Abstract

Substance abuse among Nigerian adolescents has become a major public health concern, with increasing involvement of opioids, cannabis, alcohol, and polysubstance use. Evidence between 2000 and 2018 reveals consistent patterns of experimentation and dependence among school-aged and university students, with opioids such as tramadol and codeine cough syrups frequently misused. The National Drug Use Survey 2018 reported that over 14 percent of Nigerians aged fifteen to sixty-four had used psychoactive substances in the preceding year, with the highest prevalence among young people. Smaller school-based surveys indicate prevalence rates ranging from twenty to thirty percent, underscoring the scale of adolescent involvement.
Mortality evidence specific to adolescents is limited, yet hospital case reports confirm tramadol overdoses resulting in seizures, coma, and death. Globally, drug use disorders contributed to over half a million deaths in 2017, with adolescents and young adults disproportionately affected. In Nigeria, substance-related mortality is further obscured by under-reporting, weak surveillance systems, and misclassification of causes of death.
Contributing drivers include porous drug distribution systems, weak enforcement of pharmaceutical regulations, peer pressure, socioeconomic hardship, and cultural influences such as media and music that normalize drug use. While government agencies have introduced regulatory restrictions and temporary bans, efforts remain fragmented and insufficient to address the depth of the crisis.
This review highlights urgent priorities: strengthening pharmaceutical regulation, establishing adolescent mortality surveillance, scaling up school-based prevention, and expanding adolescent-friendly treatment services. Without decisive action, Nigeria risks escalating into a full-scale opioid crisis with devastating public health and developmental consequences.