Northern governors are less serious about fighting drug abuse — Gana

A renowned Pharmacist with Aminu Kano Teaching Hospital (AKTH), Ahmad Gana Muhammad, recently bares his mind on the recent roundtable discussion organised by the Senate President, Dr. Bukola Saraki, on the drug abuse epidemic plaguing Northern Nigeria. To him, Northern governors are behaving lackadaisically in facing the challenge head-on.
What is the main reason behind the recent move by the Senate to curb the drug abuse epidemic, especially in Northern states?
Let me start by saying that the community is directly at the receiving end of these drug use crises. The governments, both at the state and federal levels, international agencies, including World Health Organisation (WHO), and the United Nations Office on Drugs and Crime (UNODC) are all indirectly affected, which may explain why nothing has been done on the issue until recently.

When the Coalition of Northern Groups (CNG) issued a quit notice to the Igbo, northern governors were highly disturbed because it would have affected them directly. They mounted pressure for the withdrawal of the quit notice. The CNG gave them terms for the withdrawal and among these was a promise to tackle the issue of drug use crisis in Northern Nigeria. But after the withdrawal, the issue was totally forgotten by the governors.

How many northern governors can boast of establishing and funding a state task force on drugs? It is obvious they do not take it as a priority, looking at their presence at this roundtable. That may explain the fundamental wisdom and reason why the Senate President came up with this strategy to face the epidemic head-on.

What informed the choice of Kano for the discussion?
According to statistics released by the National Drug Law Enforcement Agency (NDLEA), Kano State has the highest incidence of drug abuse in the whole country. The three main drugs used by abusers are codeine containing cough syrup preparations, tramadol and pentazocine. The increase in reported cases of using these substances, most especially among the youths, including married women, is a serious concern to all.

What are the major technicalities involved in categorising such drugs?
Our major problem currently is the shift of abuse of drugs from illicit to licit drugs. Illicit drugs are those under international control but produced, trafficked and consumed illegally, while licit drugs are allowed by law.

The NDLEA Act is concerned with illicit drugs, while the National Agency for Food and Drug Administration and Control (NAFDAC) Act is concerned with licit drugs. Even though I am not aware of any study on this, it is obvious, at least in the northern part of the country, that the abuse of licit drugs has overtaken that of illicit drugs.

The reasons are easy to understand. Illicit drugs are legal and therefore available. They are also user-friendly. For instance, unlike Indian hemp, in the case of cough syrup containing codeine, you don’t need to use matches, smoke it or chew it or try to mask the smell. The abuse of cough syrup with codeine in northern Nigeria has become an epidemic, which needs to be addressed.The open drug markets are one of the sources of both licit and illicit drugs. They are a distortion of the normal legal drug distribution channel. They are not regulated and are illegal.

Section 2 of the Counterfeit, fake Drugs and Unwholesome Processed Foods (Miscellaneous provisions) Act Cap. C34 Laws of the Federation of Nigeria 2004 prohibits the sale of drugs or poisons on certain premises or places. “Any person who—-Hawks or sell; or Displays for the purpose of sale; or Aids or abets any person to hawk, sell, display for the purpose of sale, any drug or poison in any place not duly licensed or registered by appropriate authority, including any market, kiosk, motor park, roadside stall or in any bus, ferry or any other means of transportation, is guilty of an offence under this Act and shall, accordingly, be punished as specified in this Act.”

What of issues that have to do with distribution network and some other strategies found newly in dismantling this epidemic? 
Muhammad Abubakar Rimi Sabon Gari Drug Market in Kano was identified as a major source of supply of these substances and in fact, a dumping ground for fake, counterfeit, expired, substandard and stolen drugs.

The Federal Government issued the National Drug Distribution Guidelines (NDDC) and gave a deadline of July 2015 for the closure of all open drug markets in Nigeria. The date was shifted to 2017 and eventually to 2018. Not only that, the market in the form of Coordinated Wholesalers was introduced into the drug distribution guideline.

This will make the whole effort useless. Why was the date shifted twice? Why was the market introduced into the distribution chain? We have to insist on international best practices, not to copy some countries, under the pretext of peculiarities, when such countries are even part of the problems we have.

The government has concentrated on the law enforcement approach in dealing with the challenges of both the licit and illicit drugs. This has so far failed, necessitating the new approach developed and adopted in the National Drug Control Master Plan (NDCMP).

The failure of law enforcement may have arisen from the fact that the incentive to engage in sales and distribution of drugs and substances of abuse is far greater than the punishment. Government should have a deliberate policy of rewarding legal operators to encourage them, just like it obtains in the agricultural sector to prevent them from turning to illegal practices.

The business environment is harsh and the regulatory agencies are not helping matters. On the part of offenders (dealers and distributors), government should try to find alternative engagement for them when apprehended, if not, the moment they are set free, they relapse into their old habits.Government should also have a social security system in place to cater for the teeming unemployed youths or by providing them with jobs. From experience, most youths that were in the habit of abusing drugs, drop the habit when engaged in productive ways.

What role do patent medicine stores play in drug abuse? 
Most of these drugs get into communities through the Patent and Propriety Medicine Vendors (PPMVs). This is from a report of Kano State Task Force: “As a result of rampant cases of drug abuse in the state, particularly codeine containing cough preparations, the task force outright banned their sale in PPMV’s outlets. Other drugs that are being used as substances of abuse and which are also banned by the task force include, diazepam, tramadol and fortwin injection (pentazocine). The task force has locked over 1,000 patent medicine shops.”

The PPMVs have outlived their usefulness and need to be cancelled in Nigeria. The argument that PPMVs are used as avenues to get drugs to remote areas is not tenable now. It is government’s responsibility to do that through the Primary Health Care Agencies (PHC), unless government wants to shy away from its responsibilities.

What are your recommendations to legislators in this regard? 
There should be a legislation to ban the production and importation of identified frequently abused licit drugs that have safe substitutes, as well as a total restriction of those that do not have substitutes. These should be included in the Strategic Objective Three of the National Drug Control Master Plan (NDCMP).Existing Acts of NAFDAC, NDLEA and Pharmacists Council of Nigeria (PCN) should be reviewed to harmonise and update the laws to reflect current situations. I was in a joint operation involving NAFDAC Task Force and NDLEA. A lot of time was wasted on who was to do what, which resulted in some of the culprits escaping, after their attempt to organise themselves and lynch us was foiled.

Section 7 of Counterfeit, Fake Drugs and Unwholesome Processed Foods (Miscellaneous provisions) Act Cap. C34 Laws of the Federation of Nigeria 2004 provides for establishment of a state task force on fake and counterfeit Drugs.Section 8 (Supra) provides for the functions of the task force as follows:
The state task force shall, subject to the general control and supervision of the federal task force, be charged with the overall responsibility of enforcing provisions of this Act. Since the issue of drugs is on the exclusive legislative list, there is the need to also make the same provision of setting state task forces on the issue of illicit drugs in NDLEA Act in order to enable state governments to act decisively on the matter. It will go a long way, if the provision is stepped down to each local government ward and incorporates the local vigilantes in the area. It should be a law that does not allow the Nigerian government a plea for clemency, when drug couriers/barons are arrested abroad.

What should the Federal Government do to drastically reduce the epidemic?
The Federal Government should, as matter of urgency, declare a state of emergency on the issue in at least three of the worst hit states in the North and establish a well-equipped rehabilitation centre in each of the states to rehabilitate victims.The government needs to introduce a deliberate policy of rewarding those that are drug-free, while encouraging those that are gradually moving out of it. This can be started with conducting drug tests on public office holders, and if found to be on drugs, summarily dismissed.

For workers and students, the test should be conducted not with a view to sacking or expelling them, but to encouraging them to drop it. It can also be extended to the issuance of driver’s licence and such similar things.Special courts should be established to accelerate the process of trying and prosecuting of drug related offenders.

The Federal Government should consider including drug abuse issue in their whistle-blowing policy. People can report farmlands, places, companies, etc. There should also be a synergy between non-governmental organisations (NGO) and the government. A body to coordinate the activities should be considered or if already available, strengthened. Drugs education should be introduced to the secondary school curriculum.

What do you suggest northern governors should do to tackle the menace?
Northern governors should, as a matter of urgency, establish and fund their state task forces on counterfeit and fake drugs. The previous administration of Dr. Rabiu Musa Kwankwaso’s efforts in Kano State is a case in point. At that time, drug abuse was drastically reduced in Kano.

Recently, there is an increase in the prescription of a particular drug targeted at the only group that is not much affected by the abuse of licit drugs, the male adult population. This drug is the major drug of addiction in another part of the world, just as cough syrup with codeine is our problem here. I would like to call on NMA and PSN to take note of this please.

Another issue is the way traditional medicine practitioners mix orthodox drugs, which can cause addiction as part of their concoctions and sell to public. This ensures a repeat purchase and continuous flow of cash.The issue of drug abuse has both political, economic, social and security dimensions. The north has become a subject of political ridicule, by making reference to them as a region of drug addicted youths that have no future ambition, while the other regions feed fat economically on youths’ craving for these drugs, thereby impoverishing the northern region the more. There is also a breakdown of social structure and institutions, resulting in insecurity in the form of escalation of crimes. Drug problem is no longer a health or social menace, but a threat to human existence that has to be decisively dealt with.