THE USE OF METHAMPHETAMINES IN

NIGERIA

TREND AND THREAT ANALYSIS

DR. ARIT ESANGBEDO MBBCH, MBA. FWACP(PSYCH), ICAP,TTS

CONSULTANT PSYCHIATRIST

FEDERAL NEURO-PSYCHIATRIC HOSPITAL,YABA, LAGOS

 OUTLINE

• WHAT IS METHAMPHETAMINE
• HISTORY
• FACTORS INFLUENCING USE
• HARMFUL EFFECTS OF USE
• BRAIN RESPONSE TO USE
• STAGES OF METH USE
• NIDA PRINCIPLES FOR EFFECTIVE DRUG
TREATMENT
 OUTLINE

• NON-PHARMACOLOGICAL & PHARMACOLOGICAL

TREATMENTS
• GLOBAL TRENDS
• TRENDS IN NIGERIA
• THREATS
• CONCLUSION
• REFERENCES
• Methamphetamine- an amphetamine derivative and most widely
manufactured amphetamine-type stimulant.
• In the powder form, it can be ingested orally, snorted, smoked, injected,
insufflated, or inserted into the rectum. In the crystalline form, it can be
injected or smoked.
• Street names include speed, ice, crystal meth, crank, tina, mkpuru
mmiri,glass, shank, etc
• The production of meth(one pot, shake and bake method or 2-liter
bottle), leads to serious burns and fire incidences, while also producing
potentially dangerous toxic waste. Hence a public health hazard.
• It is very lipophilic because of
addition of a methyl group,
hence making it penetrate into
the CNS easily.
• It has a half life of ≈12hrs,
compared to that of cocaine
which is ≈ 2hrs. Its euphoric
effect is short lived,
disappearing before significant
changes its concentration in
the bloodstream. Hence the
‘binge and crash’ use pattern.
• Its longer half life and lower
cost has earned it the name
‘poor man’s cocaine’.
 HISTORY
• First discovered in1800s; synthesized from ephedrine. Produced
by chemically adjusting its parent drug, amphetamine.
• Originally produced in Japan, for medical purposes, as a nasal
decongestant medications and bronchial inhalers
• Further synthesized into crystal form in 1919
• Popularized during World War 2(WW2); used by the military to
enhance performance of the soldiers to keep them awake and
alert and to fight fatigue and depression.
• Went mainstream post WW2 when, the meth stored for military
use became available to the public and people began to use it
recreationally’. A Japanese organized crime syndicate took
advantage of meth surplus and began the distribution of meth.
• In the 1960s, IV meth use spread through the subcultures, leading
to more violent and erratic behaviour and more emergency
presentations in the ER prompting attention by the medical
authorities to call for close regulation in its use.
• In 1970s, the U.S. government made legislation that restricts
legal production and use.
• In 1980s, A purer and smokable form of meth appeared in Hawaii
• Between 1990s and 2000s, explosion in number of meth labs.
• By 2005, “The Combat Methamphetamine Epidemic Act” was set
up to limit the sale of certain meth ingredients and required
purchase to be recorded.
• Till date seizure data continue to report increase in meth
production, trafficking and abuse globally.
 FACTORS INFLUENCING USE

• Alertness and Euphoria from use tend to last longer than

that gotten from stimulants like cocaine
• Improves sexual pleasure and performance
• Enhances sexual exploration
• Enhanced concentration; this particularly in students
• Improves energy for work performance
• Relieves chronic pain and emotional problems
• Promotes weight loss; anecdotal reports
 how the brain responds to methamphetamine

• https://youtu.be/TTMNXzL4O4s
 Stages Of Meth Use
• The Rush(Flash); initial response felt when smoking or injecting meth.
Last for about 30mins
• The High; Can last between 4-16hrs, the user feels aggressive, smarter,
argumentative and have the delusional effect of becoming intensely
focused on an insignificant item e.g. packing and repacking clothes for
hours.
• The Binge; uncontrolled use, to try to maintain the high. Can last 3-
15days. User is hyperactive mentally and physically. For every smoke or
injection, the rush is smaller till no rush and on high occurs.
• Tweaking; most dangerous stage. This is the end of the binge as the
meth no longer provides a rush or high, user loses sense of identity,
intense itching, can’t sleep, may become psychotic and may eventually
become a danger to self and others.
• The Crash; body shuts down, can no longer cope with
overwhelming effect of the drug, hence long period of sleep. Can
last 1-3days.
• Meth Hangover; after the crash, user is in a deteriorated state,
starved, dehydrated and physically, mentally and emotionally
exhausted. At this stage the addiction kicks in as the only way to
stop feeling this way is to use meth again. Last from 2-14days
• Withdrawal; often 30-90days can elapse before user realizes that
he/she is in withdrawal. There is depression, low energy,
anhedonia, Then craving for more meth sets in and user often
becomes suicidal. Meth withdrawal is painful and difficult so most
meth users continue to use.
 HARMFUL EFFECTS

BIOLOGICAL
• Raised blood pressure
• Cardiac arrhythmias
• Dental problems
• Stroke
• Parkinsonism
• Seizures
PSYCHOLOGICAL
• Dependence
• Anxiety
• Homicidal and suicidal thoughts/attempts
• Psychosis- delusions, hallucinatory experiences
• Depression
• Insomnia
• Change in personality profile
SOCIAL
• Violent/aggressive behaviour
• Criminal offending
• Financial/ occupational problems
• Marital/relationship problems
 RISK FACTORS FOR USE

• History of heroin/opiate use

• History of smoking/alcohol use
• Risky sexual behaviour
• Some psychiatric disorders
• Family history of drug/ alcohol use
• Family history of crime
• Female sex
NIDA PRINCIPLES OF EFFECTIVE DRUG TX

• Addiction is a complex but treatable disease that affects

brain function and behavior
• No single treatment is appropriate for everyone.
Treatment varies depending on the type of drug and the
characteristics of the patients
• Treatment needs to be readily available.
• Effective treatment attends to multiple needs of the
individual, not just his or her drug abuse
• Remaining in treatment for an adequate period is
important.
• Behavioral therapies—including individual, family, or
group counseling—are the most commonly used forms of
drug abuse treatment
• Medications are an important element of treatment for
many patients, especially when combined with counseling
and other behavioral therapies
• An individual's treatment and services plan must be
assessed continually and modified as necessary to
ensure that it meets his or her changing needs
• Many substance use individuals also have other co-
morbid physical and mental disorders.
• Medically assisted detoxification is only the first stage of
addiction treatment and by itself does little to change
long-term drug abuse.
• Treatment does not need to be voluntary to be effective.
• Drug use during treatment must be monitored
continuously, as lapses during treatment do occur
 PHARMACOLOGICAL TREATMENT
• Development of therapies for methamphetamine at an
early stage. No substantial evidence for use of one
effective treatment yet.
• Naltrexone shown to significantly mitigate subjective
effects of the drug in dependent users; also significantly
blocks craving
• Bupropion could be effective in early methamphetamine
abstinence to decrease withdrawal symptoms and
cognitive deficits
• A clinical trial investigating interactions between
bupropion and methamphetamine revealed non
exacerbation of meth-induced cardiovascular effects.
• Euphoria and craving significantly reduced with bupropion
• Bupropion + CBT shows promising results with less
methamphetamine use in subjects.
• Modafinil, a non-amphetamine stimulant may also be
effective in treating meth dependence. It can potentially
reduce withdrawal symptoms and produce cognitive
benefits leading to improved response to behavioural
techniques.
• Other agonist replacement medication, D-amphetamine
also show similar promise.
 NON-PHARMACOLOGICAL TREATMENT

• Behavioural therapies:
• Cognitive Behavioural Therapy
• Contingency management interventions
• The matrix model
• 12-step facilitation therapy
• Family behavioural therapy
 GLOBAL TRENDS
• First country to report misuse of the drug: Japan circa 1945
• According to UNODC there were 27 million users of meth
worldwide in 2019
• Between 2005-2009, 79 countries reported seizure of
methamphetamine worldwide. By the next decade (2015-2019)
this number increased to 111countries.
• Production and trafficking are continuously evolving. UNODC
noted that 1billion meth tablets seizure were made in East and
Southeast Asia in 2021, more than that of crystalline and powder
form by 3.2tonnes and 1.5tonnes respectively, while the liquid
form seizure also dropped from 6.4tonnes in 2020 to
908kilogrammes in 2021.
• Most meth consumed is produced and distributed locally.
• UNODC report points to lack of official check and control
of meth and political instability in the so-called ‘Golden
Triangle’ of countries, where meth originates and is
moved across porous borders in particular Myanmar,
Thailand and Laos
• It also reports that due to its cheap price, and availability
along with high purity, it remains ‘the primary drug of
concern’ to all countries especially in East and Southeast
Asia, from China to Japan, and from Indonesia to
Singapore.
 TREND IN NIGERIA
• An exponential increase in both use and production of meth has been
documented in Africa
• Nigeria being the second largest producer in Africa after South Africa.
• In the past decade the production of methamphetamine in Nigeria has
increased exponentially, with quantity of meth seized increasing from
abt 177kg in 2012 to about 1.3tonnes in 2017
• In 2018 UNODC estimated that about 89,000 Nigerians use meth.
• The first meth lab was discovered by the NDLEA in July 2010 in
Lagos, South-West Nigeria, with the capacity to manufacture 25-50 kg
batches of meth.
• Eight months later, a second facility was discovered in Satellite town,
Lagos and three Bolivians and one Nigerian were arrested.
• by 2016 experts from
South America were
imported to Nigeria by
drug syndicates to set up
meth labs.
• when a site in a village in
South-East Nigeria was
raided by NDLEA, 4
Mexicans and 5 Nigerians
were arrested
• Between 2011 and 2022
nearly 25 meth labs has
been dismantled by the
NDLEA
• Recently, on 30th
July 2022, two meth
labs were busted in
Lagos, South-West
Nigeria(248.74kg of
meth recovered) and
Awka, South-East
Nigeria and the meth
barons arrested by
NDLEA.
• in 2021, the House of Reps
asked the NDLEA to
intensify their raids on meth
labs in Nigeria.
• Fed. Govt was also urged to
develop policies to curb the
spread of meth and other
narcotics across the country.
• This was particularly due to
the fear surrounding the
effect of meth on the mental
health of its users.
• As one of the lawmakers
stated:
• In 2019 about 309kg of ephedrine was seized by the
NDLEA from members of a criminal network in Enugu,
South-East and Festac-town, Lagos, South-West Nigeria.
• A major portion of meth produced in Nigeria is exported to
South Africa and South-East Asia where 1kg reportedly
sells for up to 50,000 to 130,000 euros/usd 50,000
• Almost all of the detected trafficking from Nigeria to Asia
has involved the use of commercial air couriers.
• Methods of conveyance include swallowing latex wraps of
the drug, concealing on their person or hiding within items
like African crafts and souvenirs.
 THREATS
• Increased production in Nigeria fueled by the fact that the
precursor ephedrine and pseudoephedrine, while controlled in
most developed countries, is readily available in Nigeria.
• The alliance between Nigeria and Latin American cartels, has
made it easy for the increase in local production and accessibility
of the substance.
• This increased local production has also led to a marked rise in
availability and consequently consumption
• Relatively cheap and easy synthesizing of the drug; according to
the UNODC ‘’.....people who use meth have been known to
synthesize meth in their own kitchens using common
decongestants.’’
• Due to the economic insecurity of the country, the youth use meth
• Inadequate Funding
One of the greatest challenges faced in the implementation of
the drug treatment programme in Nigeria is that of inadequate
funding.
• Poor prescription control and drug distribution system,
hence increasing availability for production and misuse.
• Availability of treatment centres
About 48% located in the South-West with a majority in urban
areas.
• High cost of treatment; paucity of health insurance coverage
for substance abuse treatment.
• On account of
these, some
communities have
resorted to
devising other
means to act as
deterrents to the
use of the drug in
their locality e.g
public caning of
offenders.
• Increase in the use of violence by rival gangs to control
their drug market has also become a threat.
• Inadequately trained staff
• Dearth of internal/external evaluation of treatment process
or outcome. One study showed only about half of
treatment centres carried out regular audits.
• Deficient/Excessive Family Support
Dealing with families that are either not supportive, under
supportive and over supportive.
• Political instability, with its attendant rise in unemployment
and economic depression
• High profits from the sale of the substance
• Low awareness and sensitisation especially among the
youth
• A focus on traditional illicit drugs
• Inadequate development, implementation, monitoring and
evaluation of drug policies.
Other factors driving the growing use of meth include:
• Poor health-seeking behaviour; patronising of religious
homes for treatment, spiritual interpretation of drug use
problems.
• Little or no substitution/maintenance therapy
• Insufficient syringe exchange programs for injection users
• Not enough and inaccessible structured longer-term and
rehabilitation services.
 CONCLUSION
• The abuse of methamphetamine in Nigeria has grown
exponentially in the past few years, especially with the recent
proliferation of production labs in different parts of the country.
• Stricter control by national precursors of chemicals and
psychotropic substances and effective regulations of the import of
controlled precursors should be looked into by the government.
• While the government and law enforcement agents have made
concerted efforts to clamp down on these activities, there remains
a lot to be done in order to effectively curb this menace.
• The government, law enforcement and communities will need to
work in synergy to contain the spread of this substance, especially
among the vulnerable population.
 REFERENCES
• https://enactafrica.org/enact-observer/meth-has-found-its-market-in-nigeria
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International Criminal Justice Review. 2018;28(2):136-161. doi:10.1177/1057567717730104
• Instititute For Security Studies (ISSA); issafrica.org.:‘What is driving Nigeria’s growing meth market.; 10
Sept 2019 / Mouhamadu Kane
• Dumbili, Emeka, and Ikenna Ebuenyi. "Factors Influencing Methamphetamine (Mkpulummiri) Use in
Eastern Nigeria." Available at SSRN 4020039 (2022).
• Chomchai, Chulathidaa; Chomchai, Summonb Global patterns of methamphetamine use, Current
Opinion in Psychiatry: July 2015 - Volume 28 - Issue 4 - p 269-274
• doi: 10.1097/YCO.0000000000000168
• United Nations (UN) News; Global Perspecvtive Human Stories. 31May 2022/ Law and Crime
Prevention.
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• www.unodc.org
• Laurent K, Aviv W, Steven LB. et al. Pharmacological approaches to methamphetamine dependence:
a focused review.
• National Institute on Drug Abuse (NIDA/NIH);The Reward Circuit: How the Brain Responds to
Methamphetamine