AccScience Publishing / ITPS / Online First / DOI: 10.36922/itps.3894
REVIEW ARTICLE

Opioid use among Nigerian students: Exploring knowledge gaps and preventive strategies

Abdullahi Adeyemi Adegoke1,2 Maryam Tariq3 Syed Muhammad4 Malik Olatunde Oduoye5* Maryam Imam6 Omotayo Faith Olanrewaju7 John Adole Inalegwu8 Abisola Motunrayo Ojebola9 Samuel Chinonso Ubechu10
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1 Department of Pharmacy, Iwo College of Health Science and Technology, Iwo Osun State, Nigeria
2 Department of Pharmacognosy, University of Ibadan, Ibadan Nigeria, Nigeria
3 Department of Medicine, Aziz Fatima Medical and Dental College, Faisalabad, Pakistan
4 Department of Clinical Pharmacy, Farooqia College of Pharmacy, Mysuru, India
5 Department of Research, The Medical Research Circle (MedReC), Goma, Democratic Republic of Congo
6 Divison of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
7 Department of Pharmacy, University of Nigeria Nsukka, Nigeria
8 Department of Paediatrics, Federal Medical Centre Azare, Bauchi State, Nigeria
9 Faculty of Clinical Sciences, Obafemi Awolowo University, Nigeria
10 Department of Social and Behavioural Sciences, School of Public Health, Yale University, United States of America
INNOSC Theranostics and Pharmacological Sciences, 3894 https://doi.org/10.36922/itps.3894
Submitted: 7 July 2024 | Revised: 7 September 2024 | Accepted: 28 November 2024 | Published: 2 January 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The increasing rate of opioid consumption among Nigerian students is alarming. Despite the therapeutic benefits of opioids, their excessive use could be detrimental. Exploring knowledge gaps and implementing preventive strategies are necessary to curb opioid misuse among Nigerian students. This review aimed to identify the prevalence estimates of non-prescribed opioid use among Nigerian students and explore the cultural and societal factors favoring opioid and other drug use in this population. It further aimed to provide and discuss strategies that could offer effective and long-lasting solutions for Nigerian policymakers to curb opioid use among Nigerian students. A systematic search strategy identified relevant studies from databases such as PubMed and Google Scholar using keywords such as opioid misuse, students, Nigeria, prevention strategies, and opioid use disorder. Articles on the prevalence rates, associated factors, and preventive measures were extracted. The findings revealed a high prevalence of opioid use among Nigerian students, particularly in the southwestern (7.87%) and northeastern (6.57%) parts of Nigeria. Approximately 4.6 million Nigerians, constituting 4.7% of the population, have used opioids for non-medical purposes. Tramadol and codeine are the most commonly misused opioids. Cultural practices and belief systems often impact the knowledge, attitudes, and perceptions of opioid use among students. Efforts to prevent and control opioid misuse in Nigeria should focus on effective coordination among students. Health-promotion measures and specific protection should be promoted alongside early diagnosis, prompt treatment, and rehabilitation of affected individuals.

Keywords
Opioid misuse
Students
Nigeria
Prevention strategies
Opioid use disorder
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Centers for Disease Control and Prevention. Understanding the Opioid Overdose Epidemic; 2021. Available from: https:// www.cdc.gov/opioids/basics/epidemic.html [Last accessed on 2024 May 03].

 

  1. Ashrafioun L, Carels RA. Prescription opioid use among university students: Assessment of post-cue exposure craving. Addict Behav. 2014;39(3):586-592. doi: 10.1016/j.addbeh.2013.11.012

 

  1. Jones CM, Clayton HB, Deputy NP, et al. Prescription opioid misuse and use of alcohol and other substances among high school students - youth risk behavior survey, United States, 2019. MMWR Suppl. 2020;69(1):38-46. doi: 10.15585/mmwr.su6901a5

 

  1. Weyandt LL, Gudmundsdottir BG, Holding EZ, et al. Prescription opioid misuse among university students: A systematic review. J Am Coll Health. 2022;70(4):1119-1137. doi: 10.1080/07448481.2020.1786095

 

  1. Brands B, Paglia-Boak A, Sproule BA, Leslie K, Adlaf EM. Nonmedical use of opioid analgesics among Ontario students. Can Fam Phys Med. 2010;56(3):256-262.

 

  1. Akande-Sholabi W, Adisa R, Ilesanmi OS, Bello AE. The extent of misuse and dependence of codeine-containing products among medical and pharmacy students in a Nigerian University. BMC Public Health. 2019;19(1):1709. doi: 10.1186/s12889-019-8074-5

 

  1. Ajayi A, Akhigbe R. Assessment of sexual behaviour and fertility indices in male rabbits following chronic codeine use. Andrology. 2019;8(2):509-515. doi: 10.1111/andr.12717

 

  1. Ajayi AI, Somefun OD. Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use. PLOS ONE. 2020;15(5):e0232964. doi: 10.1371/journal.pone.0232964

 

  1. Niguse L, Sosengo T. Knowledge and reasons for use of analgesic medications among Haramaya University College of Health and Medical Science students, Harar town, East Ethiopia. J Clin Surg Res. 2021;2(2):1-7. doi: 10.31579/2768-2757/012

 

  1. Nelson E, Alichie B. Chronic pain and prescription opioid use among socially marginalized Nigerian women: Exploring supply channels and pathways to misuse. J Drug Issues. 2022;52(4):473-487. doi: 10.1177/00220426221083655

 

  1. Nnachi O, Akpa C, Nwani F, Edenya O. Pentazocine misuse among sickle cell disease patients and the role of lack of enforcement of opioid dispensing regulations by community pharmacies: A descriptive observational study. Adv Public Health. 2022;2022:3877882. doi: 10.1155/2022/3877882

 

  1. Rahman A, Walia N, Sahakian Y, Khaliq T, Cukovic L. Pharmacy students’ attitude towards opioid epidemic and overdose management. World J Biol Pharm Health Sci. 2022;9(3):6-12. doi: 10.30574/wjbphs.2022.9.3.0045

 

  1. Tompach PC, Vincent S, Peterson A, Tu HK, Born DO. A dental school survey assessing dental student knowledge, attitudes and prescribing behavior regarding opioid use and misuse. J Dental Sci Res Rep, 2021;3:1-6. doi: 10.47363/jdsr/2021(3)111

 

  1. Dompreh HO, Lynch M, Longworth M. A systematic review exploring the impact of socio-cultural factors on pain management approaches in Saharan Africa. Medrxiv [Preprint]; 2022. doi: 10.1101/2022.04.11.22273701

 

  1. Aboluwarin A. Management of opioid use disorder in sickle cell anaemia amidst growing menace in the general population. Open J Pediatr. 2023;13(6):807-820. doi: 10.4236/ojped.2023.136089

 

  1. Nelson E, Odeigah O, Dumbili E. Tramadol regulation, illegal markets and consumption practices: Exploring frictions of drug control in Nigeria. Drugs Habits Soc Policy. 2023;24(4):296-309. doi: 10.1108/dhs-12-2022-0051

 

  1. Dic-Ijiewere EO, Osadolor HB. Cyp24a1 and cyp3a4 levels, renal, and hepatic changes, and incidence of oxidative stress in tramadol-alcohol concomitant misuse. Cureus. 2023;15:e36877. doi: 10.7759/cureus.36877

 

  1. Jones C, Clayton H, Deputy N, et al. Prescription opioid misuse and use of alcohol and other substances among high school students - youth risk behaviour survey, United States, 2019. MMWR Suppl. 2020;69(1):38-46. doi: 10.15585/mmwr.su6901a5

 

  1. Han B, Sherman S, Palamar J. Prescription opioid misuse among middle-aged and older adults in the United States, 2015-2016. Prev Med. 2019;121:94-98. doi: 10.1016/j.ypmed.2019.02.018

 

  1. McCabe S, West B, Veliz P, McCabe V, Stoddard S, Boyd C. Trends in medical and nonmedical use of prescription opioids among us adolescents: 1976-2015. Pediatrics. 2017;139(4):e20162387. doi: 10.1542/peds.2016-2387

 

  1. Dumbili E, Ezekwe E, Odeigah O. From “codeine diet” to “gutter water”: Polydrug use among Nigerian young adults. Drugs Alcohol Today. 2020;20(2):95-107. doi: 10.1108/dat-02-2020-0003

 

  1. Hout M. “Doctor shopping and pharmacy hopping”: Practice innovations relating to codeine. Drugs Alcohol Today. 2014;14(4):219-234. doi: 10.1108/dat-03-2014-0014

 

  1. Oshodi O, Aina O, Onajole A. Substance use among secondary school students in an urban setting in Nigeria: Prevalence and associated factors. Afr J Psychiatry. 2010;13(1):52-57. doi: 10.4314/ajpsy.v13i1.53430

 

  1. Choo K, Rishya A, Manikam L, Yoong K, Kandasamy VA. Prophylactic metoclopramide use in trauma patients given tramadol: A randomised, double-blinded, placebo-controlled trial. Hong Kong J Emerg Med. 2018;26(2):98-105. doi: 10.1177/1024907918789586

 

  1. Raehal K, Schmid C, Groer C, Bohn L. Functional selectivity at the μ-opioid receptor: implications for understanding opioid analgesia and tolerance. Pharmacol Rev. 2011;63(4):1001-1019. doi: 10.1124/pr.111.004598

 

  1. Nee J, Rangan V, Lembo A. Reduction in pain: Is it worth the gain? The effect of opioids on the GI tract. Neurogastroenterol Motil. 2018;30(5):e13367. doi: 10.1111/nmo.13367

 

  1. Nelson A, Camilleri M. Chronic opioid-induced constipation in patients with nonmalignant pain: Challenges and opportunities. Ther Adv Gastroenterol. 2015;8(4):206-220. doi: 10.1177/1756283x15578608

 

  1. Whang B, Jeong S, Leem J, Kim Y. Aspiration pneumonitis is caused by delayed respiratory depression following intrathecal morphine administration. Korean J Pain. 2012;25(2):126-129. doi: 10.3344/kjp.2012.25.2.126

 

  1. Żurek U. Opioid-induced bowel dysfunction: A literature review. J Educ Health Sport. 2023;22(1):147-164. doi: 10.12775/jehs.2023.22.01.012

 

  1. Hough L, Nalwalk J, Cleary R, et al. Deficits in neuronal cytochrome p450 activity attenuate opioid analgesia but not opioid side effects. Eur J Pharmacol. 2014;740:255-262.doi: 10.1016/j.ejphar.2014.07.028

 

  1. Andresen, T., Niesters, M., Dahan A, Morlion B, O’Brien T, Drewes AM. Pharmacological management of chronic pain: How to deal with the catch-22 situation. J Curr Med Res Opin. 2021;4:773-791. doi: 10.15520/jcmro.v4i02.382

 

  1. Ishida M, Uchida N, Yabuno A, Mizunuma N, Takahashi T, Onishi H. Opioid withdrawal syndrome developing after long-term administration of naldemedine. Palliat Support Care. 2022;20(6):897-899. doi: 10.1017/s147895152200044x

 

  1. Emmanuel A, Johnson M, McSkimming P, Dickerson S. Laxatives do not improve symptoms of opioid-induced constipation: Results of a patient survey. Pain Med. 2017;18:1932-1940. doi: 10.1093/pm/pnw240

 

  1. Pizzi L, Toner R, Foley K, et al. Relationship between potential opioid‐related adverse effects and hospital length of stay in patients receiving opioids after orthopaedic surgery. Pharmacother J Hum Pharmacol Drug Ther. 2012;32:502-514. doi: 10.1002/j.1875-9114.2012.01101.x

 

  1. Zhou J, Ma R, Ying J, et al. Molecular mechanisms of opioid tolerance: From opioid receptors to inflammatory mediators (review). Exp Ther Med. 2021;22(3):1004. doi: 10.3892/etm.2021.10437

 

  1. Jamal M, Adams A, Jansen J, Webster L. A randomized, placebo-controlled trial of lubiprostone for opioid-induced constipation in chronic noncancer pain. Am J Gastroenterol. 2015;110(5):725-732. doi: 10.1038/ajg.2015.106

 

  1. Abdulkarim AA, Mokuolu OA, Adeniyi A. Drug use among adolescents in Ilorin, Nigeria. Trop Doct. 2005;35(4):225-228. doi: 10.1258/004947505774938620

 

  1. Soremekun RO, Folorunso BO, Adeyemi OC. Prevalence and perception of drug use amongst secondary school students in two local government areas of Lagos State, Nigeria. South Afr J Psychiatry. 2020;26:1428. doi: 10.4102/sajpsychiatry.v26i0.1428

 

  1. Adesida SA, Quadri MO, Adedeji AM. Use of psychoactive substances among students in a Nigerian University: An imperative for intervention programs. Sci Afr. 2022;16:e01139. doi: 10.1016/j.sciaf.2022.e01139

 

  1. Available from: https://www.unodc.org/documents/ data-and-analysis/statistics/drugs/drug_use_survey_ nigeria_2019_book.pdf [Last accessed on 2024 Apr 10].

 

  1. Otu SE, Nnam MU, Eteng MJ, Amugo IM, Idowu BM. Beyond evidence and reality: The politics, political economy and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Drugs Habits Soc Policy. 2023;24(4):320-341. doi: 10.1108/DHS-11-2022-0045

 

  1. Usoro NA, Ononokpono DN, Ette U, James NN. Community perspectives on cultural practices and belief systems influencing alcohol and drug use: A qualitative study in Anaang Community, Nigeria. Afr J Drug Alcohol Stud. 2018;17.

 

  1. Dumbili EW. A review of substance use among secondary school students in Nigeria: Implications for policies. Drugs Educ Prev Policy. 2015;22(5):387-399. doi: 10.3109/09687637.2015.1041455

 

  1. Ojonuba HS, Abdul Rahman H, Zaremohzzabieh Z, Mohd Zulkefli NA. The effectiveness of an empowerment education intervention for substance use reduction among inner-city adolescents in Nigeria. Int J Environ Res Public Health. 2023;20(4):3731. doi: 10.3390/ijerph20043731

 

  1. Ojebuyi BR, Salawu A. Decongesting the dodgy hub: The role of mass media in curtailing illicit drug trafficking and use in Nigeria. J Commun. 2015;6(1):219-228. doi: 10.1080/0976691X.2015.11884865

 

  1. Adetiloye AA, Abel OA. Drug misuse among nigerian youth and its consequences - a review of literature. Sokoto J Med Lab Sci. 2022;7(2):101-108. doi: 10.4314/sokjmls.v7i2.12

 

  1. Butters JE. The impact of peers and social disapproval on high-risk cannabis use: Gender differences and implications for drug education. Drugs Educ Prev Policy. 2004;11(5):381-390. doi: 10.1080/09687630410001704437

 

  1. Atkinson JS, Richard AJ, Carlson JW. The influence of peer, family, and school relationships in substance use among participants in a youth jobs program. J Child Adolesc Subst Misuse. 2001;11(1):45-54. doi: 10.1300/J029v11n01_02

 

  1. Fiki C. Globalization and drug and alcohol use in rural communities in Nigeria: A case study. J Soc Soc Welf. 2007;34(2):4. doi: 10.15453/0191-5096.3248

 

  1. Klein A. “Have a Piss, Drink Ogogoro, Smoke lgbo, but don’t take Gbana ”-Hard and soft drugs in Nigeria: A critical comparison of official policies and the view on the street. J Psychoact Drugs. 2001;33(2):111-119. doi: 10.1080/02791072.2001.10400476

 

  1. Ndagi I, Oduwole OO, Sanusi RA. Rural-urban differentials in the attitude of global systems of mobile communication (GSM) consumers to merits and demerits of GSM technology in Ogun state, Nigeria. Commun IIMA. 2014;9(2):10.doi: 10.58729/1941-6687.1106

 

  1. Ebigbo PO, Elekwachi CL, Nweze CF. Challenges in the treatment of drug misuse in a Nigerian female health worker: A case study applying the Wawa technique. J Contemp Psychother. 2012;42(4):257-264. doi: 10.1007/s10879-012-9213-9

 

  1. Molobe ID. Human rights misuse experienced by people who use drugs. A Nigeria-focused review. Int J Med Surg Sci. 2019;6(4):133-135. doi: 10.32457/ijmss.2019.039

 

  1. NAFDAC - National Agency for Food and Drugs Administration and Control. Available from: https://www. nafdac.gov.ng [Last accessed on 2024 Apr 10].

 

  1. National Drug Law Enforcement Agency. Available from: https://www.ndlea.gov.ng/about [Last accessed on 2024 Apr 10].

 

  1. Donnelly J, Saldutti E, Gavin L, Hecht M. Public health implications: A scoping review of opioid prevention programs among adolescents. Med Res Arch. 2023;11:72. doi: 10.18103/MRA.v11i7.2.4153

 

  1. Pius S. Drug misuse and health implication for the Nigerian federation of catholic students (secondary school and university) in Maiduguri diocese “for lent season”. Afr J Psychol Stud Soc Issues. 2017;20:8.

 

  1. McElrath K, Joseph H. Medication-assisted treatment (MAT) for opioid use disorder: Introduction to the special issue. Substitute Misuse. 2018;53(2):177-180. doi: 10.1080/10826084.2017.1404106

 

  1. Miles J, Howell J, Sheridan D, Braucht G, Mericle A. Supporting individuals using medications for opioid use disorder in recovery residences: Challenges and opportunities for addressing the opioid epidemic. Am J Drug Alcohol Misuse. 2020;46(3):266-272. doi: 10.1080/00952990.2020.1719410

 

  1. Bauder MA. Barriers to rural treatment of opioid use disorder and alcoholism. J Alcohol Drug Depend. 2018;6(4):318. doi: 10.4172/2329-6488.1000318

 

  1. Tarter RE, Cochran G, Reynolds M. Prevention of opioid use disorder. Commonwealth. 2018;20(2-3):39-60. doi: 10.15367/com.v20i2-3.187

 

  1. Webster PC. Tracking opioid use is vital to avoiding the scourge. Can Med Assoc J. 2012;184(2):E129-E130. doi: 10.1503/cmaj.109-4085

 

  1. Martins S, Fenton M, Keyes K, Blanco C, Zhu H, Storr C. Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the national epidemiologic study on alcohol and related conditions. Psychol Med. 2011;42(6):1261-1272. doi: 10.1017/s0033291711002145

 

  1. Gilson A, Maurer M, Ryan K, Rathouz P, Cleary J. Using a morphine equivalence metric to quantify opioid consumption: Examining the capacity to provide effective treatment of debilitating pain at the global, regional, and country levels. J Pain Symptom Manag. 2013;45(4):681-700. doi: 10.1016/j.jpainsymman.2012.03.011

 

  1. McCabe S, West B, Boyd C. Leftover prescription opioids and nonmedical use among high school seniors: A multi-cohort national study. J Adolesc Health. 2013;52(4):480-485. doi: 10.1016/j.jadohealth.2012.08.007

 

  1. Evans R, Widman L, Javidi H, et al. Preliminary evaluation of a prescription opioid misuse prevention program among rural middle school students. J Commun Health. 2020;45(6):1139-1148. doi: 10.1007/s10900-020-00899-5

 

  1. McCabe S, West B, Boyd C. Motives for medical misuse of prescription opioids among adolescents. J Pain. 2013;14(10):1208-1216. doi: 10.1016/j.jpain.2013.05.004

 

  1. Hall E, Cernasev A, Nasritdinova U, Veve M. The stigma of opioid use disorder and its indirect effects on student pharmacists’ perceptions and attitudes. Pharmacy. 2020;8(3):144. doi: 10.3390/pharmacy8030144

 

  1. Cepeda M, Coplan P, Kopper N, Mazière J, Wedin G, Wallace L. Er/la opioid analgesics rems: An overview of ongoing assessments of its progress and its impact on health outcomes. Pain Med. 2016;18(1):78-85. doi: 10.1093/pm/pnw129

 

  1. McCabe S, Veliz P, Schulenberg J. Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: A national longitudinal study. Pain. 2016;157(10):2173-2178. doi: 10.1097/j.pain.0000000000000624
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