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The purpose of this paper is to explore polydrug use and the factors that motivate the use of multiple substances among selected young adults.

A total of 23 male and female participants (aged 23-29 years) who use illicit drugs and prescription pharmaceuticals for non-medical purposes were recruited through snowball sampling. Qualitative interviews were conducted, and the data were analysed thematically.

The use of drug “concoctions” and cocktails was widespread among the participants. Some used what they called Codeine Diet (codeine-based cough syrup mixed with a Coca-Cola^® product or malt drink), while others took Gutter Water (a cocktail of cannabis, codeine, tramadol, vodka and juice or water). The use of Monkey Tail (a mixture of local gin, cannabis leaves, stems, roots and seeds) and petrol mixed with glue and La Casera^® (carbonated soft drink) combined with Tom-Tom^® (menthol-flavoured candy) was also revealed. Pleasure, better highs, the need to experience prolonged intoxication and the use of one drug to douse the effects of another substance motivated polysubstance use.

The findings revealed that the reasons why codeine-based cough syrups are mixed with soft drinks (Codeine Diet) include avoiding social discrimination and evading law enforcement agencies. Results suggest that these drug use practices require specifically tailored public health interventions. Social stigmatization against substance users and the use of extra-legal measures by the police should be discouraged to facilitate harm reduction.

This study represents the first qualitative research to explore polydrug use among an understudied Nigerian population.

The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated status, with individuals varying in their metabolism of codeine, estimation of safe dosages, risk of adverse health consequences and abuse potential. Efforts to quantify and address hidden non-compliant medical codeine use, overuse and intentional misuse is compromised by availability to the public in prescribed and over the counter forms. The paper aims to discuss these issues.

A review of literature on codeine use, misuse and dependence, and associated innovative medical and pharmacy interventions is presented, and was conducted as part of a larger scoping review on codeine.

The review highlights the complexities associated with monitoring public health awareness of codeine's abuse potential, and customer/patients trends in non-compliant codeine use for therapeutic and recreational purposes. Aberrant codeine behaviours centre on visiting multiple doctors for prescriptions, repeated lost or stolen prescriptions, forging prescriptions and use of multiple pharmacies. Innovations to monitor misuse of codeine include national prescription databases and recent developments in real-time monitoring of dispensing activity.

Further development of real-time monitoring processes with process evaluation is advised.

This viewpoint is intended to demonstrate how efforts to quantify and address codeine use are compromised by its availability. It intends to encourage further policy and practitioner dialogue on how to monitor, support and intervene with consumers misusing codeine.

This paper aims to explore the misuse of prescription opioids, associated consumption cultures and the emergence of “informal governing images” among young men in Nigeria.

Using a qualitative research approach involving purposive sampling: six in-depth interviews, one focus group discussion and key informant interviews with two health-care professionals using the transgressive theory approach, this paper explores consumption cultures, motivations and the resultant “informal governing images” associated with the misuse of prescription opioids among young local street high-risk users in Nigeria.

Findings show complex expressions of diverse consumption practices, such as grinding, sniffing and concoction of tramadol (TM)with other opioids. The “puff-puff pass” practice serves as induction for new users of opioids commonly accessed through street drug dealers and pharmacists sold via backdoors. Codeine mixtures with different brands of soft drinks for dilution are used to achieve a “lower high” while a concoction of different opioids, with alcohol, and spirits obtains a “higher high”. Manufacturers’ indelible colouring and bottling discourage the non-medical use of opioids. Desiring to be awake for nocturnal activities, mostly “yahoo-yahoo” (internet fraud), sexual enhancement and dosage competitions, are motivations for the non-medical use of prescription opioids. These consumption cultures create “misuse circuits”, leading to the emergence of “informal governing images” triggered by threats from formal controls.

This paper, therefore, concludes that pharmaceutical industries should also add colourings to TM and codeine just like they did in rophinol to discourage the non-medical use of prescription opioids among young people in Nigeria.

This paper concludes that rather than branding and packaging in such a way that concealability is difficult for high-risk users as the best way to discourage the non-medical consumption of prescription opioids in Nigeria, the focus should be on addressing youth poverty and unemployment and improving access to treatment for drug use disorders, instead of calling for more enforcement-based measures.

This is an original research.

The purpose of this study is to examine the politics, political economy, and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Hawkish regulatory policy on prescription drug in Nigeria, such as opioid analgesics, is a very complex and multifaceted one, which usually involves the interplay of many factors and parties.

Policy manuals, official government gazettes (legislations, regulations, Acts and decrees), academic literature and a direct ethnographic observation of events surrounding the regulation of prescription drugs were reviewed and engaged.

The results revealed that Nigerian and global political economy and politics interface to define the direction of the new restrictive opioid policy, with resultant friction between prohibition and consumption. The reviews showed that the overarching “get-tough” and “repressive” policy are not necessarily founded on empirical evidence of an increase in prescription drug sales or use, but more as a product of the interplay of both internal and external politics and the prevailing socioeconomic order.

Instead of borrowing extensively from or being influenced by repressive Western drug laws and perspectives, Nigerian policymakers on prescription opioids should take control of the process by drawing up a home-grown policy that is less intrusive and punitive in nature for better outcomes. A mental sea change is required to understand the intrigues of Western power in Nigeria’s politics and political economy to avoid the continuous symptomatic failure of drug policy.

The politics and economic influence of the United Nations, USA and Western powers, as well as the axiom of moral panic of prescription drugs scares within the Nigerian environment, are particularly significant in the making of the emerging hawkish policy on prescription drugs in Nigeria.

This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries.

The study adopted an exploratory design and qualitative methods to explore the perspectives of different actors, including officials of regulatory agencies, law enforcement agents, health-care providers and non-medical tramadol users. Data were collected through individual and group interviews, and transcripts were subjected to thematic analysis.

Findings show that tramadol fills a critical gap in treating pain across Ghana in areas with an acute shortage of opioid analgesics due to scheduling-related barriers. This was partly due to porous borders allowing for an influx of tramadol into the countries. The study further found that most tramadol purchases in Ghana and other West African countries were made from market traders rather than from health-care settings and were mainly generic medicines categorised as “substandard/spurious/falsely-labelled/falsified/counterfeit medical products” within the World Health Organization standards.

Although the findings are instructive, there were some limitations worth noting. The study encountered several limitations, especially with the non-medical users, because the environment is highly criminalised, People who use drugs were unwilling to avail themselves for fear of law enforcement officers’ harassment. Obtaining ethical clearance had its own bureaucracy – challenges that delayed the study time frame.

Placing tramadol under the list of internationally controlled substances would create barriers to access to effective pain medications, particularly by the poor, and encourage victimisation of users by law enforcement authorities.

The study is based on empirical research on tramadol use and regulation in African countries, contributing to knowledge in an under-researched subject area on the continent. The comparative approach further adds value to the research.

The purpose of this study is to understand the complex interplay between illicit opioids trade and consumption practices and state policies that aim to reduce their misuse.

The study adopted an exploratory design. Data were gathered through in-depth interviews with 31 commercially oriented drug dealers in Uyo, Nigeria. The framework approach was used in data analyses, while “friction” provided the interpretive lens.

Accounts revealed public concerns over the misuse of tramadol and other opioids among young people and the associated health and social harms. These concerns provided support for enforcement-based approaches to prescription opioids control, including police raids on pharmacy stores. These measures did not curtail opioids supply and consumption. Instead, they constrained access to essential medicines for pain management, encouraged illegal markets and fuelled law enforcement corruption in the form of police complicity in illegal tramadol trade.

The findings reveal the frictions of drug control in Nigeria, wherein enforcement-based approaches gained traction through public concerns about opioids misuse but also faced resistance due to the persistence of non-medical use and illegal supply channels made possible by law enforcement complicity. These indicate a need to prioritize approaches that seek to reduce illegal supply and misuse of opioids while ensuring availability of these medications for health-care needs.

The study is unique in its focus on the creative tension that exists between state control measures and local opioids supply and consumption practices.

Many young people around the world embrace hip-hop music and culture. Since the genre’s conception in the 1970s, hip-hop music and lyrics have made regular references to drugs. Understanding the relevance of these documented trends is important, especially as adolescence is a period of high risk for substance misuse. The purpose of this paper is to explore how and possibly why different lyrical trends in hip-hop music have emerged, risen and fallen out of popularity by examining word usage frequency of drug terminology in hip-hop lyrics spanning several decades of this genre.

Electronic searches were completed using an open source database known as Rap Genius Rap Stats, which contains verified annotations and text. Word frequency was plotted against time using data available from 1988 to 2015. Word frequency was defined as a percentage of the number of hip-hop songs containing a specific drug-term (per year) based on the number of hip-hop songs recorded/produced (that year). Standardized “medical/pharmaceutical” terminologies and common “street” terminologies were plotted independently for time series visualization. Drug terms were represented using the highest frequency search term. Generic “street” terms with multiple meanings were excluded.

As might be predicted, the usage of “street” terms in hip-hop lyrics was more frequently observed than the usage of “medical/pharmaceutical” terms. An exception was the term “crack”, which was included in both plots as this word could be referenced as a “street” term and as a “medical/pharmaceutical” term. The authors observed larger fluctuations in “street” term usage across time relative to only slight fluctuations of “medical/pharmaceutical” term usage across time.

In this study, the authors illustrate several drug terminology trends in hip-hop lyrics. The authors discuss some of the socio-political, socio-demographic and geographical implications that may have influenced these trends, such as the rise of the “street” term molly that emerged when references to molly made by hip-hop artists became increasingly popular and a more suburban demographic transpired. This preliminary work may help to enhance two-way youth-oriented communication between health care professionals and service users, possibly improving the translation of drug-related medical messages. The preliminary work may also inform future research to consider whether such lyrical trends precede or follow changes in population substance use.

The purpose of this paper is to explore the prevalence and patterns of substance use among Canadian social workers. With legalisation of can professional regulatory bodies are pressed to consider implications of substance use for their members.

An online survey collected data about demographics and substance use prevalence and patterns. Statistical analysis involved pairwise comparisons, binary logistic regression models and logistic regression models to explore correlations between substance use and demographic and work-related variables.

Among the respondents (n=489), findings indicate that past-year use of cannabis (24.1 per cent), cocaine (4.5 per cent), ecstasy (1.4 per cent), amphetamines (4.3 per cent), hallucinogens (2.4 per cent), opioid pain relievers (21.0 per cent) and alcohol (83.1 per cent) are higher than the general Canadian population. Years of work experience and working night shift were significant predictors of total number of substances used in the past year. Use of a substance by a person when they were a student was highly correlated with use when they were a professional.

Prevalence of substance use among social workers was found to be higher than the Canadian population; potential due to the anonymous nature of data collection.

This study has implications for social conceptualisations of professionalism and for decisions regarding professional regulation. Previous literature about substance use by professionals has focussed predominantly on implications for increased surveillance, monitoring, and disciplinary action. We contend that since substance use among professionals tends to be concealed, there may be exacerbated social misconceptions about degree of risk and when it is appropriate to intervene.

Shops and shopkeepers are a British tradition. More than 150 years ago, we were a nation of shopkeepers, and the picture of shops and the shopping public seemed unchanging. There were, of course, the early departmental stores, the co‐operative societies, the multiple shops, the chain‐stores, but the position was much as it had always been and the greatest proportion of retail trade was still in the hands of the traditional type of shopkeeper. The two Wars changed many things, but it was not until after the last War that retail trade really began to change and looking at it objectively and at the food trade particularly, it has become a revolution.

This paper aims to examine the friction that has surfaced since the adoption of policy measures restricting access to tramadol, a synthetic opioid, in Nigeria in 2018. Our analysis reveals how non-licensed pharmaceutical actors, who have played an integral part in the supply chain, have been criminalised for activities that have previously been sanctioned by the state. This criminalisation has given rise to friction between what is perceived as illegal by the state and what is acceptable for other actors in the tramadol economy.

The paper is based on more than 20 in-depth interviews with illicit actors and regulators in the tramadol economy in Lagos, Nigeria’s commercial centre, and a review of key policy documents, media reports and popular cultural outputs on tramadol.

The paper highlights the effects of prohibitionist policies and the voices of criminalised actors to provide a contextual view of the Nigerian tramadol economy. Relying on the concepts of friction and quasilegality, we show how social relationships have become the main backbone of the illicit tramadol economy and how they enable participants to resolve the pervasive friction between illegality and social acceptability of tramadol.

This paper provides an inside understanding of the nuances of the rarely studied illicit trade in synthetic opioids and how restrictive policies that are seemingly not well thought through have created friction in the Nigerian context.