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NBS Publishes Drug Use in Nigeria 2018 Survey Report

Health	10020 VIEWS
Health
10020 VIEWS

Tuesday, January 29, 2019 01:32 PM / NBS

Executive Summary

This report presents the results of the first large-scale, nation-wide survey to examine the extent and patterns of drug use in Nigeria. The results of this survey aim to provide the baseline information needed for the design and implementation of effective prevention, treatment and care services that are evidence-based and targeted to reduce the demand for drugs and prevent the morbidity and mortality attributable to drug use in Nigeria.

The results of this survey highlight a considerable level of past-year use of psychoactive substances in Nigeria, in particular the use of cannabis, the non-medical use of prescription opioids (mainly tramadol, and to lesser extent codeine, or morphine) and cough syrups (containing codeine or dextromethorphan). The past year prevalence of any drug use in Nigeria is estimated at 14.4 per cent or 14.3 million people aged between 15 and 64 years. The extent of drug use in Nigeria is comparatively high when compared with the 2016 global annual prevalence of any drug use of 5.6 per cent among the adult population.[1] The past year prevalence of psychoactive substances excluding alcohol, overall was higher among men in Nigeria, however the gender difference in the non-medical use of prescription opioids, tranquilizers and cough syrups was less marked. Drug use was most common among those who were between the ages of 25 and 39 years, while the rates of past year use were lowest among those who were below 24 years of age. Cannabis was the most commonly used drug followed by opioids, mainly the non-medical use of prescription opioids and cough syrup. (the key findings of drug use survey are presented below).

A dichotomy in the past year prevalence of drug use was found between the North and South geopolitical zones. Highest past-year prevalence of drug use was found in the southern political zones: South-East, South-West, and South-South zones (past year prevalence ranging between 13.8 – 22.4 per cent of the population) compared to the North (ranging between 10 - 14.9 per cent of the population).

People who inject drugs constitute a sizeable proportion of high risk drug users in Nigeria. 1 in 5 high risk drug users is injecting drugs. The most common drugs injected in the past year were pharmaceutical opioids, followed by cocaine and heroin. While overall, more men were injecting drugs, women were more likely than men to report injecting heroin. The extent of risky injecting practices and sexual behaviours among the high risk drug users and in particular those who inject drugs is also of concern as is the extent of self-reported HIV among this group. Women who injected drugs were more likely than men to engage in high-risk sexual behaviours further compounding their risk for acquiring HIV among other infections.

There is a clear gap in meeting the needs for treatment and care for people with drug use disorders. Two-thirds of high-risk drug users reported a self-perceived need for drug treatment. Around 40 per cent among those reported that they had wanted to receive drug treatment but were unable to access such services. The cost of treatment, stigma associated with accessing such services as well as stigma associated with substance use in general, and availability of adequate drug treatment services were the major barriers in accessing drug treatment in Nigeria.

Past-year users of tranquilizers, heroin and methamphetamine were more likely to report chronic health conditions and poorer health status as compared with other drug users or the general population. Access to services to reduce the adverse consequences of drug use was also limited. Less than half of the high risk drug users had received HIV testing and counselling while in treatment. While this proportion was higher among women, it was lower among those injecting compared to all high-risk drug users. Only 12 per cent of the high risk drug users reported referral to anti-retroviral therapy.

Nearly one quarter of high-risk drug users had been arrested for a drug-related offence during the course of their drug use, while the majority (73 per cent) had been arrested for possession of drugs, many high risk drug users had also been arrested for burglary, sex work, shoplifting and theft.

The social consequences of drug use are also evident in Nigeria. Key informants considered that there were major social problems such as disruption in family lives, loss in productivity and legal problems as a consequence of drug use in their communities. Also, nearly 1 in 8 persons in the general population had experienced consequences due to other peoples’ drug use in their families, workplace and communities.

Key Findings

In Nigeria, one in seven persons aged 15-64 years had used a drug (other than tobacco and alcohol) in the past year. The past year prevalence of any drug use is estimated at 14.4 per cent (range 14.0 per cent - 14.8 per cent), corresponding to 14.3 million people aged 15-64 years who had used a psychoactive substance in the past year for non-medical purposes.
Among every 4 drug users in Nigeria 1 is a woman. More men (annual prevalence of 21.8 per cent or 10.8 million men) than women (annual prevalence of 7.0 per cent or 3.4 million women) reported past-year drug use in Nigeria.
The highest levels of any past-year drug use was among those aged 25-39 years.
1 in 5 person who had used drugs in the past year is suffering from drug user disorders.
Cannabis is the most commonly used drug. An estimated 10.8 per cent per cent of the population or 10.6 million people, had used cannabis in the past year. The average age of initiation of cannabis use among the general population was 19 years.
Cannabis use was 7 times higher among men (18.8 per cent among men vs. 2.6 per cent of women), while the gender gap in the non-medical use of pharmaceutical opioids (such as tramadol) was less marked (6 per cent among men vs. 3.3 per cent among women).
An estimated 4.7 per cent of the population, i.e., 4.6 million people had used opioids (such as tramadol, codeine, or morphine ) for non-medical purposes in the past year.
The non-medical use of cough syrups containing codeine and dextromethorphan is estimated at 2.4 per cent of the adult population (nearly 2.4 million people). The misuse of cough syrups is almost comparable among men (2.3 per cent) and women (2.5 per cent).
The non-medical use of tranquilizers (0.5 per cent), and the use of Ecstasy (0.3 per cent), inhalants (0.3 per cent) amphetamines (0.2 per cent) and cocaine (0.1 per cent) though not insignificant remains lower than the drugs mentioned earlier.
Overall, an estimated 376,000 were estimated to be high risk drug users. The majority of high risk drug users were regular users of opioids.
1 in 5 high risk drug users injects drugs, i.e., nearly 80,000 people (nearly 0.1 per cent of the adult population) are estimated to be PWID. The majority (78 per cent) of those injecting drugs were men. The most common drugs injected in the past year were pharmaceutical opioids (such as tramadol, codeine, or morphine), followed by cocaine, heroin and tranquilizers.
Poly-drug use was very common - among high-risk drug users nearly all (95 per cent) as compared to nearly half of the drug users in the general population reported using either simultaneously or concurrently more than one drug in the past year.

An estimated 87,000 (nearly 0.1 per cent of the population) had used heroin in the past year. The mean age of initiation of heroin use was 22 years, and almost half of regular heroin users reported smoking it. Proportionally more women than men, were likely to report injecting heroin.
Geographically, the highest past-year prevalence of drug use was found in the southern geopolitical zones (past year prevalence ranging between 13.8 per cent and 22.4 per cent) compared to the northern geopolitical zones (past year prevalence ranging between 10 per cent and 13.6 per cent).
Nearly 40 per cent of high-risk drug users indicated a need for treatment of drug use disorders. Most of the high risk drug users considered it was difficult to access drug treatment. The cost of treatment and stigma attached to drug use and seeking treatment were cited as the primary barriers in accessing or availing drug treatment services.
Yobe, Imo, Bayelsa, Rivers and Lagos states were ranked as “the states where it was more difficult to access treatment for drug use disorders”.
Nearly one quarter of high-risk drug users had been arrested for a drug-related offence during the course of their drug use, while the majority (73 per cent) had been arrested for possession of drugs, many high risk drug users had also been arrested for theft (12 per cent), sex work (5 per cent), burglary ( 4 per cent) and shoplifting 2 (per cent).
Two-thirds of people who used drugs reported having serious problems, as result of their drug use, such as missing school or work, doing a poor job at work/school or neglecting their family or children.
Nearly 1 in 8 persons (12 per cent of the adult population) in Nigeria has suffered some kind of consequence due to another person’s drug use. Among those who had experience any consequences, most had felt threatened or afraid of someone’s use of drugs (8 per cent of the adult population). Other important consequences that people had experienced were that someone using drugs had harmed them physically (5 per cent of the adult population) or that they had stopped seeing a relative or friend due to their drug use (5 per cent of the adult population).