‘People are addicted to escape’: psychoactive drug crisis hits Sierra Leone

An addiction crisis is gripping Sierra Leone, one of the world’s poorest nations, driven by a surge in use of “kush”, a toxic blend of psychoactive substances.

As the west African nation struggles to boost its economy, thousands of unemployed young adults have turned to the potent alternative to marijuana to fill their days. The kush crisis is part of a growing trend of substance abuse across Africa, particularly among the continent’s youth.

“People are addicted to escape,” said Abass Wurie, a biomedical scientist in Freetown who is studying the effects of the drug on the heart and kidney. “They are addicted to leaving this realm to be somewhere else. [Kush] is just a symptom . . . we’ve ended up with a lot of people who just don’t want to be awake. The day is too long to not have anything to do.”

As the authorities clamp down on multiple-use substances used in the drug such as acetone, the active ingredient in nail polish, and formaldehyde, desperate users have dug up graves to crush the bones of the deceased embalmed with formalin, the commercial form of formaldehyde.

“The deterioration and alarming mortality of our young people due to the addictive use of kush is no longer acceptable,” President Julius Maada Bio said in a recent televised address where he declared a national emergency on drug and substance abuse.

A government-backed analysis found that kush mainly refers to a synthetic drug containing nitazenes, synthetic opioids that can be 100 times more potent than heroin.

Other analyses have found kush to be a drug made from a cocktail of marijuana and substances including MDMA (ecstasy), other opioids such as fentanyl, amphetamine, sleeping pills, analgesics and adhesives such as glue.

Kush’s heady mix is rolled and smoked. Users say the drug makes them happy and calm but they are left unable to eat or sleep without using it. Kush users often experience severe weight loss and develop open sores while shying away from help and becoming increasingly volatile.

The country’s under-developed health system cannot cope with the surge in physical injuries and mental illness caused by the kush epidemic.

There was a 1,000 per cent increase in drug abuse-linked admissions to the country’s only psychiatric hospital between 2020 and 2022, according to Foday Sahr, co-ordinator of a new government task force on substance abuse. The government was still compiling data on fatalities linked to kush, he added.

Austin Demby, Sierra Leone’s health minister, told the Financial Times that a noticeable increase of “unclaimed dead bodies [of drug users] showing up in marketplaces and hospital morgues made us realise there was something going on that we needed to pay close attention to”.

Ernest Fornah has been unemployed since he graduated from university four years ago. The 32-year-old father of one has taken on odd jobs, including informal sand mining, to make ends meet. He turned to kush to occupy his mind and make the days shorter. He now smokes four times daily. He has tried to quit but admits the lure of the high and the withdrawal symptoms make it very difficult to stop.

“These drugs are killing us,” he said while rolling his afternoon hit of kush, in a slum in Goderich, a Freetown suburb. One man had passed out nearby as other users looked on.

Kush, which had been circulating in Sierra Leone since about 2018, became ubiquitous during the coronavirus pandemic as unemployment among young people increased.

About 60 per cent of 15 to 35-year-olds in the aid-dependent country are unemployed, according to 2021 UN data. Even before Covid-19, Sierra Leone had faced a long list of problems, including an Ebola epidemic, deadly mudslides in the capital and a Lassa fever outbreak. The value of the leone currency has almost halved since 2022.

Sierra Leone is not alone in fighting a surge in recreational drug use on the continent. In South Africa, nyaope, a mix of low-grade heroin cut with marijuana, cleaning chemicals, rat poison and other harmful substances, is popular in townships. Nigeria and parts of north Africa suffer bouts of tramadol abuse. A dangerous home-brewed cocktail — known locally as “God take me” — is prevalent in Malawi.

The problem is overwhelmingly male: only one in 10 drug users in Africa is female, says the UN’s Office on Drugs and Crime. And the outlook is bleak: the UNODC estimates there will be a 40 per cent rise in the number of drug users in Africa by 2030.

Yet the kush epidemic is not solely an affliction of the disillusioned or left behind. Ansu Konneh, director of mental health services at the social welfare ministry, said drug abuse stretched across class lines, with a notable rise in the number of university students becoming addicted.

Sonialia Kudoh, a bubbly 25-year-old, was studying software engineering at a technical college before she dropped out because of her addiction. She is now living at the government’s rehabilitation centre in Hastings, 20km east of the capital.

Kai Edward Khanda, a tax official who lives in a vast tree-lined compound in a wealthier part of Goderich, has seen his son’s struggles with addiction. Now in his fourth stint in rehab, the 25-year-old stole items from his parents to fund his habit.

His dealer is a fellow church member living two doors down. “I feel so embarrassed for our youths,” Khanda said. “All I see is a bleak future.”

A lack of funds is hindering efforts to contain the crisis. The government has still not confirmed the budget for its task force, which is focused on law enforcement, care and treatment, social services support and community engagement.

A senior law enforcement official on the task force said an arrest warrant had been issued for a Sierra Leonean living in the Netherlands who is described as a leading importer of the drug’s narcotic ingredients.

The government-funded rehabilitation centre occupies a small wing of a military training base in Hastings.

The first group of recovering addicts were admitted in February for a seven-week rehabilitation programme. A barbed-wire fence was installed after a few patients escaped by destroying the roof. In addition to medical care and counselling, the recovering addicts spend their time playing sports and card games and receive lectures from drug addiction experts from the drug enforcement agency.

“The first seven days are usually the hardest,’ said Mohamed Bah, the lead social worker at the centre. “They are hostile and use abusive language because of the urge to use drugs again.”

With the Hastings facility only able to house 120 recovering addicts, the limits of the rehabilitation programme are evident.

Ibrahim Koroma, a social worker and advocate, urged the government to increase help. “They need to extend that number [of patients at the facility] if they really want to contain the number of people using drugs. They need to add more facilities”, he said.

Konneh said the government’s programme was still in the pilot phase, and said it planned to partner with faith-based and traditional rehabilitation centres once their staff completed relevant training.

Demby, the health minister who previously worked for the US government on its response to west Africa’s Ebola outbreak, said there were lessons learned almost a decade ago, and during the pandemic, that could be applied to the latest health emergency.

“If you have all of government and society engaged in [finding] the solution . . . you could manage even the worst situations.”

He added: “With kush, all we needed was the rallying cry.”