“Stop Tramadol Now” Campaign – The Case of The Drug Addict or Drug Dependent

Photo credit: liyouthsafetycoalition.org

Hitherto I had no sympathy on drug addicts or drug dependents. I had thought of their situation as a free will choice to continue to engage in substance abuse. In my ignorance, I thought that they could on any day take a decision to cut off from substance abuse if they so wished. I showed outright scorn against addicts. Not even remorseful feelings of addicts during their subtle withdrawal and subsequent relapse could make me see an invisible force at play against them, for me to at least revise my harsh thoughts of deliberate irresponsible behavior attributed to them. Many like my former self, assume addicts hold onto the chains of the misery of substance abuse willingly.

I, however, had my prejudices against addicts reversed when I took the course “Drug Tolerance and Dependence” under the veritable Prof Lutterodt as part of my training for an MPhil Pharmacology degree. My ignorant assumptions against addicts got cured after the course. The course dealt in part the neurobiology of opioid addiction and management of addiction. The basis of which I hold misgivings and reservations on the effectiveness of the national campaign slogan – “Stop Tramadol Now” against tramadol abuse.

Tramadol is a synthetic opioid drug for the treatment of moderate to severe pain. It acts by changing the way the body responds to pain. Opioids alter the normal function of the human system and could lead to drug dependence and tolerance. Opioid addiction stems from its interference with normal release of neurotransmitters. Opioids have a suppressive effect on the release of noradrenaline, the flight hormone and a stimulatory effect on the release of dopamine and serotonin the feel-good chemicals. Continued opioid use causes the system to adapt to the altered biology caused by opioid to offset the change. It heightens noradrenaline release to offset the suppressive effect of opioids on noradrenaline release. The system also increases cellular dopamine and serotonin release “brakes” to balance off the opioid stimulating effect on the release of these neurotransmitters. Opioids withdrawal thus could cause jitters, anxiety, muscle cramps, and diarrhea as a result of the excess release of noradrenaline. Opioid addicts could also suffer from dysphoria, characterized by pain, agitation, and malaise as a result of reduced dopamine and serotonin levels due to withdrawal. Thus drug dependents will need a continued use of opioids to mitigate their withdrawal symptoms. We also overlook in our dealings with drug dependents that some of them are genetically predisposed to opioid-use disorder.

How realistic are we in suggesting opioid addicts or dependents would simply heed to a campaign of “Stop Tramadol Now”? How sensitive and appreciative are we concerning their altered biology and condition from the use of these drugs? We can’t possibly believe opioid dependents could go cold turkey in light of the debilitating withdrawal symptoms. These addicts or dependents need our support and not our cold campaign slogan of “Stop Tramadol Now”. We need to provide support services and encourage addicts or dependents to avail themselves for these services through friendly approaches. As if our delinquency in providing support services to addicts or dependents is not enough, stigmatization against tramadol use is on the rise. The everyday Ghanaian communication associating tramadol use with anything despicable is a drain on the willingness of tramadol addicts or dependents to seek help and even be part of educational programs to share their experiences. This must catch the attention of key stakeholders such as the FDA, Ghana Health Service, and the Narcotics Control Board among others to curb the tide of stigma against addicts. Addiction in one substance opens one up to abuse other substances and engage in illicit drug use. Thus substance addicts must be treated with outermost circumspection.

Opioid addiction is not peculiar to Ghana. Many countries are facing similar challenges. Opioid addiction is actually a health crisis in the United States. Unlike us, addicts or drug dependents in the United States are not stigmatized. They do not have fear of intimidation or prejudice in seeking care for their condition. The United States thus have data on their addicts and makes provision for free support services which are well-advertised for rehabilitation of their addicts.  

Drug addiction or dependence is a medical condition requiring treatment. We have a collective responsibility to show love and supportive care to opioid addicts and refrain from mean jabs against them. The nation needs to review its strategy on the campaign against opioid abuse. Suffice to say substance abusers are most likely addicts or dependents. It is absurd to tell addicts to “Stop Tramadol Now”. That is an insensitive joke! Waning drug addicts or dependents from drugs is a gradual painstaking process. The success of which is driven by community love and acceptance. In some instances, very little to nothing can be done to drug addicts in terms of treatment. Even in such conditions, addicts still need our love and support. In some European countries, there are state-sponsored heroin clinics for addicts to get a fix. This has gone a long way to improve their lives and make them live responsibly with a reduction in drug-related crimes.

Even as one is cautioned not to take a literal or narrow meaning of the campaign slogan for an argument, the seemingly little to nothing complementary strategies to the campaign slogan makes the above argument against the campaign valid. The “Stop Tramadol Now” campaign isn’t totally wrong. However, it must be targeted. It is its encompassing message of the campaign against tramadol abuse that is problematic. Let us stop the stigmatization and show more love and support to tramadol abusers in order to "Stop Tramadol Now"!

Martin Akandawen.

MPhil Pharmacology (student)

University of Ghana.

martinakandawen@gmail.com