Religious rehab centres fill gap as Nigeria grapples with soaring drug use

Kola* was in secondary school in Nigeria when he started smoking cigarettes. He soon graduated to cannabis, heroin and eventually to crack cocaine. Access to drugs was easy and he felt the pressure of friends to participate.

In 2002, when he was 39, he was introduced to a private drug rehabilitation centre in Ibadan, in the south-west of the country, where he spent 90 days weaning himself off his addiction.

“Cold turkey … It was like dying,” Kola says. But he eventually got clean, married and now works as a community facilitator at the centre. He was one of the fortunate ones.

Nigeria has been grappling with a growing drug problem for several years, with cases surging since 2016. In its World Drug Report, published in June, the UN recorded a rise in the country’s rate of abuse from 5.6% in 2016 to 14.4% in 2018, with cannabis the most commonly used drug.

Ease of access to drugs, poverty, job insecurity and unemployment have fuelled the increase. Now there are concerns that lockdown restrictions during the Covid-19 pandemic have exacerbated the problem.

According to Nigeria’s National Drug Law Enforcement Agency (NDLEA), the south-west of the country has the highest rates of abuse and trafficking, with more than 22% of 15- to 65-year-olds using drugs in the past year.

In Ibadan, the capital of Oyo state, hundreds have passed through the same rehab centre as Kola, the Goodworker Ministry International. As well as accepting inpatients, the Christian-based centre, which says its drug treatment work was “divinely commissioned by the Lord” in 2002, organises outreach programmes to encourage people to bring their relatives to the centre.

Ahmed* was in primary school when he started experimenting with drugs. He began smoking cigarettes, then marijuana, and went on to use opioids and crack cocaine. He explains that there are countless “bunks” (where users go to inject) and “joints” (for smokers) across Ibadan. “In Bere [a central district] alone, the ‘joints’ there are over 40 … and it’s increasing every day.”

After going through the rehab programme, Ahmed also started working at the centre. He says the work helped his recovery because he had little spare time to spend with drug users. “That was what led me out of cocaine and heroin.”

The centre received a rise in calls during lockdown. “Requests for treatment increased by more than 300% but we could not help [everyone],” says its founder, Tunji Agboola, a Christian pastor.

During the lockdown, the centre’s inpatients were discharged to their families. Many relatives were not equipped to care for them and some patients relapsed. “We suspect that it led to the increase in the usage of prescription drugs and substances such as Rohypnol, tramadol and many more,” says Agboola. “A drug user will not allow the lockdown to make him have withdrawal problems.”

Poverty and food inflation have also increased in the past year – 100.9 million Nigerians are predicted to be living in poverty by 2022 – and so has crime. “The fact that they were hungrier at that time made them do stuff,” Agboola says. “If anything disrupts their day-to-day activities, they will come at people. That was why crime increased.

“Most of these guys that live on the streets are the engine room for drug demand,” he says. “The children of the rich get their drugs because the children of the poor exist.”

Faith Yvonne Abiodun, a mental health counsellor and manager at the Compassionate Recovery Centre in Ibadan, another rehabilitation facility set up by a cleric, says that during the pandemic staff there had received more calls than they had ever before. “Normally, people go about their activities, they have places and people to visit to make them feel better,” she says. With the restrictions, habits were forced to change. “People take solace in these substances.”

Founded in 2013, the centre only operated an outpatient model until last year. Such was the demand for its services after lockdown restrictions eased, however, that it started admitting people to a residential facility, where they spend up to six months. “We moved from a seven-client capacity to 18 clients,” Abiodun says of the surge in demand during the pandemic. “Even people who have been feeling well started using more [drugs].”

The local authorities are attempting to address the drug problem. Two years ago, Oyo state began enforcing free basic school enrolment as a preventive measure because drug use is so rampant among teenagers who have dropped out of school. It is too early to say if it is having an impact. The state government is also collaborating with community leaders on awareness programmes and targeted intervention.

“The main goal is prevention,” says Olufemi Josiah, special assistant on community relations to Oyo’s governor. “When children escape certain menaces, the possibility of getting involved in drugs at adulthood is very slim.”

Josiah says that, to achieve impact at scale, agencies, communities and all levels of the government have to work together. He would like to see the NDLEA be more proactive and collaborate more with national and state government. “A lot of attention is placed on the elected government,” Josiah adds. “The institutions that should really treat some of these things, are they really working?”

Dr Victor Makanjuola, a consultant psychiatrist at University College hospital in Ibadan, also sees a clear need for more rehabilitation centres. There are only eight government-owned psychiatric hospitals in Nigeria.

“We need to have a full rehab centre,” says Makanjuola, who works with addicts and people with drug-related disorders such as psychosis and anxiety. He says UCH is planning a separate addiction centre for long-term patients.

Currently, the hospital works with private rehabilitation centres, such as Goodworker, referring patients there for long-term care.

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The majority of rehabilitation centres in Nigeria are run by religious groups, and are widely accepted by the medical community. They meet a need the government is failing to address. However, although most operate under international standards of drug-use prevention, patients in these centres are usually expected to participate in some form of religious worship.

Goodworker has been admitting inpatients since lockdown was eased last year. After three months in rehab, recovering users are released to their families, but that can give rise to new challenges. The team at the centre monitor people after they leave. They know their families and friends, and follow up on them if they start socialising again with drug users. “The final stage is lifelong,” Agboola says. “That’s where we handle every form of relapse.”

* Names have been changed