“Red,” tramadol, and silence: Ghana’s drug abuse crisis

Across Ghana in 2026, drug abuse has become a widespread issue, extending beyond the streets to classrooms, universities, markets, and workplaces. The most commonly abused substances are tramadol, a prescription painkiller, and codeine-based cough syrups informally referred to as "red" or "lean." Other substances include marijuana, shisha, and synthetic drugs sold in small sachets.

Health professionals explain that tramadol is abused for three primary reasons: to extend working hours, manage stress, and improve sexual performance. A 200mg or 250mg tramadol pill, which should be prescribed by a doctor, can be purchased for just a few cedis on the street. Pharmacists report that people buy large quantities at once and use them in a manner similar to vitamins.

Data from hospitals and rehabilitation centers in 2026 indicate that the highest numbers of drug abusers fall within the age range of 15-35, although counselors note that more young women and senior high school students are also showing signs of addiction. Teachers have observed that students struggling to concentrate often become aggressive or fall asleep during class.

Employers in construction, transport, and factory sectors report an increase in accidents and absenteeism linked to substance use, with one HR manager sharing a concerning incident of a worker operating machinery while under the influence, which could have had disastrous consequences.

Health and social consequences of drug abuse are dire, with long-term effects ranging from liver damage, kidney problems, seizures, and mental health disorders to the exacerbation of pre-existing conditions. Psychiatric hospitals are facing heightened demand and longer waiting periods, while rehabilitation centers are overwhelmed with cases.

Beyond the physical health impacts, the social cost entails broken homes, school dropouts, increased petty crime, and the adoption of illegal activities to fund the habit. Families often struggle in silence due to the stigma associated with drug abuse, leading parents to hide their children's issues until it's too late.

In response to this crisis, the Food and Drugs Authority and the Narcotics Control Commission have stepped up efforts to dismantle illegal drug operations and destroy seized substances. The government has also implemented stricter import controls on tramadol and other controlled substances, launched school-based awareness campaigns to educate students on the dangers of drug abuse, and trained health workers to identify and refer addiction cases for appropriate treatment rather than punitive measures.

The Ministry of Health is actively working to expand treatment and rehabilitation services and integrate drug counseling into primary healthcare.

Health advocates argue that enforcement measures alone are insufficient to combat drug abuse and are advocating for more affordable and non-stigmatizing rehabilitation centers, employment and skills programs for the youth as alternatives to drug use, parental education on early warning signs, and harsher penalties for drug dealers while providing treatment for users.

They emphasize that young people often turn to drugs as a coping mechanism and that without job opportunities, mental health support, and hope, the allure of pills will continue to grow. The experts agree that drug abuse in Ghana is now a public health issue requiring a comprehensive approach that combines supply reduction, treatment with dignity, and prevention efforts to safeguard the future generation.