Worku Abebe
January 25-31, 2016 is a National Drug and Alcohol Facts Week (NDAFW) in the US. This is a health observance week designed to give an opportunity for teenagers to learn the facts about drugs, alcohol and addiction from experts. The event is facilitated through various means of educational activities suited to the occasion and target population. The program is sponsored by NIDA and NIAAA, under the umbrella of the National Institutes of Health (NIH). Taking advantage of this important occasion, hereby are discussed some relevant issues related to illicit drugs in Ethiopia. Illicit drugs are substances that are available through illegal means. In other words, these are drugs that are illegal to produce, sell/supply or use. This categorization is based on scientific, medical and socioeconomic justifications and has generally universal acceptability. Almost all known illicit drugs are mind-altering substances that do not have any currently accepted medical use. Following consumption, these drugs interact with brain pathways involved in reward and reinforcement responses, producing a sense of pleasure/euphoria, at least initially. Their continued use, in most cases, results in the development tolerance, dependence and addiction.
Cessation of consumption after chronic use usually leads to multiple unpleasant withdrawal/abstinence syndromes, and this is one of the driving factors for the continued use of these drugs, irrespective of consequences. In addition to effects in the brain, each of the illicit drugs also causes a number of other harmful effects on other organs of the body (eg., heart, intestine, reproductive organs), sometimes with fatal consequences. Beyond causing unwanted effects on individual users, illicit drugs also have considerable negative impacts on other individuals and the society at large. Research has shown that the types and quantities of illicit drugs used by consumers and the effects they produce can vary from place to place and with time. For instance, the use of the drugs, cannabis/marijuana, heroin, cocaine and ecstasy in the US has been all time high during the past several years, resulting in greater problems relative to previous years.
Some authorities believe that this scenario has a share of contribution to the medical, economic and social ills that the country is currently experiencing. That said, what is the situation of illicit drugs in Ethiopia? More specifically, what are the drugs considered illicit, where are they produced, who consume them and are there trafficking issues? As with many other things, information on illicit drug use and trafficking in Ethiopia is generally scanty and largely remains vague. The discussion here is based on the best available estimates and should be interpreted with this shortcoming in mind. Reports from different sources indicate that drugs that are categorized illicit in most other countries are also found in Ethiopia and these include cannabis, khat, heroin and cocaine.
However, while cannabis, heroin and cocaine are also considered illegal in Ethiopia, khat is not. Since there is strong evidence to classify khat as illicit, the lack of this consideration in Ethiopia is puzzling. Many believe that, coupled with the negligent attitude of the TPLF government regarding the well-being of the Ethiopian people, this decision is largely politically and economically motivated. Based on available scientific evidence and the overwhelming recognition of khat as an elicit substance by the global community, in this article, the use of khat in Ethiopia is, quite rightly, considered illegal. Cannabis In most urban centers of Ethiopia, cannabis is more commonly known as hashish, but this actually refers to marijuana.
In some rural or traditional communities, it is also referred to as by the Amarigna/Geez name, etse-faris, a name which is sometimes confused with that of Datura stramonium (Jimson weed). Marijuana is a “preparation” made from the dried leaves, twigs and flower parts of the cannabis plant; it is consumed by inhalation as smoke. Similar to the classification in most other countries with functional regulatory systems in place, marijuana/hashish/cannabis is also considered illegal in Ethiopia. Accordingly, the Ethiopian federal drug law lists penalties for illegal production, use or sell/supply of cannabis. However, despite this law, the possession or use of cannabis in present-day Ethiopia seems to be prevalent and widely socially accepted. The cannabis plant in Ethiopia is reported to grow in many places across a wide range of geography.
More notably, it is cultivated in Alemaya, Shebendia, Shashemene and Debre Berhan areas. Among all the places, of special interest is the cultivation of cannabis in the Shashemene area which was offered by Emperor Haile Selassie in 1966 to Rastafarians of Jamaican origin. Since then, this area has been recognized for its ties to Rastafarianism and for the production and quality of its cannabis. In most of these places, however, cannabis is usually cultivated in inaccessible locations where enforcement of laws is difficult to achieve.
Such places include those which had never traditionally cultivated the plant. There is also evidence that some cannabis is smuggled into Ethiopia from West Africa by traffickers. Although most of the cannabis production in Ethiopia is meant for local use, some of it is trafficked to outside (mainly to UK) by air, the vast majority being sent via the Ethiopian postal service. Different reports indicate that, cannabis, in the form of marijuana, is used by a wide range of the Ethiopian population for different purposes. The UN Office on Drugs and Crime has reported a prevalence of 2.6% cannabis use for adult Ethiopians for the year 2008. Other studies also have documented that the recreational use of cannabis by the Ethiopian youth, including students, has dramatically increased in recent years, particularly in urban communities.
For a small proportion of the rural population, cannabis is useful as a medicinal and recreational substance. Still for some others, it is a source of extra income because of the increased demands both in the cities and from traffickers operating in the rural areas. In view of the documented ritual use of cannabis by the Coptic Church of Alexandria, it is also believed that elements of this tradition still exist in the Ethiopian Orthodox Tewahedo Church.
What does cannabis do to the human brain and behavior? Pharmacologically, many authorities classify cannabis as a hallucinogenic substance with mixed effects. The major compound (active ingredient) that enables cannabis to produce effects in the brain is delta-9-tetrahydrocannabionol (THC). The immediate effects include euphoria, a sense of relaxation, mood changes, increased appetite, reduced thinking capacity, suspicion and paranoia, and impairment of motion coordination.
With higher doses, cannabis may also cause hallucinations, delusions, agitation and feeling of panic, especially in venerable individuals. Regular use of cannabis for a prolonged period leads to a lack of motivation and poor performance in school as well as in work place. Individuals with problems of cannabis use usually look tired with no desire to work on a regular basis; they are also less concerned about their appearance or even life. In users with psychosis susceptibility, high doses of cannabis for a long duration may trigger psychotic episodes.
Abstinence from cannabis can cause a range of symptoms including sleep disturbances, insomnia, irritability, restlessness, excessive sweating, nausea, diarrhea and lack of appetite, among several others. For most consumers, these unpleasant withdrawal experiences can be a cause for continued use of the substance, whatever the cost may be. Khat Khat is a popular stimulant plant widely grown and used in Ethiopia and neighboring countries.
It is commonly known as chaat in Amarigna. It is grown, distributed and consumed in Ethiopia without regulatory oversight. The use of khat has deep-rooted cultural and social tradition in some Ethiopian communities, particularly among the Muslim population. Ethiopia, besides being a major khat producer, is believed to be the pioneer of its consumption. The plant is typically consumed by chewing the leaves and swallowing the juicy product. While the reasons for the use of khat can vary from individual to individual, the plant is generally recognized as a stimulant of the brain, with abuse potentials, and a number of other unwanted effects.
From published research results and general observations, it is clear that the use of khat in Ethiopia has become a growing problem in recent years, especially among the younger generation, including high school and college students. Three major factors are believed to contribute to this observation: (1) absence of regulation of the production, distribution and use of khat, despite its well-documented harmful effects; (2) lack of sufficient awareness of consumers about the harmful effects khat; and (3) push by the TPLF government and its beneficiary collaborators (more notably Dr. Ezekiel Gebissa of Kettering University, who wrote a promotional book on khat some years ago), for increased production and consumption of khat for economic and political self-interest.
Even more alarming is that, beyond the traditionally recognized places, the availability and use of khat have spread out of Ethiopia to other parts of the world due to the recent explosion of migration of young people from Ethiopia and neighboring countries and improved transport systems for khat smuggling. Accordingly, the drug is now more commonly used in North America, Europe and Australia, where it is largely considered illegal. Khat being among the top five exports of Ethiopia, the TPLF government has become a beneficiary of this illegal activity through population displacement. From most of the evidence reviewed thus far, it appears that the policy of the government and its collaborators is a major factor for the problem of khat in Ethiopia and elsewhere around the world.
The differences in drugs laws implemented for khat regulation in Ethiopia and in most other parts of the world have created a situation that encourages the illegal trafficking of khat from Ethiopia to prohibited countries mostly in Europe and North America. While engagement in such an illegal practice has become profitable for some, it has caused disastrous outcomes for many others, such as serving jail times, paying huge fins and facing deportations. Even worse, for some khat-related crimes, associations have been implicated with international terrorist organizations. Khat’s brain stimulating effects come mainly from its constituent compound known as cathinone, which resembles amphetamine. Classified as Schedule I drug, cathinone is an illicit substance in the US, and other countries.
Shortly after chewing, khat induces euphoria, wakefulness, mydriasis and increased energy, primarily as a consequence its action in the brain. With continued use, it also causes reduced appetite, increased body temperature, constipation, paranoia, sleeplessness and aggressiveness. Prolonged consumption further leads to a range of symptoms that include depression, anxiety, irritability, anger, sleep disturbance, fatigue, suspiciousness, hallucinations, panic attacks, and suicidal thoughts. With cessation of consumption after chronic use, like most other psychotropic drugs, khat causes withdrawal effects which are at least associated with depression, sadness, lethargy, reduced social interactions and vivid unpleasant dreams. The appearance of these symptoms is a contributing factor for the persistent consumption of khat by chronic consumers.
Of additional note is that the consumption of khat in Ethiopia is usually associated with the concomitant use of other mind-altering substances, such as alcohol and tobacco smoke. Several research studies have reported a link between the use of khat and sexually transmitted diseases, including HIV, but this is suggested to be more directly linked to the consumption of alcohol that usually follows khat sessions. Heroin Heroin is an opiate (a narcotic analgesic) derived from morphine, a drug obtained from the opium poppy plant. It is highly addictive and widely held as one of the most destructive illicit drugs in the world. Presently, the vast majority of the world’s heroin originates in the war-ravaged country, Afghanistan, corresponding to the cultivation and harvesting of opium poppies.
Another big player in the global heroin market is Myanmar (formerly Burma) in Asia. Ethiopia has increasingly become a transit hub for heroin originating in Southwest and Southeast Asia, and destined for Europe. This popularity of the country as a route for drug trafficking is due to its convenient location, suitable air service, limited law enforcement and likely conflict of interest. In addition, limited poppy cultivation has been reported in the southwest part of Ethiopia for local consumption of poppy seeds.
There are also reports that at least some of the poppy fields have recently been eradicated by police. Whether or not this approach has significant impact on the overall heroin problem in the country is unclear. Other news sources, such as The UN Office on Drugs and Crime, have also reported the use of opiates/heroin per se in Ethiopia, especially in the Addis Abeba. There is now a concern that opioid consumption in Ethiopia is likely to increase in the future partly because of the country’s location on major trafficking routes into Europe and the ineffectiveness of the local regulatory and control systems. Cocaine Cocaine is a stimulant derived from the leaves of the coca plant (Erythroxylum coca) which is widely cultivated in South America. It is one of the most sought-after and fought-over drugs in the world. It was reported to have been used by an estimated 17 million people worldwide in 2009. For cocaine, Ethiopia is also considered a transit hub from West Africa destined for markets in Europe and southern Africa. As yet, no reports are available suggesting the cultivation of coca in Ethiopia.
Other related drugs The UN Office on Drugs and Crime has reported amphetamine use by adult Ethiopians in 2008 at a prevalence rate of 0.3%. It appears that this compound is manufactured elsewhere in Africa and smuggled into Ethiopia. Furthermore, methamphetamine made in West Africa (notably in Nigeria) usually finds its way to East Africa (most likely including Ethiopia) for marketing. Both of these synthetic drugs are powerful brain stimulants with potencies much greater than that of khat.
The compounds are highly addictive and their chronic consumption is usually associated with considerable withdrawal syndromes. Concluding Remarks As in many other developing countries, the use of mind-altering substances in Ethiopia is becoming an increasing problem, particularly among the younger generation in urban environments. This includes the consumption of illicit drugs, such as cannabis, khat, heroin and cocaine, among others.
The problem is compounded by the cultivation and trafficking of these substances into and out of Ethiopia and by the lack of effective regulatory mechanisms and support system from the TPLF government in power and other institutions. The Ethiopian people have no choice but to take more personal responsibilities to protection themselves from the harmful effects of illicit drugs and other similar substances. This can be achieved through education, respecting legitimate drug laws, cooperative efforts, and seeking help from reliable provider(s).
Key Information Sources Worku Abebe, 2014. Khat chewing among high school and college students in Ethiopia: prevalence and associated factors of relevance for intervention measures. The Journal of Ethnobiology and Traditional Medicine. Photon 123, 906-916. Maria Phelan, Marie Nougie & Jamie Bridge, 2013. IDPC Briefing Paper HIV prevention among people who use drugs in East Africa, IDPC-Briefing-Paper_HIV-prevention-among-PWUD-in-East-Africa.pdf Seshata, 2013. Canabis in Ethiopia. http://sensiseeds.com/en/blog/cannabis-in-ethiopia/ Worku Abebe, 2013. Prevalence and consequences of substance use among high school and college students in Ethiopia: a review of the literature. African Journal of Drug & Alcohol Studies, 12(2) Ethiopia: illicit drugs, 2015. http://www.indexmundi.com/ethiopia/illicit_drugs.html
A Tale of Two Plants in Ethiopia: Datura stramonium L …
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