- It is now clear that there is considerable awareness of the menace of tramadol and other opioids. We are all aware of the impact it is having on our youth and the parallel society it is creating. However, we have failed to move from the awareness stage ....
Malcolm Gladwell in David and Goliath argues, “The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.”
Last week I was tagged in a number of video clips some of which were too gruesome to even share. Many of them were footage of people in varying states of trance thanks to the abuse of one narcotic analgesic or the other. However, three of them were footage showing young females who had allegedly lost their lives. In one of them, I was struck by the utter chaos in an attempt to save the dying youth whilst bystanders used their smartphones to capture the scene. By the end of this viewing, I was mortified. I was because I couldn't understand how in the midst of this public health pandemic, we had collectively connived to let a large section of our youth down.
It is now clear that there is considerable awareness of the menace of tramadol and other opioids. We are all aware of the impact it is having on our youth and the parallel society it is creating. However, we have failed to move from the awareness stage to a stage where we try to understand the problem in an effort to provide help to those already addicted. Neither have we come out with any plan to prevent more people from getting addicted, thanks to the curiosity that comes with a state of awareness.
Today, I will try to provide a roadmap that will help begin a conversation in an effort to hopefully lead to the provision of help to those living in our self-created parallel society. In my view, there is an urgent need for civil society and government to have discussions on public health education targeted at teens, parents and educational institutions explaining the inherent risks associated with opioid abuse. Such information seems to be woefully lacking. These activities must be sustained and not handled as one-off events. This, when undertaken, will ensure that the number of new addicts is brought to a minimum and allow time for the retooling of experts to deal with those already addicted.
It is also important that those who have made it a point to create awareness in the hope that it will help stop tramadol addiction, for example, have amongst their team, professionals versed in addiction control who can address issues that potentially could arouse curiosity and fuel the epidemic. Sociologists have always indicated that the mind has a default of exploring should information be provided without adequate explanation. Therefore, issues like the enhancement of sexual prowess should be promptly debunked and explained should any addict indicate this in a positive light.
The extent of abuse and the repeated incidence of overdose is indicative that this crisis has reached a tipping point where the preparedness of our health institutions will be crucial. From the footage I saw last week, the preparedness of the staff at the hospital left a lot to be desired. To start with, the dying lady was stripped of all her dignity. There was no confidentiality provided what so ever, to talk about privacy will leave a lump in my throat. But wait a minute; does addiction management and control not come under mental health? If it does, should I be really surprised at what I saw? If I am honest to my conscience, surely not. The extent of deprivation mental health has suffered over the years and the grave lack of expertise even in the most specialist institutions is what was being made manifest. This situation needs urgent arresting. It will be incredulous if we failed to de-stigmatise mental health and as a result confined a large section of our youth to a life of shame.
Whilst scrolling through comments on the many threads I was tagged onto, however, I became gobsmacked with the subtle suggestion by many that the situations the ladies found themselves in was self-inflicted and the lack of empathy from those making such comments. These comments gave me the biggest indication that most of us either lacked an understanding of how addiction occurs and the role society plays or were just trying to be reasonable humans, aligning themselves to the views of the world, all be it warped and ill-informed. In my state of confusion, my resolve to continue advocating for these voiceless youth was strengthened.
In this state of strength, I became increasingly aware of how as a society we have watched whilst all the institutions of state responsible for policing our drug supply chain have failed these youth. I was struck with awe trying to resolve the role the profession of pharmacy, a profession I hold so dearly to have been complicit in this failure. I wondered whether all the reasons being given by state actors and professionals alike were tangible enough and acceptable reasons for this spiralling pandemic. In the end, I concluded in the negative; no reasons are good enough to make any of us, accepting of the current situation. There is, therefore, the need to shun the excuses and begin a journey that is judged by outcomes and not mitigation.
Our law enforcement agencies especially the police and prisons services cannot be left out too. The time for them to be tooled to appreciate symptoms of withdrawal and actions to be taken is long overdue. Many who fall foul of the law due to addiction are victims of a broken society themselves and this must be recognised. Like Lee Harper opines in “To Kill a Mockingbird,” “You never really understand a person until you consider things from his point of view... Until you climb inside of his skin and walk around in it.” This journey of walking the addict's path is one many law enforcement personnel should be encouraged to undertake.
Finally, the laws around medicines procurement and supply which are treated with the colloquial Ghanaian attitude of, “the law was made for man and not man made for the law” should be discouraged and those who breach them severely punished. The era of being Mr or Mrs Nice One in the name of supplying all sorts from pharmacies is disgraceful and can no longer be acceptable. That even cough mixtures have become agents of addiction is the clearest indication that oversupply of pharmacy medicines is part of the problem. The practice of pharmacy is based on law and not a simple profit and loss endeavour.
Many may see those who abuse opioids as lost souls and societal pests. However, it is only a failing society that kills mockingbirds without realising that they only mimic the failings inherent in the society. This is why in this advocacy some of us will always be unreasonable and insist that the current situation is untenable. This is why I insist that throwing our hands up in despair following the death of these ladies is unacceptable and should rather gear us into action for they are just victims of our inactions and societal failings.