Exploring contextualised narratives of lived experience of people who abuse Tramadol.

TRAMADOL ABUSE IN GHANA.

Exploring contextualised narratives of lived experience of people who abuse Tramadol.

Maame Ama Owusuaa- Asante (MPH), an awardee of the Ghana Scholarship Secretariat, is conducting a qualitative study to understand the increasing trend of Tramadol abuse in Ghana for her doctoral studies in Public Health and Health Promotion at Robert Gordon University in Aberdeen, UK. The study aims to gain an in-depth overview of the complexities, sensitivities and realities of Tramadol abuse through the lived experience of people who abuse it. The study will allow the introduction, initiation, sporadic and continuous use trajectories of the drug to be explored and understood. It will also provide insights into any inequalities that may exist in this group and inform strategies that can minimise disparities in the prevalence of Tramadol abuse. The safety perceptions and knowledge of abuse potential will also be explored.

The World Drugs Report in 2019 described Tramadol abuse as a crisis hitting the African continent due to emerging evidence of abuse in some African countries and the seizure of large quantities of the drug in North and West Africa. Despite the paucity of epidemiological data on Tramadol abuse in Africa, the World Health Organization and International Narcotics Control Board highlight a possible growing trend of Tramadol abuse in Egypt, Ghana and Nigeria, among other African countries. Nigeria has seen an increase in the trafficking of Tramadol, reporting seizures of more than 100tons of the drug between January 2017 and March 2018, exceeding that of cocaine, heroin and methamphetamine all combined (National Drug Law Enforcement Agency, 2018). The prevalence of Tramadol abuse according to the National Survey for addiction in Egypt in 2016 was 3%, making it the second most prevalent substance of abuse after Cannabis which was 3.7% in the country. In Ghana, Tramadol abuse is evidenced by reports on the proliferation of the drug by the Food and Drugs Authority and various media reports on social issues linked to abuse.

In 2016, disturbing amounts of unapproved doses of Tramadol (120 mg, 225 mg, and 250 mg) were exposed through strategic searches conducted in three target regions (Northern, Volta and Western) to verify reported cases of abuse of Tramadol in Ghana (Food and Drugs Authority (FDA), 2018). Despite the efforts of the FDA to implement measures such as monitoring of entry points, collaborative work with sector partners like the National Pharmacy Council to curb the illegal distribution and sale of Tramadol, the availability and unauthorised access to higher doses contrary to medical recommendation persists and remains a significant challenge and a Public Health crisis.

It is anticipated that this research will provide a description of the initiation scenarios and variations in the patterns of Tramadol abuse and facilitate a deeper understanding of the pathways and realities of abuse. The findings of this study can help inform prevention, treatment and support initiatives by policymakers to address the problem of Tramadol abuse in Ghana. It will also contribute to the body of academic knowledge and understanding of public health theories.

This is an interesting and necessary research that has a good potential for policy change. Highly topical and feasible, given the groundwork already done and the expertise and resources available. It’s great that Maame Ama has such close ties to a strong community organisation and that they seem to be very excited about her research project. It is clear that the funding provided by the Ghana government will allow Maame Ama to pilot test her ideas and help her complete an excellent final doctoral degree. (Dr Sam Assan, Lecturer, Public Health and Health Promotion, School of Health Sciences, Robert Gordon University, Aberdeen)

Maame Ama’s PhD research is timely, important and will provide fresh insights into this challenging problem. (Dr Nicola Torrance, Senior Research Fellow, School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen)

Robert Gordon University prides itself in pursuing impactful research with global reach that will address real issues such that positive changes can be made for society. It is very evident that Maame Ama’s research degree studies contribute to this strategic aim. (Dr Andrew Lamb, Head of Graduate School, Robert Gordon University, Aberdeen)

Acknowledgements
This study is being funded by the Ghana Scholarship Secretariat. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Secretariat.