Narcotics consumption: We will only make it available to medical professionals — NAFDAC

…Vows to curb illicit use

T he Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Prof Mojisola Adeyeye has reiterated the Agency’s commitment to ensuring the availability of narcotics and controlled substances for medical and scientific purposes while preventing diversion to illicit use in Nigeria.

The assertion, however, came against the backdrop of the unprecedented outcry by the Provost of the Medical School, University of Lagos, Prof Adewale Anthonio Oke that some surgeons and other medical professionals involved in the surgical operation of patients tend to be addicted to narcotic drugs used as painkillers for patients after surgery.

Speaking at the launch of the International Narcotics Control Board (INCB) annual report availability supplement and precursor report 2023 by NAFDAC in Lagos on Thursday, Prof Adeyeye admitted that narcotics and psychotropic substances are indispensable in the management of pains and other medical conditions.

However, due to the addictive potential of many of them, she noted that there is a need to balance the access and control of these substances, adding that INCB therefore reports the world drug situation yearly to inform governments of countries that are party to the International Conventions on drug control efforts.

According to her, the annual report for the year 2023 has a special focus on the role of the Internet, including social media, in drug trafficking and use. It explores the challenges and opportunities for drug control, prevention, and treatment, in the era of the Internet, with a specific look at the evolving landscape of online drug trafficking.

The NAFDAC boss who was represented by the Director, Laboratory Services (Food), Dr Charles Nwachukwu, however, stressed that Competent National Authorities must scale up their activities, and monitor online advertisement and sales of controlled substances to stay ahead of traffickers.

The report further analyses the global availability of narcotic drugs and psychotropic substances for medical and scientific purposes. It highlights the persistent disparities in access to medicines for the treatment of pain.  The precursors report x-rays issues related to trafficking in synthetic drugs including non-medical synthetic opioids, cocaine and their precursors which represent a growing threat to public health.

The DG reiterated some of the measures already put in place by NAFDAC to ensure availability and prevent the diversion of controlled medicines to illegal use.

E -permit issuance: The Agency has commenced the issuance of an electronic permit to import controlled substances since 2017 with the intention to link this process to the international Import and Export Authorization system (I2ES).

Pre-Export Notification (PEN) Online System: This platform has been of great utility in monitoring international trade in controlled medicines and precursor chemicals. Its use is to confirm the legitimacy of transactions of proposed imports.

Monitoring the integrity of the distribution chain: The Agency is scaling up its monitoring and surveillance of the distribution chain by verification of sales, documentation review and increasing the frequency of warehouse and facility inspection.

National Drug Control Master Plan (NDCMP): This is a multi-agency, multi-sectoral strategic planning and implementation framework that covers key aspects of drug supply and reduction impacting Nigeria. It is aimed at strengthening responses to drugs to contribute to the enhanced health, security and well-being of all Nigerians.

National Pharmaceutical Traceability: NAFDAC’s traceability implementation strategy is in line with the Nigeria National Traceability Strategy Policy document published by the Federal Ministry of Health in May 2020. The implementation started with controlled substances in January 2024. Other pharmaceutical products will be added in due course.

Global Rapid Interdiction of Dangerous Substances (GRIDS): INCB Regional Technical Officer for Central and West Africa has been selecting focal points for multi-agency training courses on real-time communication and intelligence sharing tools (IONICS and GRIDS intelligence) and awareness raising and safe handling of dangerous substances in the region. This aims to support law enforcement and regulatory agencies to identify and dismantle criminal organisations through the identification of modus operandi, risk profiling operations, and the exchange of information for launching and supporting investigations and enforcement operations against the trafficking of new psychoactive substances (NPS), non-medical synthetic opioids, and other dangerous substances.

Drug Demand Reduction Activities: The Agency carries out education and awareness campaigns in schools, workplaces, religion organizations, marketplaces etc. and collaborates with National Drug Law Enforcement Agency (NDLEA) NGOs and other relevant organisations to create drug abuse sensitization across the country.

She, however, acknowledged the collaborative efforts and cooperation of sister agencies like the Nigeria Customs Service, National Drug Law Enforcement Agency (NDLEA), and The Nigeria Police, who have all been of tremendous help to the agency.

Speaking in the same vein, Provost of the Medical School, University of Lagos, Prof. David Adewale Anthonio Oke, underscored the aptness of the occasion, given the fact that in clinical practices, several drugs and derivatives of narcotics, particularly opium and their derivatives are used in pain management, most especially in some critical conditions that involve excruciating pains.

Prof Oke, who was represented by Prof Olatunji Aina, a professor of Psychiatry at the College of Medicine disclosed that not only the members of the public indulge in abuse of medical narcotics. He lamented that doctors and other professionals that have these drugs in custody at the hospitals overtime tend to be addicted to the drugs they administer to the patients.

“Even amongst our colleagues in the health practice, especially those that work in the theater including professionals that are directly in charge of these drugs, some of them overtime tend to be addicted to the drugs,” he said, describing it as a big public health problem that only a collaboration between NAFDAC and NDLEA could nip in the bud.

He explained that some medical conditions like sickle cell disease crisis, orthopedic cases, particularly fracture cases and in the management of cancer, would warrant giving some of these narcotics to the patients to relieve them of severe pain.

He averred that severe pain is one of the symptoms in most cases of cancer when the tumor is exerting pressure on a certain part of the body, adding that in post-surgery, quite a number of these drugs are used in management of pain after surgery.

According to him, the dilemma of the physician is when the patient now becomes addicted, stressing that it is very important to know at what point a patient no longer requires analgesics and has become addicted.

In some cases, he said sometimes when you think the clinical situation has improved and would not warrant demand for analgesics, such patients still demand the drugs.

“I’m very happy about the control of these medicines by NAFDAC because it’s one of the commonest problems we have in psychiatry, particularly patients that are addicted to the controlled medicines and injections,” he said.