Enhancement motivations for using prescription drugs among young adults in Nigeria

Dumbili, Emeka W.; Gardner, John; Degge, Hannah M; Hanewinkel, Reiner

doi:10.1016/j.drugpo.2020.102995

Cited by 13 publications

(14 citation statements)

References 53 publications

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“…Recognition of the secondary benefits of opioids also led to the use of these medications in strategic ways to meet different biopsychosocial needs, including alleviating the social and health harms of structural violence (Nelson, 2021). This corroborate findings from an earlier study in south-eastern Nigeria, which highlighted how prescription medications are used strategically by young adults across different domains of social life based on the users’ first-hand experience of the bodily effects of the drugs and a social context that encourages self-medication (Dumbili et al, 2021). By reporting similar use patterns among socially marginalized women, this study suggests a wider spread in strategic use of prescription opioid medications to meet social and health needs.…”

Section: Discussionsupporting

confidence: 89%

“…In other cases, medical use exacerbated pre-existing substance use problems, corroborating the finding that prior substance use is a risk factor for misuse of prescription opioid among patients with chronic pain (Stumbo et al, 2017;Weiss et al, 2014). There were also cases were prescription opioid became part of polysubstance use as self-medication for pain, confirming findings on self-medication for pain among PWUD in Nigeria (Dumbili et al, 2021;Nelson, 2021). Our study contributes to existing literature by highlighting how pathways to prescription opioid misuse are framed by intersecting processes of social marginalization and how they create a context of risk for misuse.…”

Section: Discussionsupporting

confidence: 81%

“…Non-medical use, on the other hand, refers to using without prescription or for purposes for which they were not prescribed. Tramadol is used non-medically to improve work performance, relief emotional distress and also for pleasure (Agberotimi et al, 2020; Dumbili et al, 2021; Madukwe & Klein, 2020; Peprah et al, 2020). Non-medical tramadol use is partly shaped by the inadequacies of the health system, including low access to pain medications.…”

Section: Introductionmentioning

confidence: 99%

“…Non-medical tramadol use is partly shaped by the inadequacies of the health system, including low access to pain medications. Madukwe & Klein, 2020 have described how difficulties in obtaining pain medications owing to prescribing restrictions have encouraged self-medication with falsified or counterfeited tramadol obtained from informal sources, including unlicensed chemist stores and street vendors (see also Dumbili et al, 2021; Nelson, 2021). Lacking in this literature are studies that focus on women.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Pain and Prescription Opioid Use Among Socially Marginalized Nigerian Women: Exploring Supply Channels and Pathways to Misuse

Nelson

Alichie

2022

Journal of Drug Issues

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This study explores pathways to prescription opioid misuse and supply channels based on in-depth interviews with 16 socially marginalized Nigerian women suffering chronic pain. The pathways identified were medical pain treatment, prior substance use and opioid use for recreation and coping with psychological distress. Facing barriers to prescription opioids due to prescribing restrictions and provider stigma, many resorted to unlicensed chemist stores and street drug dealers for opioid analgesics, including fake and potentially harmful products. Patterns of prescription opioid misuse were woven into multiple and overlapping dynamics of marginalization shaping the lives of these women, including homelessness, sex work, substance use and intimate partner violence. Findings show a need to improve access to prescription opioids and other evidence-based approaches, framed within a trauma-informed approach to pain management. Further, integrating substance abuse treatment and pain management could make services responsive to the inter-related problems of chronic pain and prescription opioid misuse.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Chronic Pain and Prescription Opioid Use Among Socially Marginalized Nigerian Women: Exploring Supply Channels and Pathways to Misuse

Nelson

Alichie

2022

Journal of Drug Issues

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“…Cannabis is the most commonly used drug considered illegal by the Nigeria state (10.6 million users in 2018) [39] and previous studies have reported its use for therapeutic purposes such as pain relief [32,40]. Pain relief is part of diverse motives for cannabis and prescription opioids use, which includes recreation, energy for work and relief for emotional distress [32,[40][41][42][43].…”

Section: Introductionmentioning

confidence: 99%

Cannabis use for pain relief in the context of health service barriers: Accounts of street‐involved Nigerian women suffering chronic pain

Nelson

Kitchen

2022

Drug and Alcohol Review

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Introduction: This study explored cannabis use for pain relief among socially marginalised Nigerian women in the context of barriers to pain management. Methods:The study was designed as a qualitative exploratory study of pain experience and management. Sixteen in-depth, individual interviews were conducted with street-involved women who use drugs and had chronic pain. Transcripts were coded and analysed thematically.Results: Pain was experienced as a pervasive feature of everyday life that disrupted daily routines, affected economic activities, strained social relationships and had adverse effects on health and wellbeing. Participants sought treatment in health facilities, but faced social and health system barriers to service utilisation including financial cost of services, dismissal of symptoms by providers, stigma due to physical appearance, substance use and lack of social support. These barriers encouraged disengagement from services and reliance on cannabis (along with heroin and diverted prescription opioids) for pain management. Cannabis use relieved pain and improved daily functioning, enabling participants to undertake economic activities. However, using cannabis to enhance the effects of opioids and heavy and long-term use owing to pain chronicity and disability generated concerns about harms. Discussion and Conclusions: Findings show the therapeutic benefits of cannabis in the face of barriers to pain management. This support calls to explore the potentials of cannabis for pain management for socially marginalised populations and to develop medical guidelines to reduce the risk of adverse health consequences. Therapeutic cannabis, provided based on medical guidance, could improve pain management for socially marginalised populations.

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Adverse childhood experiences, individual‐level risk and protective factors, and recent drug use in a community sample of Nigerian women

Agwogie,

Kliewer,

Ibrahim

2024

Journal of Traumatic Stress

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Adverse childhood experiences (ACEs) are associated with a wide range of health problems and health‐compromising behaviors, including drug use, but are understudied in sub‐Saharan Africa. Further, some data suggest that some types of ACEs are more strongly associated with outcomes than others. We investigated associations between different types of ACEs and recent drug use among 2,011 women living in Katsina State, Nigeria. This community‐based survey included questions on ACE exposure, modifiable individual‐level risk and promotive factors, and past‐year drug use. Tobacco, cannabis, and the nonmedical use of cough syrup with codeine and tramadol were the most frequently used drugs. Logistic regressions revealed that across most drugs, ACEs reflecting abuse, neglect, and household dysfunction, but not community violence, increased the likelihood of drug use, odds ratios (ORs) = 1.30–3.10. Ease of access to drugs, ORs = 1.33–2.98, and personal religiosity, ORs = 1.19–2.27, also enhanced the risk of drug use, and higher depressive affect was associated with codeine, OR = 1.27, and tramadol use, ORs = 2.42. Practicing religious rites, ORs = 0.38–0.70; disapproval of drug use, ORs = 0.36–0.57; and perceived harm from drug use, ORs = 0.54–0.71, reduced the likelihood of drug use. Efforts to prevent abuse, neglect, and household dysfunction; reduce access to drugs; treat depression; and increase disapproval and harm associated with drug use may reduce drug use in the context of ACE exposure.

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Enhancement motivations for using prescription drugs among young adults in Nigeria

Cited by 13 publications

References 53 publications

Chronic Pain and Prescription Opioid Use Among Socially Marginalized Nigerian Women: Exploring Supply Channels and Pathways to Misuse

Chronic Pain and Prescription Opioid Use Among Socially Marginalized Nigerian Women: Exploring Supply Channels and Pathways to Misuse

Cannabis use for pain relief in the context of health service barriers: Accounts of street‐involved Nigerian women suffering chronic pain

Adverse childhood experiences, individual‐level risk and protective factors, and recent drug use in a community sample of Nigerian women

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