Chronic Pain and Prescription Opioid Use Among Socially Marginalized Nigerian Women: Exploring Supply Channels and Pathways to Misuse

• Author: Ediomo-Ubong E. Nelson,Bridget O. Alichie
• DOI: http://doi.org/10.1177/00220426221083655
• Published date: 01 October 2022
• Date: 01 October 2022
• Subject Matter: Articles

Article

Journal of Drug Issues

2022, Vol. 52(4) 473–487

© The Author(s) 2022

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DOI: 10.1177/00220426221083655

journals.sagepub.com/home/jod

Chronic Pain and Prescription

Opioid Use Among Socially

Marginalized Nigerian Women:

Exploring Supply Channels and

Pathways to Misuse

Ediomo-Ubong E. Nelson

1,2

and Bridget O. Alichie

3,4

Abstract

This study explores pathways to prescription opioid misuse and supply channels based on in-

depth interviews with 16 socially marginalized Nigerian women suffering chronic pain. The

pathways identif‌ied were medical pain treatment, prior substance use and opioid use for rec-

reation and coping with psychological distress. Facing barriers to prescription opioids due to

prescribing restrictions and provider stigma, many resorted to unlicensed chemist stores and

street drug dealers for opioid analgesics, including fake and potentially harmful products. Patterns

of prescription opioid misuse were woven into multiple and overlapping dynamics of margi n-

alization shaping the lives of these women, including homelessness, sex work, substance use and

intimate partner violence. Findings show a need to improve access to prescription opioids and

other evidence-based approaches, framed within a trauma-informed approach to pain man-

agement. Further, integrating substance abuse treatment and pain management could make

services responsive to the inter-related problems of chronic pain and prescription opioid misuse.

Keywords

chronic pain, prescription opioid, substance use, tramadol, Nigeria

Introduction

The misuse of prescription opioids is a public health problem of global magnitude. Attention has,

however, rested on the opioid crisis in North America, particularly the exceptionally large number

1

Global Drug Policy Observatory, Swansea University, Singleton Park, UK

2

Centre for Research and Information on Substance Abuse, Uyo, Nigeria

3

Department of Sociology, University of Alberta, Canada

4

Department of Sociology and Anthropology, Nnamdi Azikiwe University, Awka, Nigeria

Corresponding Author:

Ediomo-Ubong E. Nelson, Centre for Research and Information on Substance Abuse, 10 Okon Essien Close, Uyo 520241,

Nigeria.

Email: degreatnelson@yahoo.com