiction,.
A colleague from the same university is also struggling with tramadol addiction.
The 23-year-old, who opted for anonymity, said he uses the drug to ‘get high’.
He said: “It gives me pleasure whenever I use it and it is better than drinking alcohol or smoking.”
The ‘high’ feeling the teenager referred to is part of tramadol’s side effects.
According to the United Kingdom’s National Health Institute, side effects include dizziness, tiredness or low energy.
But unlike Noel, the colleague was introduced to the drug by a friend.
He first used it during a social gathering at the school they both attended.
Nation on Sunday also interacted with three other youths; two from Lilongwe aged 19 and 21 and 19-year-old from Mzuzu who got hooked through friends.
We were also able to buy tramadol from various pharmacies in both Blantyre and Lilongwe without prescription.
The pharmacy owners claimed that the majority of buyers are under 30, with a few older and legit ones. Some pharmacies were strict about prescription while others suspected a Medical Council of Malawi (MCM) ploy to close down the entities for not complying with guidelines and regulations of selling prescription medication.
Doctors we talked to in separate off-the-record interviews said tramadol prescriptions is given to serious cases to avoid addiction.
In a circular dated October 24 2023 addressed to service providers, Medical Aid Society of Malawi (Masm) chief executive officer Dr. Ulemu Katunga said it is imperative to ensure prescribing practices that align with the best interests of patients as regards the use of tramadol.
The circular was issued against the background of tramadol over-prescription, a situation Katunga said mirrors global trends where it has transitioned into crisis levels in other countries.
Reads the circular: “While this issue may not be as widespread in Malawi as it is in some western countries, Masm usage statistics is showing evidence of this shocking trend and it is essential to act proactively to prevent it from becoming a significant problem here.”
MCM registrar Dr. Dave Zolowere, who also doubles as chief executive officer, referred this reporter to Pharmacy and Medicines Regulatory Authority (PMRA), saying they are better placed to comment.
PMRA director general Mphatso Kawaye in an email response yesterday said by law, the institution expects all prescription-only medicines to be sold and dispensed upon production of a valid prescription issued by a registered medical practitioner.
But he said PMRA cannot rule out the possibility of some pharmacy practitioners selling prescription-only medicines without prescription.
He said: “Continuous use of prescription only-medicines could be dangerous, especially when it is the same medicine as it may lead to addiction in cases of opioids or drug resistance in case of antibiotics. Uncontrolled use of these two categories of medicines are a danger to an individual and to the society/public if abused.”
He said PMRA through its Inspection and Enforcement Department, regularly conducts routine inspections to enforce adherence to and compliance with the requirements.
But Drug Fight Malawi executive director Nelson Zakeyu in an interview on Friday expressed worry that youths are getting addicted.
He said: “Several strategies should be used to help in reducing unnecessary use of prescription drugs. For example, parents and guardians, teachers and all interested leaders should not only ensure there are strong family relations to reduce unnecessary use of prescription drugs.
“On the other hand, government needs to introduce drug rehabilitation centres in districts for affordable and accessible treatment to those addicted to these drugs.”
Zakeyu further said youths should also guard their lives and resist peer pressure.
