Substance abuse on the rise


Malawi is sitting on a time bomb through a silent substance abuse epidemic, which if left unchecked, is likely to hit very critical levels.

Psychiatrists that Malawi News has spoken to have admitted that most of their patients are the youth within the age range of 15 to 40, but sadly the problem is largely being ignored.

This comes following reports that young people, especially in colleges and secondary schools, are using cough syrup containing Codeine for pleasure to ‘get high’. This also coincides with revelations that Malawi is a vibrant platform for a drug smuggling syndicate, which is involving young people.


Medical experts say Codeine is a sedative pain reliever and cough suppressant similar to morphine. The substance is not administered to patients on its own but it is rather included in other medicines such as pain killers and cough syrups.

Information sourced from Zomba Mental Hospital shows that Codeine is typically administered in liquid or pill form, and when used under the direction of medical professional, it is a relatively safe way to treat minor pain or control troublesome coughs. However, users often abuse Codeine for relaxation through the euphoria they produce.

Codeine can cause withdrawal (these are symptoms that come after reduction or stopping codeine use), physical, social and lifestyle effects. Withdrawal can be quite severe, keeping the user in a cycle of use they find difficult to stop.


Internationally certified addiction professional, Nunga Segamatsi Kamau, said she deals with four cases of adolescent addiction per month.

“These are children whose parents made an initiative and they were able to reach me. How many are out there? This is an epidemic blowing up in our faces,” she said, adding that common drugs used are cough syrup containing Codeine, alcohol, cocaine among others.

She said the adolescents she has dealt with indicate that they get the Codeine cough syrup over the counter from local pharmacies.

“Some pharmacists question the young ones and would not sell syrup without prescription while others don’t mind. They just sell the drug to the young ones,” observed the Lilongwe based expert, adding that the country has laws which are not being efficiently implemented.

Zomba Mental Hospital admitted 30 clients with alcohol problems and 161 clients with substance induced psychosis in 2015/16. In 2016/17, the facility admitted 14 clients with alcohol related problems and 129 with substance use psychosis.

Spokesperson for the institution, Harry Kawiya, said the figures might look small because some clients are admitted at St. John of God in Mzuzu and district hospitals.

“Furthermore, some clients are completely missed or misdiagnosed. Some clients present with withdrawal symptoms like convulsions or seizures which can result in being misdiagnosed for other conditions,” he said.

Kawiya disclosed that the facility mainly admits teens from 15 to18 years and that the majority of their patients are youthful. While admitting the abuse of Codeine, Kawiya however said they have never assessed the use of Codeine in their patients.

“Common drugs or substances that are abused are alcohol, Cannabis and tobacco because they are readily available and cheap,” he said.

Clinical Psychologist at College of Medicine, Eric Umar also noted that substance abuse among the youth is a neglected epidemic.

“It’s not seen as a problem but young people are abusing all sorts of drugs. In case of Codeine substance, it is abused indirectly through pain killers or cough syrup,” he said.

Umar explained that when one takes a substance containing Codeine, the substance relieves the tense and pain, “the excess of this is what makes people to feel high.”

He however pointed out that there is lack of research in this area.

Drug Fight Malawi Executive Director, Nelson Zakeyu, noted that many people are not interested in taking up the issue yet it is costing lives.

“You might have heard of a few youths that have died recently but I bet this is just a tip of an iceberg. I feel law enforcing agents have somehow been relaxed on this matter,” he said.

Zakeyu also highlighted that some organisations, such as his, that want to help in raising awareness are not supported.

“It seems this isn’t an area of interest of government, donors and others. We have been having very good plans but we are left frustrated because there is very little or no support,” he lamented.

Acting Registrar for Pharmacies, Poisons and Medicines Board, Mphatso Kawaye, said the Board is aware that there is an abuse of controlled medicine and it is trying to get to the bottom of it.

“We have had unofficial reports this year. Last year, we had one complaint from Nkhotakota but we know that this could be a tip of an iceberg that’s why we are investigating the matter. This issue involves several points of supply from the manufacturer, wholesaler to retail pharmacies. We want to know where the leakage is coming from,” he said.

Kawaye confirmed that there is a breach of use and whoever is found to be involved needs to face the law.

“The public should ensure that they follow doctor’s prescriptions and buy medicines from reputable pharmacies. The pharmacists should desist from selling several bottles of cough syrup to patients. They should even become more curious when its youngsters going for such medicines,” he concluded.

Last month, a college student died after consuming a mixture of Codeine and alcohol at a social weekend event in Zomba. This week, a Malawian young man, Riyadh Randera, died in Brazil on suspected drug related mission.

Mental effects of Codeine

  • Major depression
  • Agitation
  • Getting irritated easily
  • Hallucination (hearing or seeing that other people can’t hear or see)
  • Psychosis (Delusions-false and fixed brief and hallucinations)
  • Suicidal thoughts
  • Racing thoughts
  • Homicidal thoughts (thoughts of wanting to kill someone)

Source: Zomba Mental Hospital

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