Combating opioid misuse in Nigeria: A comprehensive strategy for public health and social stability

Opioid consumption has grown faster than any other drug category and is the leading cause of fatal overdose [1]. In Nigeria, use of opioid medications not as directed is increasingly concerning [2, 3]. Approximately 4.6 million Nigerians have used opioids like tramadol, codeine and morphine, with 2.4 million people engaging in non-medical use of cough syrups containing codeine and dextromethorphan [2, 4]. This situation, coupled with the 3 million Nigerians with drug use disorders, exacerbates strains on an already weakened public health system [5] and is associated with social instability [6], necessitating urgent targeted interventions.

Several factors contribute to rising opioid-related problems in Nigeria [4, 7]. Opioids are easily accessible in the country, often sold without prescription, whereas weak enforcement of drug regulations fails to address the issue effectively. Cultural attitudes normalize drug use as a coping mechanism in some communities. Additionally, peer-group influence significantly predicts non-medical drug use [8, 9]. Studies have shown that individuals with friends who use drugs are more likely to engage in similar behaviors themselves. Poverty [10], high unemployment rates [10], parental deprivation [11] as well as lower educational level [11] further complicate the situation and highlight the need for a holistic response.

The Nigerian government has taken steps to combat opioid-related problems through the establishment of a National Drug Law Enforcement Agency [12], and enforcement of drug laws, including seizing illicit and trafficked opioids, arresting individuals involved in drug offenses, and implementing a sensitization program involving athletes, fans and the public to raise awareness about the harmful impacts of illicit drug use. The Pharmacists Council of Nigeria has banned open drug markets—unregulated stalls and shops selling medications without oversight—whereas the National Agency for Food and Drug Administration and Control has prohibited codeine production and sales without prescription. Despite these initiatives, challenges persist because of an underlying socio-political context [13, 14].

A multi-pronged approach for Nigeria is vital. The government should enforce stricter opioid prescription regulations and enhance border surveillance to curb trafficking. Creating employment opportunities for young people is crucial to address socioeconomic factors fueling drug use. Non-governmental and community-based organizations are leading public awareness campaigns by using culturally accepted communication channels, including media houses, adverts, flyers, banners and radio jingles, to promote healthier lifestyle choices.

Community stakeholders, such as religious, educational and family institutions, should be involved in prevention efforts. Religious leaders can educate their congregations about the dangers of non-medical opioid use, whereas academic institutions should incorporate drug education into curricula. Families should actively monitor their children's environments and peer associations to reduce the risk of exposure to illicit drugs and non-prescribed opioids. For individuals struggling with addiction, the government should expand addiction treatment programs and increase funding for research institutions to strengthen research infrastructure, enabling evidence-based, data-driven policies for a proactive response to the opioid crisis and achieve Sustainable Development Goal 3 (good health and well-being) [15].

Rasaq Oladapo: Conceptualizing and drafting the initial manuscript. Editing, revising and finalizing the manuscript. Mariam Oladapo: Conceptualization (equal); writing—original draft (equal).

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