Highlights
- Millions of high-strength tapentadol tablets from India are reaching West Africa.
- Officials say tapentadol is now being mixed into the street drug kush.
- Several African governments say the products are unauthorized or illegal.
- Investigators linked seized tapentadol consignments to Indian pharmaceutical firms.
- Health workers warn children and students are increasingly using tapentadol.
Millions of India-made tapentadol tablets are contributing to a worsening opioid crisis across West Africa, according to officials, researchers, and an investigation by AFP. The opioid, sold in blister packs similar to common painkillers, is reportedly being distributed widely through roadside kiosks, informal markets, and small pharmacies in countries including Nigeria, Sierra Leone, Ghana, Guinea, and Senegal.
Health authorities and researchers say the spread of tapentadol has intensified addiction problems in the region and is now tied to the rapid growth of kush, a dangerous synthetic street drug often described as a “zombie drug” because of its severe physical and psychological effects.
The investigation found that large quantities of high-strength tapentadol tablets continue to be exported from India despite increased scrutiny and a government crackdown announced earlier this year.
Tapentadol increasingly linked to kush crisis
Researchers and public health officials told AFP that tapentadol is now commonly being mixed into kush, which has already triggered national emergencies in Liberia and Sierra Leone.
Officials in Sierra Leone said the crisis has become severe, especially in urban areas such as Freetown. Ansu Konneh, director of mental health at Sierra Leone’s social welfare ministry, told AFP that bodies were being collected daily from “the streets, markets and slums.”
According to officials, more than 400 corpses were reportedly collected in three months in the capital.
Public health researcher Ronald Abu Bangura said users now “grind and mix it with kush,” adding that tapentadol was “being misused all over the place.”
Authorities and aid workers say addiction treatment systems in the region are struggling to cope with rising demand. AFP reported visiting informal detox centers where users were allegedly chained during withdrawal treatment.
Konneh said around 90 percent of people admitted to official rehabilitation centers in Sierra Leone had used kush mixed with tapentadol or other powerful opioids such as nitazenes.
High-strength tapentadol exports continue after crackdown
India announced a “zero-tolerance” policy on illegal pharmaceutical exports in February 2025 after growing international concern over opioid shipments to Africa.
The Indian government banned exports of tablets combining tapentadol and carisoprodol following a BBC investigation into the impact of the drugs in Ghana. India’s drug regulator, the Central Drugs Standard Control Organisation (CDSCO), later stated it was withdrawing export approvals for “combinations of tapentadol… which are not approved by an importing country.”
However, AFP reported that exports of pure tapentadol tablets continued even after the crackdown.
Shipment records reviewed during the investigation reportedly showed millions of dollars’ worth of tapentadol consignments leaving India for West Africa each month. Many of the exported tablets were 225mg and 250mg strengths.
Experts questioned why such strengths were being shipped overseas when they are not commonly approved domestically.
Professor Andrew Somogyi of the University of Adelaide told AFP he did not know of any country that had approved 225mg tapentadol tablets. He questioned “why a country would want that strength except to bypass regulatory and commercial restrictions.”
India’s CDSCO reportedly told AFP it had “no record” of approving export clearances for 225mg and 250mg consignments.
Indian pharmaceutical companies connected to seized tapentadol tablets
AFP linked seized tapentadol products in multiple African countries to Indian pharmaceutical manufacturers using shipment databases, seizure reports, packaging license numbers, and records obtained through India’s Right to Information law.
Tapentadol tablets seized in Sierra Leone and Guinea reportedly carried manufacturing numbers linked to Gujarat Pharmaceuticals.
Another seized batch reportedly matched license numbers linked to Merit Organics.
Authorities in Senegal reportedly seized 250mg tapentadol tablets tied to McW Healthcare.
AFP also identified shipments linked to PRG Pharma, including consignments labeled “Harmless Medicines for Human Consumption.”
The report noted that PRG Pharma director Manish Goyal is also a shareholder in Maiden Pharmaceuticals, whose cough syrup was linked by Gambian authorities to the deaths of 69 children in 2023.
Another company identified in the investigation was Syncom Formulations, which AFP described as the largest exporter of tapentadol to West Africa by value after India’s crackdown. Shipment records reportedly showed exports worth nearly $15 million.
The Indian Drug Manufacturers’ Association defended the trade, stating that “a legitimate manufacturer who has followed the procedures cannot be held responsible for what happens later in the supply chain.”
West African governments say tapentadol imports are illegal
Authorities in several West African countries told AFP that tapentadol products entering their markets were unauthorized.
Ghana’s Food and Drugs Authority said it had “never issued any permit for the manufacture or importation of tapentadol of any strength.”
Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC) stated that “Any tapentadol product found within Nigeria is unauthorised and illegal.”
AFP also reported irregularities involving importers in Nigeria. One listed importer address in Lagos allegedly led investigators to a camera repair shop rather than a pharmaceutical distributor.
Why tapentadol use is spreading in West Africa
Researchers said many users initially take tapentadol not for recreational purposes, but to manage physically demanding work and economic hardship.
Motorbike taxi rider Abubakar Sesay told AFP the drug “energises my body to ride day and night,” adding, “Without it, I can’t survive.”
Medical anthropologist Axel Klein explained, “It’s used as a performance enhancer to enable people to do long hours of hard work.”
Aid workers and researchers said laborers, market workers, miners, and transport workers increasingly rely on tapentadol to suppress hunger, fatigue, and pain.
At the same time, Nigerian officials warned that criminal organizations and armed groups are also using opioids extensively.
Femi Babafemi of Nigeria’s anti-drug agency said authorities seized two billion high-strength opioid pills during 2023 and 2024. He stated, “Kidnappers, terrorists and bandits use these drugs so they can carry out their nefarious activities.”
Babafemi also said opioid pills are now reportedly being used as ransom payments during kidnappings.
Tapentadol replacing tramadol in illegal opioid trade
For years, tramadol dominated the illegal opioid market across West and Central Africa. The Global Initiative Against Transnational Organized Crime previously reported that 90 percent of global tramadol seizures occurred in the region.
India classified tramadol as a controlled narcotic in 2018, increasing restrictions on exports.
Experts now believe tapentadol is replacing tramadol in several African countries because it remains easier to export.
Researchers in Sierra Leone reportedly found that some tablets sold as tramadol were actually tapentadol.
Experts say tapentadol is significantly stronger than tramadol and may present greater addiction and overdose risks.
Brookings Institution senior fellow Vanda Felbab-Brown said the situation reflected “poor law enforcement and regulatory controls” along with a “sense of impunity.”
She added, “This creates opportunities for unscrupulous Indian companies to sell products that are problematic, dangerous, harmful or outright illegal to African countries.”
Children and students increasingly exposed to tapentadol
Officials in Sierra Leone warned that the tapentadol crisis is increasingly affecting children and students.
Police reported an “unprecedented increase” in use among schoolchildren and university students.
Mental health director Ansu Konneh said one of the most concerning developments was that “young children in primary schools are now taking the pills.”
According to Konneh, some children break the tablets into smaller pieces and mix them with energy drinks “to increase potency.”
Health workers also warned that many people underestimate the risks associated with tapentadol because the drug is sold in pharmaceutical-style packaging and resembles legitimate medicine.
Konneh said many users seeking treatment still believe the pills are safe. “They tell us, ‘I’ve stopped taking kush, I’m just taking tapentadol tablets.’ They don’t see that to be a problem to their health.”
Traditional healer Hassan Kamara, who runs an informal detox center outside Freetown, described the scale of addiction as overwhelming.
One recovering addict, 31-year-old Manso Koroma, told AFP he began using kush after losing his leg in a traffic accident. “When I came here I was really violent,” he said. “I’ve recovered. I’m just waiting for my sister to come and I can leave here.”
