[e-drug] Opioid crisis in Africa?

e-drug
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E-DRUG: Opioid crisis in Africa?
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Dear colleagues,

I am doing a quick scan of perspectives following the recent BBC piece on cough syrup addiction in Nigeria, and other alerts related to illicit opioid use in Africa (see below). I would be interested in your views on the extent of this challenge, available data, and policy responses.

Sample articles:

  * How cough syrup in Nigeria is creating a generation of addicts - BBC News: http://www.bbc.com/news/world-africa-43912282

  * Sahel and beyond: UNODC sounds the alarm on the increase in trafficking and consumption of tramadol and its security and health implications: https://www.unodc.org/westandcentralafrica/en/2017-12-11-unodc-warns-tramadol-use.html

  * [U.S., comparison] Anguished Families Shoulder The Biggest Burdens Of Opioid Addiction: https://www.npr.org/2018/04/18/602826966/anguished-families-shoulder-the-biggest-burdens-of-opioid-addiction

Many thanks!
Lombe

Lombe Kasonde
Health Specialist
Health, Nutrition and Population Global Practice
The World Bank
E lkasonde@worldbank.org

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E-DRUG: Opioid crisis in Africa? (2)
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Dear Lombe,
   Please note that the opioid crisis in Africa is the lack of access to
   pain management first, and do not be lured by sensational media
   reports.

   Last week I presented in Copenhagen, Denmark, on this issue for a
   meeting organised by the Chair of the Health Committee of the
   parliament and the Danish pain organisation Smerte Denmark.

You can download my powerpoint presentation from Dropbox here:
https://www.dropbox.com/s/u7z1lbpf2ggbyph/Copenhagen%2025%20april%20
   2018%20ScholtenW.pdf?dl=0
  
The presentation is directed at industrialized countries, but much of
   it applies to developing countries too.
   Especially:
   1. The burden of disease from substance use disorder is much lower than
   the burden of disease from pain.
   2. "PrescriptION opioids" and "prescribED opioids" is not the same;
   illicit fentanil ls is not the same as the prescription medicine
   fentanyl.

   The USA failed to analyse its problems with opioids properly, resulting
   in counter productive policy responses (see graphs in the presentation
   with sky rocketing mortality figures).

Now some American opinion leaders try to export the false solutions to other countries. We should not step into the pitfall, but instead make a proper analysis of the situation in each country, and ensure that pain patients are not duped by policy mistakes. Remember: Human Rights Watch is investigating the USA now for torture of pain patients!

   See also the WHO policy guidelines mentioned in my presentation:

  http://www.who.int/medicines/areas/quality_safety/guide_nocp_sanend/en/

They continue to be valid.
   Best regards,
   Willem

   Willem Scholten Consultancy
   Willem Scholten PharmD MPA
   Consultant - Medicines and Controlled Substances
   Wielsekade 64
   3411 AD Lopik, the Netherlands
wk.scholten@xs4all.nl

References
   1. https://www.dropbox.com/s/u7z1lbpf2ggbyph/Copenhagen%2025%20april%202018%20ScholtenW.pdf?dl=0
   2. http://www.who.int/medicines/areas/quality_safety/guide_nocp_sanend/en/