Economic Hardship Drives Self-Medication
At dawn, motorbike taxi rider Nelson, 26, swallows four 100-milligram tablets before weaving through Juba’s traffic. With food prices surging, the opioid blunts hunger and fatigue, allowing longer shifts.
He recalls first using the drug in 2023, when a friend suggested it as “cheap energy.” Today, he calls it “a daily ticket to survive a brutal economy.”
Medicine Turned Street Fuel
Tramadol, licensed globally for moderate postoperative pain, is now crushed into tea, Coca-Cola or plain water on Juba sidewalks, creating an instant stimulant fashionable among rickshaw drivers and laborers.
Peter Moses, 22, says he consumes eight capsules daily to cushion pothole-induced aches, admitting sharp abdominal pain but fearing reduced fertility more than toxicity.
Health Professionals Sound Alarm
“Young users may swallow 300 milligrams at once, a potentially lethal dose,” cautions Dr. Luka Dut, Secretary General of South Sudan Doctors’ Union.
He lists acute drowsiness, seizures, hypotension and sudden death, alongside longer-term addiction, neglect of hygiene and diminished productivity, warning that a “public-health time bomb” threatens national output.
Supply Gaps and Regulation
South Sudan’s 2012 Drug and Food Control Authority Act restricts opioid dispensing to licensed professionals, yet tramadol packets costing about 5,000 pounds remain available over counters and through informal street vendors.
Clinics profit from brisk demand, says Nelson, while regulators lack resources for consistent inspections. Dr. Dut calls for stricter inventory logs and real-time surveillance of pharmaceutical imports.
Social Strain and Security Risks
Rights advocate Ador Akoi links escalating gang violence to tramadol, arguing the drug dulls fear and amplifies anger among idle youth abandoned by overstretched families.
Police round-ups in Western Equatoria and Jonglei promise three-year sentences, yet supply chains adapt swiftly, leaving many casual users criminalised while major dealers evade arrest.
Toward Integrated Solutions
Experts argue that arrests alone cannot stem consumption; mental-health services, job creation programmes and community mentorship must work in tandem with pharmacy oversight.
“We must protect our next generation,” insists Dr. Dut, urging families, clerics and educators to confront stigma, discuss addiction openly and guide peers toward safer coping strategies.