From “Codeine Diet” to “Gutter Water”: polydrug use among Nigerian young adults

Abstract

<jats:sec> <jats:title content-type="abstract-subheading">Purpose</jats:title> <jats:p>The purpose of this paper is to explore polydrug use and the factors that motivate the use of multiple substances among selected young adults.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Design/methodology/approach</jats:title> <jats:p>A total of 23 male and female participants (aged 23-29 years) who use illicit drugs and prescription pharmaceuticals for non-medical purposes were recruited through snowball sampling. Qualitative interviews were conducted, and the data were analysed thematically.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Findings</jats:title> <jats:p>The use of drug “concoctions” and cocktails was widespread among the participants. Some used what they called <jats:italic>Codeine Diet</jats:italic> (codeine-based cough syrup mixed with a Coca-Cola<jats:sup>®</jats:sup> product or malt drink), while others took <jats:italic>Gutter Water</jats:italic> (a cocktail of cannabis, codeine, tramadol, vodka and juice or water). The use of <jats:italic>Monkey Tail</jats:italic> (a mixture of local gin, cannabis leaves, stems, roots and seeds) and petrol mixed with glue and La Casera<jats:sup>®</jats:sup> (carbonated soft drink) combined with Tom-Tom<jats:sup>®</jats:sup> (menthol-flavoured candy) was also revealed. Pleasure, better highs, the need to experience prolonged intoxication and the use of one drug to douse the effects of another substance motivated polysubstance use.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Social implications</jats:title> <jats:p>The findings revealed that the reasons why codeine-based cough syrups are mixed with soft drinks (<jats:italic>Codeine Diet</jats:italic>) include avoiding social discrimination and evading law enforcement agencies. Results suggest that these drug use practices require specifically tailored public health interventions. Social stigmatization against substance users and the use of extra-legal measures by the police should be discouraged to facilitate harm reduction.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Originality/value</jats:title> <jats:p>This study represents the first qualitative research to explore polydrug use among an understudied Nigerian population.</jats:p> </jats:sec>

Prescription Opioids and New Psychoactive Substances Use in Nigeria: A Systematic Review and Policy Implications

“…However, illegal brands containing stronger dosages ranging from 120mg to 250mg are locally produced, imported, and trafficked across most West African states (UNODC, 2021b). A similar increasing trend in the non-medical use of codeinebased cough syrups has also been observed in the country (Dumbili et al, 2020). Cough syrups with codeine are commonly used in the treatment of coughs.…”

“…Enhancing physical performance at work was a common motive reported for NMU of tramadol across the qualitative studies (Dumbili et al, 2020;Madukwe & Klein, 2020;Nelson & Alichie, 2022;Olley et al, 2019;Owonikoko et al, 2021). Although tramadol is an opioid with sedative effects, the studies reported that it was seen to be a body enhancing drug with a stimulant-like effect that is useful for increasing an individual's productivity and sustaining physical activities.…”

“…Among university students, 9.5% and 3.2% were consuming CCCS on a daily and weekly basis respectively (Ehis et al, 2021). Codeinecontaining cough syrups were consumed either alone, or mixed with alcohol, water, or malt drink (Dumbili et al, 2020;Uthman et al, 2016).…”

“…Cocktails of substances were also reported among young adults including 'codeine diet' a blend of CCCS mixed with coke (a soft drink produced by Coco-Cola®) or malt drinkand 'Gutter water'a blend of CCCS, tramadol, vodka and Alomo Bitters® (a herbal blend with 42% alcohol) (Dumbili et al, 2020), or CCCS, tramadol, cannabis, Rohypnol (flunitrazepam), and spirit or juice (Dumbili et al, 2020). The cocktails of codeine were mainly used to mask NMU, and avoid social discrimination and being apprehended by law enforcement agencies.…”

Codeine Substitute Challenges Drug and Substance Abuse Controls in Nigeria: Histopathology Evaluations of Norvegicus rattus on Lacatomtom

“…In Southeast Nigeria, Dumbili et al [3] reported that young adult interviewees (University undergraduates and graduates) used Gutter-Water (a cocktail of tramadol, cannabis, codeine, and vodka) and Monkey-Tail (a cocktail of locally-produced gin, cannabis seeds, leaves, stems, and roots). The study also revealed the use of a mixture of 'La Casera Apple Drink (carbonated soft drink) and 'Tom-Tom' (menthol-flavoured candy) to get high (Lacatomtom) [4]. According to Dumbili et al [3], the motivations for taking these substances include heightening and prolonging intoxication and pleasure.…”