Tramadol Baby, International Killer

It’s the little opioid that could. Less potent than its sister painkillers, OxyContin, Vicodin and fentanyl, Tramadol, a narcotic that was born in Germany (originally made by Grunenthal) has spread worldwide. Into the poorest nooks and crannies, the third world and particularly in war zones, often completely unregulated. While Tramadol is controlled substance in Canada and the US, until recently, it was not regulated even in large parts of Europe.

Taken in quantities that have become way too commonplace, Tramadol has also become a killer. Addictive and easy to counterfeit, it has become everything from a coping mechanism for impoverished souls seeking escape from hunger and daily misery, a substitute for genuine but unaffordable medical care, to the currency that finances global terrorism like no other. Vigorous international controls that track other dangerous narcotics have somehow missed these nasty little pills. They are virtually everywhere. Not being on an international control list, Tramadol often passes openly across international borders without even being tracked.

Claire Galofaro and Emily Schmall, writing for the December 14^th Associated Press, paint this dark picture: “[Now Tramadol pills] are the root of what the United Nations named ‘the other opioid crisis’ — an epidemic featured in fewer headlines than the American one, as it rages through the planet’s most vulnerable countries.

“Mass abuse of the opioid tramadol spans continents, from India to Africa to the Middle East, creating international havoc some experts blame on a loophole in narcotics regulation and a miscalculation of the drug’s danger. The man-made opioid was touted as a way to relieve pain with little risk of abuse. Unlike other opioids, tramadol flowed freely around the world, unburdened by international controls that track most dangerous drugs. 

“But abuse is now so rampant that some countries are asking international authorities to intervene… This year, authorities seized hundreds of thousands of tablets, banned most pharmacy sales and shut down pill factories, pushing the price from 35 cents for a 10-pack to $14. The government opened a network of treatment centers, fearing that those who had become opioid-addicted would resort to heroin out of desperation. Hordes of people rushed in, seeking help in managing excruciating withdrawal… For some, tramadol had become as essential as food.

“‘Like if you don’t eat, you start to feel hungry. Similar is the case with not taking it,’ said auto shop welder Deepak Arora, a gaunt 30-year-old who took 15 tablets a day, so much he had to steal from his family to pay for pills. ‘You are like a dead person.’…

“Jeffery Bawa, an officer with the United Nations Office on Drugs and Crime, realized what was happening in 2016, when he traveled to Mali in western Africa, one of the world’s poorest countries, gripped by civil war and terrorism. They asked people for their most pressing concerns. Most did not say hunger or violence. They said tramadol.

“One woman said children stumble down the streets, high on the opioid; parents add it to tea to dull the ache of hunger. Nigerian officials said at a United Nations meeting on tramadol trafficking that the number of people there living with addiction is now far higher than the number with AIDS or HIV.

“Tramadol is so pervasive in Cameroon that scientists a few years ago believed they’d discovered a natural version in tree roots. But it was not natural at all: Farmers bought pills and fed them to their cattle to ward off the effects of debilitating heat. Their waste contaminated the soil, and the chemical seeped into the trees.

“Police began finding pills on terrorists, who traffic it to fund their networks and take it to bolster their capacity for violence, Bawa said… Most of it was coming from India. The country’s sprawling pharmaceutical industry is fueled by cheap generics. Pill factories produce knock-offs and ship them in bulk around the world, in doses far exceeding medical limits.

“In 2017, law enforcement reported that $75 million worth of tramadol from India was confiscated en route to the Islamic State militant group. Authorities intercepted 600,000 tablets headed for Boko Haram. An additional 3 million were found in a pickup truck in Niger, in boxes disguised with U.N. logos. The agency warned that tramadol was playing ‘a direct role in the destabilization of the region.’”

In the end, we are so concerned with what happens inside the United States, increasingly withdrawing from multinational organizations and treaties and not concerned with the pains and struggles of impoverished or war-ravaged peoples elsewhere, that our lack of involvement or concern just makes it all so much worse. Does it matter that terrorists, with “death to America” high on their “to do” list, generate their supporting financing from poor regions far from our shores? 

              I’m Peter Dekom, so whether the United States gets involved for moral reasons, empathy or a just crass desire to survive, our withdrawal from the world does not serve us well or remotely represent who we are as Americans.