Introduction

Tramadol abuse has emerged as a significant public health crisis in Ghana, particularly among young people, commercial drivers, and those engaged in strenuous labor.

Initially developed as a pain-relieving medication, tramadol has increasingly been misused for its psychoactive effects, leading to widespread addiction, severe health complications, and socio-economic consequences.

Despite its therapeutic benefits in managing moderate to severe pain, tramadol’s accessibility and lack of regulation have contributed to its misuse.

In this his opinion and article, I will try to provide an in-depth exploration of tramadol abuse in Ghana, examining its background, causes, health consequences, and strategies for control, with full support and evidence base scientific literature and public health reports.

What is Tramadol?

Tramadol is a synthetic opioid analgesic primarily used for pain management, particularly in conditions involving moderate to severe pain.

It exerts its effects by binding to opioid receptors in the brain while also inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine.

This dual mechanism alters pain perception, providing effective relief (NHS, 2025).

Tramadol is often considered a safer alternative to other opioids such as morphine and oxycodone due to its lower potential for respiratory depression. However, its abuse potential has become a growing concern, particularly in regions with inadequate regulatory oversight.

Unlike highly controlled opioids, tramadol is readily available in Ghana due to weak enforcement of pharmaceutical regulations. It is commonly sold in pharmacies, chemical shops, and by unlicensed street vendors without requiring a prescription (Danso et al., 2021).

This widespread availability has fueled its misuse, with many individuals using tramadol recreationally or for non-medical purposes such as enhancing physical performance or prolonging sexual activity.

Background and Rising Tramadol Misuse in Ghana

The misuse of tramadol in Ghana can be traced back to the early 2000s when its availability increased through both legal and illegal channels.

Reports from the Ghana Food and Drugs Authority (FDA) have consistently highlighted the alarming rate of tramadol abuse, particularly among students, commercial drivers, and market traders (Danso et al., 2021).

The illicit market for tramadol has thrived due to limited government intervention and the lack of awareness regarding its risks.

A study conducted by Alhassan (2022) found that nearly 45% of tramadol users in Ghana are male, with 49% aged between 16 and 30.

The study also revealed that unemployment and economic hardship are major drivers of tramadol abuse, with only 2% of users being employed in the formal sector. This indicates that social instability and limited economic opportunities are key factors fueling the crisis.

Causes of Tramadol Misuse

Several factors contribute to the widespread misuse of tramadol in Ghana:
•Self-Medication for Pain Relief: Due to limited access to healthcare, many individuals self-medicate with tramadol to manage chronic pain and injuries without proper medical supervision.

•Recreational Use and Euphoria: The euphoric effects of tramadol make it appealing for recreational use, particularly among young people seeking a temporary escape from reality (Bapat, 2025).

•Performance Enhancement: Many laborers and commercial drivers use tramadol to suppress fatigue and enhance physical endurance, leading to dependency (Alhassan, 2022).

•Sexual Enhancement: There is a widespread belief that tramadol enhances sexual performance and prevents premature ejaculation, increasing its misuse among men (Ghana News Agency, 2018).

•Peer Pressure and Unemployment: Unemployment and peer influence contribute to tramadol abuse, particularly in urban and peri-urban areas where economic opportunities are limited (Albin et al., 2022).

Health Consequences of Tramadol Abuse

The misuse of tramadol poses severe health risks, both in the short and long term. The impact of tramadol abuse extends beyond individual users, affecting families, communities, and healthcare systems.

Short-Term Effects:

Drowsiness and dizziness

Constipation and dry mouth

Nausea and vomiting

Light-headedness and impaired coordination

Slurred speech and confusion (Baliyan,2024)

Long-Term Effects:

Psychological Dependence and Addiction: Prolonged tramadol use leads to tolerance and dependence, increasing the likelihood of addiction.

Neurological and Psychiatric Disorders: Chronic tramadol misuse can cause hallucinations, paranoia, anxiety, depression, and suicidal tendencies.

Seizures and Respiratory Depression: High doses of tramadol increase the risk of seizures and respiratory distress, which can be fatal.

Organ Damage: Prolonged abuse can lead to liver and kidney damage, impairing overall health and increasing mortality risk (Nakhaee et al., 2021).

Strategies for Controlling Tramadol Abuse

To address tramadol abuse in Ghana, a multi-faceted approach is necessary. This involves legal regulations, law enforcement measures, medical, public health interventions, and community-based strategies.

1.Strengthening Laws & Regulations

•Enforce strict prescription control for Tramadol.

•Monitor imports and distribution to prevent illegal smuggling.

•Implement stricter penalties for illegal possession and trafficking.

2.Law Enforcement Action

•Crack down on black markets and unlicensed drug sellers.

•Train law enforcement for surveillance and intelligence gathering.

•Collaborate with international agencies like INTERPOL.

3.Public Awareness & Education

•Conduct school and community campaigns on Tramadol dangers.

•Use TV, radio, and social media for awareness.

•Engage parents, religious and traditional leaders in advocacy.

4.Healthcare & Rehabilitation Services

•Expand drug rehabilitation centres and counselling services.

•Train healthcare workers to identify and manage addiction.

•Promote non-addictive alternatives for pain management.

5.Community & Youth Empowerment

•Provide job opportunities and vocational training for youth.

•Encourage sports and recreational activities to reduce drug abuse.

Conclusion

Tramadol abuse in Ghana is a growing crisis with far-reaching health, social, and economic consequences. Addressing this issue requires a comprehensive, evidence-based approach that integrates strict regulatory measures, enhanced law enforcement, widespread public education, and robust medical and healthcare interventions.

Governments, healthcare professionals, community leaders, and international organizations must work together to implement policies that control tramadol misuse and support individuals affected by addiction.

Without immediate and sustained intervention, the burden of tramadol abuse will continue to escalate, placing immense pressure on public health systems and human well-being.

By fostering collaboration and adopting a proactive stance, Ghana can mitigate the devastating impact of tramadol abuse and create a healthier future for its citizens.

References:

1.NHS Choices (2025). About Tramadol. Available at: https://www.nhs.uk/medicines/tramadol/about-tramadol/ (Accessed: 25 February 2025).

2.Alhassan, J.A.K. (2022). Where is the pain? A qualitative analysis of Ghana’s opioid (tramadol) ‘crisis’ and youth perspectives. PLOS Global Public Health. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10021380/ (Accessed: 25 February 2025).

3.Albin, J. K., Korem, Alhassan, et al. (2022). ‘Here in Ghana hard work don’t deserve money’: The uncertainty and precarity of youth who use Tramadol. SSM - Qualitative Research in Health. Available at: https://www.sciencedirect.com/science/article/pii/S2667321522001275 (Accessed: 25 February 2025).

4.Baliyan, A.A. et al. (2024). Tramadol addiction: Symptoms, side effects, withdrawal, and treatment. The Diamond Rehab Thailand. Available at: https://diamondrehabthailand.com/what-is-tramadol-addiction/ (Accessed: 25 February 2025).

5.Danso, M. and Anto, F. (2021). Factors associated with tramadol abuse: A cross-sectional study among commercial drivers and assistants in the Accra Metropolitan Area of Ghana. Drugs - Real World Outcomes. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8324647/ (Accessed: 25 February 2025).

6.Nakhaee, S. et al. (2021). A review on Tramadol Toxicity: Mechanism of action, clinical presentation, and treatment - Forensic Toxicology. SpringerLink. Available at: https://link.springer.com/article/10.1007/s11419-020-00569-0 (Accessed: 25 February 2025).

7.Ghana News Agency (2018). FDA warns against tramadol abuse. Available at: (Original source link not provided in initial document).

8.Bapat, S. (2025). Tramadol: Uses, effects, and potential for addiction. Available at: (Original source link not provided in initial document).

9.Tramadol abuse and addiction (2025). Resources for Addiction Rehabilitation & Recovery. Available at: https://americanaddictioncenters.org/opioids/tramadol (Accessed: 25 February 2025).

Dr Baba Musah Patrice Awonseba

Specialist Obstetrician and Gynaecologist, Ireland

MSc Global Public Health, Queen Mary University of London

Board member Mind ‘N’ Health