As the opioid crisis in the US continues to balloon, the abuse of such drugs for non-medical purposes is also gaining recognition in Africa and Asia. In fact, the continents accounted for more than half of all pharmaceutical opioids seized worldwide, according to a UN drug report.  

Although China and the US are stepping up to curb opioid production and consumption, the prescription drug fentanyl, a synthetic opioid, continues to dominate media headlines. The Trump administration has even called for the death penalty for some drug dealers.

But another synthetic opioid called tramadol has taken over West, Central, and North Africa, says a report released by the United Nations Office on Drug and Crime (UNODC) on Tuesday. It is also prevalent in Europe and Asia.

Tramadol, like fentanyl, is used as a painkiller for those who suffer from moderate to severe pain, such as cancer patients. It is about ten times less potent than morphine, Doctors Without Borders says on its website.

However, it works similarly in that it blocks our body’s pain messages by binding to opioid receptors in the nervous system. Withdrawal symptoms can include anxiety, loss of appetite and depression.

China and India became lead producers of the drug after the German patent for it expired. The Asian countries also manufacture increased concentrations of the medication due to high demand, says a Lancet report. The drug is generally consumed orally, and can either sedate or stimulate depending on the dosage.

Some in the African country of Togo are taking tramadol for the latter, states the Lancet report. From truck drivers to sex workers, many are using the cheap medicine to gain an edge in their work. The prescription drug is cheap even by local standards, and can often be obtained without a doctor’s approval or on the black market.

The widespread abuse of the medication has led to a mixture of responses from governmental authorities, and has proven difficult for travelers who are uninformed on the drug’s restrictions in their destination countries. 

The US drug enforcement agency, for instance, lists tramadol as a narcotic. Last year, Egyptian authorities even jailed a woman from the UK for bringing almost 300 tramadol tablets to her husband, which she said was intended to treat his chronic back pain. The UK's regulations on the drug are less strict, as tramadol is prescribed widely as a painkiller there. The Guardian reported in December that she was sentenced to three years in prison.