Nigeria has about 14.3 million people abusing illicit drugs but fewer than 200 treatment centres. This imbalance is troubling. Even worse, only a small number of these centres actually treat addiction, as most focus mainly on psychiatric care. TINA ABEKU reports that this problem, combined with the high cost of treatment even in government facilities, has made efforts to clean up society and help addicts rebuild drug-free lives very difficult. With drugs still easy to obtain, alongside unemployment and rising poverty, tackling the growing rate of Substance Use Disorders (SUDs) remains a major challenge.
When a traumatised and dejected 17-year-old Hajara Musa was thrown out of her home by her father, it did not take long before she sought and found comfort among strangers, who metamorphosed into friends, one of whom she later engaged in an intimate relationship.
Dwelling among substance users, it did not take long before Hajara got fully initiated into the pack – a misadventure that left her psychologically distressed and morally derailed.
Now an unhappy single parent, Hajara summarised her foray into drug addiction thus: “I was not always like this. I developed the habit after I was driven away from home into the streets by my father for frowning at his incessant domestic violence against my mother. My parents eventually divorced, and my father got married to another woman. Although he wanted me back at home, I was no longer comfortable around him. He sent me away from home before I turned 18 years, and I had been living away from him. The child I bore outside of wedlock is now five years old.”
For about five years, Hajara attempted to detach from the horrible pack, but to no avail because the pull was intense. That notwithstanding, in her search for help, she confided in her aunt. Sadly, rather than receiving a lifeline, the instant judgment, condemnation, and isolation that she experienced made her withdraw into her shell.
Abuja resident, Oluchi Chinedu’s script reads differently, even though both are in the same cul-de-sac. Unlike Hajara, whose parents are still alive, Chinedu’s loss of both parents left her drifting into dangerous waters seamlessly.
She recalled: “I needed an escape route from the pain and difficulties that I faced after the death of my mother, who died six years after my father’s demise. Life has not been fair to me, so I was taking the substance to distract myself from thinking. As the first of three children, I needed money to take care of my siblings, but without financial support, my plans always ended up as mere dreams”.
Admitting that she was not ignorant of the consequences of substance use and abuse, Chinedu insisted that taking hard drugs became imperative for her mental stability and survival, as, according to her, the circumstance-compelled lifestyle helped in numbing her emotional pain.
“Having lost both parents, my siblings and I were left all alone, so I had to drop out of school to take care of them. The substance that I was taking kept me from so many negative thoughts, including suicide. My youngest sibling has just graduated from a college of education, while I also supported my immediate younger sister through a skills acquisition centre, and she is now self-reliant. We are all girls, but the fact is that I did so many other things to facilitate our survival, which I am not proud of.
“Even though using substances made me forget my problems temporarily, I was not completely satisfied with my lifestyle, given the social and health implications. However, I don’t think anyone willingly indulges in drugs. Most times, circumstances beyond their control force them into it,” she submitted.
While Hajara and Chinedu’s stories drip with pity and still evoke enormous concerns, that of Ibrahim Yusuf-Gombe gladdens the heart as the drug abuse survivor is now championing efforts to return his erstwhile comrades to the path of rectitude.
Referring to claims by the National Drug Law Enforcement Agency (NDLEA) that 40 per cent of Nigerian youths were using drugs, he said the situation may have worsened, especially in the face of the current economic hardship ravaging the country and peer pressure.
“The truth is that drug abuse is increasing in Nigeria. Sadly, of the 40 per cent of youths who are abusing drugs, well over 80 per cent of them don’t have access to treatment, which is very expensive. So, the health implication is so heavy that it requires a lot of commitment to get people out of the scourge,” said Yusuf-Gombe, who is now a mental health trainer and Convener, Drug-Free Arewa Movement, while painting a picture of the scourge.
Recent findings by the International Journal of Medical Research on Drug and Substance Abuse Prevalence in Nigeria revealed that social and environmental factors, such as the need to belong to a clique or be influenced by what is trending in the environment, are some of the greatest reasons that young Nigerians are bingeing on illicit substances.
The research buttressed that people also get into substance abuse to get high; to help them when they feel depressed or nervous; forget about their problems; to cheer up when sad; not to feel left out, and to fit in groups that they like.
Evolving patterns of consumption, rising numbers as fresh worries
LAST Tuesday, the NDLEA revealed that in the last five years, it has recorded significant operational successes, including the arrest of 77,792 drug offenders, 128 of them identified drug barons who were central to major trafficking networks.
“We seized a total of 14,847,000 kilograms of assorted illicit drugs, thereby significantly disrupting both local and transnational supply chains. In further strengthening the criminal justice response to drug offences, the agency successfully prosecuted and secured convictions against 14,225 offenders, reinforcing deterrence and affirming that drug crime attracts consequences. In line with our balanced approach, the agency also prioritised drug demand reduction,” NDLEA Chairman/Chief Executive Officer (CEO), Brig-Gen Buba Marwa (Rtd) said.
All these notwithstanding, the agency noted that drug-themed parties and related incidents, which are emerging of late, constitute a concerning trend nationwide. It maintained that these parties often showcase a variety of illicit substances, leading to increased drug use among attendees.
The NDLEA agents recently arrested several individuals involved in trafficking drugs to parties, including a resurgence in cannabis and synthetic opioids.
According to NDLEA’s Director of Media and Advocacy, Femi Babafemi, the agency has noted an uptick in the arrest of dispatch riders and those operating courier services linked to drug trafficking.
On January 9, 2025, NDLEA operatives apprehended one Ani Onyebuchi Romans, a 37-year-old businessman, who was found smuggling tramadol pills in body mannequins during his travels from Nigeria to Cameroon. Since then, more arrests have been recorded.
“Trends like these suggest a transformation in the trafficking model, where drug syndicates leverage legitimate courier services, complicating enforcement efforts… Our investigations reveal a structural shift in trafficking methods, necessitating more adaptive strategies in our fight against drug abuse,” Babafemi said.
Expanding clan of female drug abusers as threat to family life
WITH the prevalence of drug use in the country alarmingly high – nearly three times above the global average, according to statistics from the United Nations Office on Drugs and Crime (UNODC) – a troubling dimension to the country’s drug challenge is the growing trend in women drug abusers and attendant impact on family life.
The United Nations organ, in painting a sad picture, said that one in every four Nigerians involved in drug and substance abuse is a woman, while only one in every 20 persons receiving drug rehabilitation and treatment in the country is female. Furthermore, women make up to seven per cent (3.4 million) of the estimated 14.3 million population of drug users aged between 15 and 64 in the country.
The report also indicated that while the number of women addicted to drugs might be lower than that of men, women now represent up to 49 per cent of amphetamine users and non-medical users of pharmaceutical stimulants – opioids, tranquillisers, and sedatives in the country.
The statistics revealed that women have a 0.12 (57,000) high risk of drug use, comprising up to 0.4 per cent (18,000) of the people injecting drugs, and 2.6 per cent (1,280,000) cannabis users.
They also constitute 3.3 per cent (1,606,000) opioid users, 0.03 per cent (16,0000) heroin users and 3.3 per cent (1,600,000) users of pharmaceutical opioids, including tramadol, codeine and morphine.
The UNODC equally revealed that substances such as cough syrups, ecstasy, cocaine and hallucinogens were among the substances with a high amount of consumption by females.
Last month, the UNODC, in a memorandum submitted to the House of Representatives ad-hoc Committee investigating the rising cases of drug and substance abuse in the country, warned that these and sundry projections indicate that drug use across Africa will increase by 40 per cent by 2030. For Nigeria, this could translate to more than 20 million drug users, posing a severe threat to public health and national security.
Shedding light on the expanding clan of female illicit drug consumers, the Programme Officer, Healthy Life Advancement Promotion Initiative (H-LAPI), Grace Okoye, noted that having male partners that are drug users; emotional and financial problems; being a victim of domestic violence; a history of sexual abuse and incest; low self-esteem; a history of sex work and peer pressure; loneliness, depression and isolation etc are all causative factors that predispose women to drug use.
According to her, “Women drug users, especially those who have children, are demonised. This makes a lot of them hide it from the public. The majority of the women who use drugs have sexual partners who also use drugs, but this is often not the case with men, whose female partners use drugs.
“A man may be using or injecting drugs and is dating or married to a woman who is not using drugs. In fact, male drug users are very intentional when it comes to dating and marriage; they look for partners who don’t have drug habits, but once a woman is substance-dependent, no man wants to have any serious relationship with her. That in itself is a stigma. The only men who would want to be involved with them are the ones who are also taking drugs, and that pathway leads them to become drug-dependent.”
Rehab as a weak link in fight against substance abuse
NOTWITHSTANDING the avalanche of arrests, prosecution of suspects, drug barons and users, as well as seizures of truckloads of illicit drugs, successful interventions for substance use disorders (SUDs) can never be completed without assorted treatment options, abundant rehabilitation centres and affordable treatment regimes.
In other words, considering the sheer scope of the country’s drug abuse crisis, weaning the rising number of substance abusers from the habit remains a tough assignment that should be complemented by the availability of a well-endowed rehabilitation landscape, which is clearly not the case now.
Matter-of-factly, what is available on the ground to service a burgeoning clan of 14.3 million substance abusers in the country are 10 federal neuro-psychiatric hospitals; 30 drug rehabilitation centres administered by the NDLEA; eight state governments’ owned psychiatric centres within general hospitals, and about 150 privately-owned rehabilitation centres, with a sizable number belonging to faith-based organisations, including churches and mosques. They often emphasise spiritual healing over orthodox treatment. The NDLEA, which runs 30 psychiatric facilities across all the states, says it is expecting seven more this year to complement the existing ones.
However, the best-equipped of the privately-owned rehabilitation centres offer more evidence-based care, which includes therapy, counselling, and sometimes medication-assisted treatment. A major characteristic of this set of rehabilitation centres is that they are prohibitively expensive for the average Nigerian; hence, their clientele comprises more affluent than have-nots.
While the state of these drug rehabilitation centres reflects a system under immense strain, and grappling with a severe and growing drug use epidemic, government-owned multi-specialist hospitals, which also offer psychiatric services located in cities like Calabar, Kaduna, Benin City, Akure, Port Harcourt, etc., are often overcrowded and under-resourced. They also provide treatment, but they are primarily for mental health, with addiction as a subset.
While the rehab system constitutes a downstream solution, it does not address the upstream drivers of the country’s drug menace, which include mass youth unemployment, poverty, social upheaval, and the easy availability of cheap illicit drugs.
Yusuf-Gombe, who is also the Convener, Youth Action Network on Substance Abuse, emphasised that access to rehabilitation, or some forms of neuropsychiatric treatment to enable abusers to escape drug dependency, remains a challenge due to the high cost of treatment, the limited number of rehabilitation facilities and centres, as well as a dearth of appropriate professionals.
He said: “I can tell you from experience that 90 per cent of those with drug-related problems or drug use disorder do not have access to treatment because the treatment is expensive, and some are afraid of going to a psychiatric hospital for fear of being tagged as mad people.”
Prohibitive treatment cost as an albatross
A cross-sectional survey of patients managed for SUDs at two psychiatric hospitals entitled, “Direct Medical Cost of Treating Substance Use Disorders in Two Tertiary Hospitals in South-West, carried out between January and June 2020, by Margaret Ilomuanya, Ogochukwu Amaeze, Chinenye Umeche and others, pointed out that successful interventions for SUDs, though obtainable, are not effectively utilised due to the high cost of treatment.
Carried out at the Federal Neuro-Psychiatric Hospital (FNPH), Lagos, and the Neuro-Psychiatric Hospital, Aro, Abeokuta, Ogun State, both tertiary healthcare facilities attend to the state’s mental healthcare needs.
The direct treatment cost of SUDs, the survey stated, includes the cost of medicines, laboratory tests, professional health consultations, psychosocial therapy, behavioural therapy, inpatient admission, and medical devices.
Also, the average cost of treatment for alcohol use disorder five years ago was N146,425.38; drug use disorder N135, 282.09, and drug/alcohol use disorder N143, 877.33. These rates applied to inpatients and were different for outpatients; hence, the highest contributors to SUD treatment cost are inpatient admissions and the cost of medicines; inpatient admissions include accommodation, feeding, and laundry. Today, the story is different, as the cost of treatment has skyrocketed. But Babafemi countered the claim that treatment is prohibitive.
“At all our facilities (NDLEA), we don’t ever have space because they are always filled up as people are always turning up, since we do not really charge. Because we are the first responders, ours is the cheapest. In fact, we don’t really charge for treatment; we only charge for their maintenance, their feeding, and if there are medical interventions, that’s all. The services that we provide are more or less free, and vary from location to location.”
While Babafemi, who refused to mention the exact amount charged for treatment in NDLEA-run rehabilitation centres, maintained that his agency offers the cheapest services for addicts, Yusuf-Gombe said that, considering the high cost of living, SUD treatment is way beyond the reach of the average Nigerian.
“Treatment is very expensive, especially in private rehabilitation centres, while about 90 per cent of people with substance use disorder lack access to treatment. At some facilities in Abuja, treatment costs range from N600,000 to N1 million per month. If you are using a government facility, three months is about N400,000. So, how can the poor afford it? The Convener, Drug-Free Arewa Movement, said.
Yusuf-Gombe, who said that Nigeria has a beautiful policy on drug abuse prevention and control, however, regretted that “it is not being implemented, and many don’t even know about it. Ultimately, the economy will suffer because those who are supposed to champion economic development are wasting away due to the impact of drug abuse.”
“The National Drug Control Master Plan, which is supposed to lead campaigns on drug prevention, drug treatment, care and everything, is still not being effectively implemented. Many have observed that Nigeria, with about eight overburdened neuropsychiatric hospitals and grossly insufficient rehabilitation centres, may have to resort to desperate measures. Indeed, there are worries that Nigeria may go the way of Sierra Leone, whose government declared a state of emergency on substance abuse to tackle the menace, which saw many dead bodies being exhumed in search of decomposing bones used in a concoction of inhalant known as Kush,” he stated.
Taking The Guardian through the process of acquiring treatment, the Founder and Executive Director, Vanguard Against Drug Abuse, an Abuja-based drug rehabilitation centre, Dr Hope Omeiza Abraham, said that regular patients pay as much as N2,000 to see a psychiatrist, while VIPs may pay between N5,000 and N10,000 in government-owned facilities.
“For private facilities, based on what value they put into what they are doing, they can charge as much as N100,000 for a session to see a psychiatrist. It should be made clear that some patients may need to see a psychologist depending on the severity of their case, so the cost may vary. But to admit someone for drug treatment or for mental illness in our centre, for example, the minimum we charge monthly is N600,000, which is inclusive of feeding, accommodation, medications, therapy sessions with an expert three times daily and water,” Abraham explained.
He continued: “The experts are not just the psychiatrists, there are medical doctors, mental health nurses, psychiatric nurses, and psychiatrist counsellors. In between, there are also game activities, drug tests, maintenance and a whole lot of other things. The VIPs involved may want a room, a suite, etc., but the minimum for us is N600,000. I can’t speak for government facilities, but I know their charges may be in the range of N150,000 per month.
The President of the Association of Psychiatrists in Nigeria (APN), Prof. Taiwo Obindo, is worried about the very low number of Nigerians who have access to mental care in the face of dire socio-economic challenges.
He said: “Only two out of 10 Nigerians have access to mental health care, and we have had an increase in the number of these cases, but a lot of them remain without treatment or are unrehabilitated. Most of our hospitals do not have units to keep people that long, especially those who are dependent on substances. The average minimum stay for them is about three months; some can stay for a whole year, but the facilities for that are not there, so we don’t have that luxury of keeping them that long,” he explains.
While the Head of Psychiatry Unit at the National Hospital, Abuja, Dr Sola Oluwanuga, also accedes to the negative impact of psychoactive substances on the mental health of Nigerians, both Yusuf-Gombe and Prof. Obindo charged communities to take responsibility by ensuring that affected persons are availed the right treatment, but without the use of force, which he said does not work on drug users.
They said governments at all levels must reduce economic hardship and demonstrate political will to drive efforts to end the scourge, in partnership with Civil Society Organisations (CSOs) and schools.
“Let the children know the implications of their actions without putting them under unnecessary pressures, but we must not overindulge them. Early discovery improves the chances of having a better outcome,” Obindo stated, adding that: “The government should make more provisions in this direction. Maybe rather than setting up new psychiatric hospitals, it should equip the teaching hospitals more for the treatment and management of substance use disorder. Philanthropists can help in building drug units for this cause.”
