Domestic drug consumption in Ghana An under-reported phenomenon

West Africa’s emergence in the early years of the 2000s as a key transit hub in the global illicit drugs trade has led to a large number of studies that outline the configurations of networks moving drugs across the region and their routes.

It is only more recently that the deeply destabilizing and corrupting effects of the international drugs trade on the region’s governance mechanisms have been recognized.

Nevertheless, the focus of research is still largely confined to law-enforcement approaches for combating trafficking. And only recently has the impact of the increase in drugs flowing through the region on domestic consumption drawn the attention of the international press and, to a lesser extent, policy actors.

This report sheds light on the growing market for illicit drugs in Ghana, which has so far remained in the shadows, and is only now starting to garner media attention.

In the early 2000s, Ghana’s political elites repeatedly denied that there had been any increase in the domestic consumption of drugs. But, in recent years, this trend has become more difficult to ignore.

Health professionals, lawyers and law-enforcement officers in Ghana now report a dramatic increase in the domestic consumption of illicit drugs over the past decade. However, the scale of the increase remains unclear, as figures to accurately quantify the prevalence of drug use in Ghana do not exist.

Within the region, Ghana’s deep-water ports make the country an attractive logistics hub for drugs being moved overseas, while its anglophone status strengthens its links with Nigeria, from where there is a significant overland transit route into Ghana.

Opera, the name of an area of central Accra near the shoreline, is known to be home to many Nigerians who immigrated before independence but who retain links to Lagos. This is reportedly a key spot for heroin to be brought into Ghana.

The drugs are typically smuggled into the country concealed in bags of Thai white rice – lending heroin its local street name, ‘Thai’.

The notable absence of investigatory capacity in most of the Ghanaian police force is a major obstacle in tackling drug trafficking at the local level

Even if an investigation is successful, the weak adherence by law enforcement to necessary processes poses further barriers to conviction: contamination or loss of evidence, and poor adherence to investigatory procedures result in many cases being thrown out of court by judges.

Ghana's 50th Independence Anniversary national parade. (Golden Jubilee)

The NPP, the party currently in government, has a history of links to key players in the drugs trade. In 2008 Raymond Kwame Amankwah (allegedly one of Ghana’s most wanted drug barons who had evaded arrest warrants issued by the UK and INTERPOL for drug trafficking) was arrested in Brazil and sentenced to seven years in prison.

Nana Akufo-Addo (Leader of the NPP, President of Ghana since December 2016) at the time attorney general of Ghana, is reported to have quietly returned the state-seized assets of Amankwah to his family a few months after his arrest. Amankwah, who happens to be Akufo-Addo’s brother-in-law, is believed to have become a major donor to the NPP.

New Patriotic Party (NPP) logo.

The demographic of people who use drugs (PWUD) in Ghana has changed significantly since the mid-1990s, when cocaine and heroin use was largely confined to more affluent families.

In the current landscape, drug use is believed to be most prevalent across middle- and lower-income demographics, and most visible in the latter.

In Ghana, PWUD are predominantly male and young – generally between the ages of 18 and 40.

Faces of addiction: Kofi

Kofi (not his real name) is a tall man, with broad shoulders and a weathered face. He sits on a low wooden bench in a small, dark room with no door; PWUD can pay to sit in here while they use. As it is morning, there are only five men in the room. Later in the day, it will be full, and a queue of people will form outside, each of them willing to pay the GH¢2 (US$0.5) entry fee.

Kofi is a carpenter by profession, and he is married with two children, both at school. He has been using drugs for over eight years, but was clean for two years until he relapsed in March 2017. He now uses heroin and crack cocaine daily and is here smoking his Saturday-morning hit of heroin before heading to work. He remains employed but fears that he will soon lose his job if he is unable to stop using.

I can’t stop earning, I need to keep my children in school. My family know I use; they don’t like it, but what can they do. I want to stop; I know it is bad for me and my family

But Kofi is stuck as he cannot afford to pay the inpatient fee charged by local rehabilitation centres.

In Ghana, the use of illicit drugs is far more visible among men than women, with one health professional interviewed estimating the ratio at 50:1, male to female. The drugs hubs appear to be almost exclusively populated by men, a startling contrast to street-life elsewhere in Ghana.

Women who use drugs are particularly vulnerable to abuse, as well as health risks in the form of sexually transmitted diseases.

Emerging trends: Tramadol

The popularity of tramadol among PWUD continues to grow across West Africa and internationally, placing further strain on already limited health resources.

In a 2018 statement, Ghana’s Mental Health Authority called for tighter control of tramadol imports, demanding a change to current legislation to permit NACOB to regulate imports.

It is illegal to buy tramadol without a medical prescription or to sell it without a license. Non-medical tramadol use has continued to spread throughout Ghana’s lower-income demographic.

Local media have focused on non-medical tramadol usage among children and young adults. PWUD interviewed in Accra referred to tramadol use as a ‘new fad’ among the youth.

Emerging Trends: Methamphetamines.

The amount of methamphetamines being seized in Ghana is increasing in line with global figures, which are experiencing year-on-year growth.

The amount of methamphetamines being seized in Ghana is increasing in line with global figures, reaching over 158 tonnes seized globally in 2016.

Law-enforcement officials believe there to be methamphetamine labs in Accra and have therefore identified the city as a significant new area of challenge in the region. Previously, meth labs had existed predominantly in Nigeria, with the drugs then transported overland across the country’s borders primarily into Benin, with some of the drugs then reaching Ghana at a later stage.

None of the PWUD or health professionals interviewed had respectively used or witnessed the use of methamphetamines. This might suggest that although the drug is transiting through Ghana, it has not yet entered the domestic market on a large scale.

Public perception and access to treatment

  • In Ghana, substance-use disorders, already poorly understood, are typically conceived of as issues of morality. PWUD are seen variously as morally defective, under the influence of the devil or otherwise ‘unholy’.
Unable to escape this religious rhetoric, one rehabilitation worker described the unsympathetic attitude towards PWUD as the result of their ‘demonization’ by society.

Religion-based treatments typically include fasting, intensive prayer sessions and physical hardship, with more extreme accounts revealing that patients are whipped or chained to trees in the rain or under the hot sun. PWUD are usually ‘checked in’ by concerned family members, often without their consent.

  • Even when addiction is contextualized within a public-health framework, it is often still seen as intrinsically linked to mental illness.
According to one former user, ‘There is the view that even if a person stops using they will have a residual mental illness that will be with them for the rest of their lives,’

This perceived overlap between drug addiction and mental illness is widespread not only among the general populace but also among medical professionals, and is one of the reasons why PWUD are frequently shunned by society.

Current regulatory framework:

In line with other West African countries, Ghana has traditionally ascribed to a ‘war on drugs’ approach, with punitive sentencing seen as a key tool in eradicating drug use.

Although this hard-line attitude towards drug usage reflects the position of most of Ghanaian society, senior law-enforcement officials report a shift in judicial attitudes towards PWUD, with judges increasingly seeking to minimize the penalties meted out to low-level offenders, often changing the charge from ‘possession’ to ‘use’ in order to lower the mandatory sentence.

For the past few years, legislation has been on the brink of changing as a result of the draft Narcotics Control Commission Bill 2017, which would repeal and replace the previous act and mark a significant shift in the Ghanaian regulatory framework for tackling drug use.

Passing the Narcotics Commission Bill 2017 into law would constitute a significant step towards treating drug addiction as a public-health issue rather than one of law enforcement. However, in order to yield visible results, it would need to be accompanied by an increase in government spending on drug rehabilitation and treatment facilities, a move that the cash-strapped Ghanaian government is unlikely to take when there are so many other more socially acceptable causes requiring attention.

This Bill works towards an approach based on harm mitigation rather than one focused on punitive measures yet may still unfairly target low-income groups. Under the proposed new legislation, a person charged with ‘possession or control of a narcotic drug for use’ will no longer face criminal sanctions.

Picture: Ghana Ministry of the Interior, Ambrose Dery


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