New Delhi (AFP) – They come in blister packs of 10 like any normal painkiller, and you can buy them easily in roadside kiosks and street pharmacies across West Africa. Millions of tapentadol tablets from India are helping drive a deadly opioid epidemic ravaging the region. Officials and researchers have told AFP that they are also being added to the “zombie drug” kush. The cheap pills are so strong that no regulatory authority in the world has approved them. Yet an AFP investigation found that Indian pharmaceutical firms were flooding West Africa with the pills despite New Delhi vowing to crack down on the trade. Some shipments were even labelled “Harmless Medicines for Human Consumption.” Customs records show millions of dollars’ worth of the high-strength synthetic opioid being shipped from India every month to Nigeria, Sierra Leone, and Ghana, where even low doses of the drug are not permitted.
With opioids now heavily regulated in wealthier nations after being linked to one million deaths in the United States alone, some manufacturers in India—the world’s biggest producer of generic drugs—are pushing hard into Africa. In a frightening development, tapentadol is now being added to the “zombie drug” kush, according to health chiefs and researchers who spoke to AFP. Kush, infamous for the speed with which it hollows out its victims, has already been declared a national emergency in Liberia and Sierra Leone.
Bodies are being picked up from “the streets, markets, and slums on a daily basis,” Ansu Konneh, director of mental health at Sierra Leone’s social welfare ministry, told AFP. He reported that more than 400 corpses were collected over three months in the capital Freetown alone. “They grind and mix it with kush,” Freetown-based public health researcher Ronald Abu Bangura added, noting that tapentadol is now “being misused all over the place.” The impoverished nation is struggling to tackle the death and misery linked to this crisis. AFP visited addicts in informal detox houses where some have been chained up for months to go cold turkey. Konneh reported that 90 percent of those admitted to the country’s few official rehabilitation centers had smoked kush mixed with tapentadol or other powerful opioids such as nitazenes.
New Delhi declared a “zero-tolerance” crackdown on illegal drug trading in February 2025, banning the export of tablets that mixed tapentadol with the muscle relaxant carisoprodol after a BBC investigation exposed the damage they were doing in Ghana. India’s drug regulator, the Central Drugs Standard Control Organisation (CDSCO), later stated that it was withdrawing all export clearances for “combinations of tapentadol…which are not approved by an importing country.” However, researchers assert that the main trade was always in pure tapentadol tablets. Shipment records reviewed by AFP show that millions of dollars’ worth of the high-strength pills are still being exported from India to West Africa every month. The vast majority are so strong that India officially does not allow their production without special permission.
Yet AFP matched high-strength tapentadol tablets seized in at least four West African countries with Indian export records through their makers’ license numbers. This was established using commercial shipment data, government seizure records, interviews, and documents obtained under India’s Right to Information transparency law. Tapentadol tablets seized in Sierra Leone in December, marked “Made in India,” had a manufacturing licence number corresponding to Gujarat Pharmaceuticals, a company based in Godhra, Gujarat, according to images of the boxes photographed by AFP. The firm was listed in the export monitoring database Volza as an exporter of tapentadol to West Africa, and its manufacturing license number appeared on tablets seized last June in Guinea.
A second license number on tablets seized in the same Guinean operation corresponds to Merit Organics, another Gujarat-based company in the database. Senegalese authorities seized high-strength 250mg tapentadol tablets in November with a license number registered to McW Healthcare, a Madhya Pradesh-based company. A fourth company, PRG Pharma, also made several shipments after New Delhi’s ban last February, labeling them as “harmless medicines.” Its director, Manish Goyal, is a shareholder in Maiden Pharmaceuticals—a company controlled by his father—whose cough syrup Gambian authorities blamed for the death of 69 children in 2023.
The Volza database shows that McW Healthcare shipped dozens of consignments of 250mg tablets worth more than $1 million to Sierra Leone and Nigeria after the February crackdown. AFP found a camera repair shop at the Nigerian importer’s address in Lagos. Health authorities said it had no pharmaceutical permit and termed the imports “illegal.” Kuwait Customs intercepted tapentadol tablets in January carried by a Beninese traveller. Their packaging bore the license number of Syncom Formulations. AFP’s analysis identified the company as the largest tapentadol exporter to West Africa by value, having shipped consignments worth nearly $15 million after February, many of them declared as “Harmless Medicines for Human Consumption.” Benin is among the declared destinations for Syncom’s shipments.
The Indian Drug Manufacturers’ Association—the largest industry body—defended the trade, claiming that “a legitimate manufacturer who has followed the procedures cannot be held responsible for what happens later in the supply chain.” However, government officials in Nigeria and Sierra Leone informed AFP that tapentadol was illegal, while Ghana stated it has never been permitted there.
Most people in Africa take tapentadol not to get high but to do brutal back-breaking work, experts say. It “energizes my body to ride day and night,” said motorbike taxi rider Abubakar Sesay, who earns a pittance bumping over the bone-rattling backroads of Freetown. “Without it, I can’t survive.” Market porters and gold miners from Lagos to Mali use tapentadol pills to push through the pain, according to NGOs. “It’s used as a performance enhancer to enable people to do long hours of hard work,” said medical anthropologist Axel Klein of the Global Initiative Against Transnational Organized Crime.
Opioids are now the second most used drug in Nigeria after cannabis. Femi Babafemi of the country’s NDLEA anti-drug agency reported that it had seized two billion high-strength pills in 2023 and 2024 alone. “Kidnappers, terrorists, and bandits use these drugs so they can carry out their nefarious activities,” he added, noting that police have stated that jihadist fighters like Boko Haram also take it “for courage.” The pills are also being used as a form of currency in ransoms for kidnappings, Babafemi explained. A tablet is cheaper than a meal in the poor and dusty suburb of the capital Abuja, where Boluwatife Owoyemi of YouthRISE Nigeria works with drug users. Along with providing “lots of strength,” she said that some users take it as an appetite suppressant “until they have the money to get food.”
With brands like TramaKing, Super Royal 200, and Tamol-X, the pills are “made to look like a medicine,” Klein noted. “Consumers (in West Africa) are much more naive than in other parts of the world,” he said, pointing out that there is little government regulation or enforcement on the ground to protect them. “This creates opportunities for unscrupulous Indian companies to sell products that are problematic, dangerous, harmful, or outright illegal to African countries,” Vanda Felbab-Brown, a senior fellow at the Brookings Institution who has long studied opioid flows, told AFP. “Africa is a market that provides opportunities at a low end,” she said, emphasizing that it’s a prime situation for trafficking networks from India to try to get people hooked.
Ninety percent of the world’s seizures of tramadol over the last decade have occurred in West and Central Africa, according to a new report by the Global Initiative Against Transnational Organized Crime. India declared the opioid a controlled narcotic in 2018. However, the report stated that tapentadol has now “replaced or supplemented” tramadol in many West African countries. Lab tests indicated that pills sold as tramadol in Sierra Leone were all tapentadol. While tapentadol is often sold on the streets as tramadol, it is actually two to three times stronger and even more dangerous, experts warn.
“Indian pharmaceutical companies began exporting vast quantities of tramadol to West Africa, often at potency levels far beyond what was considered safe for human consumption” about 15 years ago, Felbab-Brown continued. “Domestically, they could not sell such potent tramadol, but they were indifferent to what was well known to stimulate substance-use disorders in their export markets.” Now, the pattern is repeating with even stronger tapentadol, driven by “poor law enforcement and regulatory controls” and a “sense of impunity.” Tapentadol’s tongue-twister name and the confusion with tramadol have further helped it slip under the radar.
Nearly three-quarters of tapentadol exports to West Africa since India’s crackdown have been high-strength 225mg and 250mg pills, according to AFP’s analysis. Andrew Somogyi, a professor of pharmacology at the University of Adelaide, remarked that 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.” Dr. Viranchi Shah of the Indian Drug Manufacturers’ Association stated that there was a “shared responsibility of all key stakeholders” to stop misuse of the drug.
India’s drug regulator, the CDSCO—which is responsible for issuing export clearances—told AFP it had “no record” of issuing them for consignments of 225 and 250mg tapentadol. It did not respond to follow-up queries. Jaydip Patel of Gujarat Pharmaceuticals, whose tapentadol tablets were seized in Sierra Leone, asserted that their exports were conducted legally. “The importer gave us an authorization letter,” he explained. “After that, we got the permission here.” Patel added that Indian manufacturers switched from exporting
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