India bans two drugs behind opioid crisis in West Africa

Indian authorities have banned two highly addictive opioid drugs after a BBC investigation found they were fueling a public health crisis in parts of West Africa. Dr. Rajeev Singh Raghuvanshi, Drug Controller General of India, stated in a letter seen by the BBC that the manufacturing and export licenses for the two drugs have been revoked, effectively halting their production and distribution.

The BBC investigation revealed that a pharmaceutical company called Aveo had been illegally exporting harmful mixtures of oxycodone and tramadol to countries including Ghana, Nigeria, and Côte d'Ivoire. The Indian Food and Drug Administration stated that the company's factory in Mumbai had been raided and all stocks had been seized, preventing further shipments of the dangerous substances.

Dr. Raghuvanshi cited the BBC investigation in a notice issued on Friday as the basis for his decision to ban all oxycodone and tramadol combinations, with the ban taking immediate effect. He also stated that officials had previously investigated "the possibility of drug abuse and its harmful effects on the population," leading to the decisive action.

Oxycodone is a powerful opioid, and tramadol is a muscle relaxant, both of which are highly addictive and have been banned in Europe. Tramadol is approved for use in the United States, but only for short-term use of up to three weeks. Withdrawal symptoms include anxiety, insomnia, and hallucinations. The combination of these two drugs is not licensed anywhere in the world because they can cause breathing difficulties and seizures, and overdoses can be fatal, posing significant health risks.

Despite the risks, these opioids remain popular street drugs in many West African countries because they are very cheap and easily accessible. Public export data shows that Aveo Pharmaceuticals and its sister company, Westfin International, have shipped millions of such pills to Ghana and other West African countries. BBC World News also found pills bearing the Aveo logo being sold on the streets of Nigeria and in towns and cities in Côte d'Ivoire, demonstrating the widespread availability of these drugs.

Nigeria, with a population of 225 million, is the largest market for these pills. The Nigerian National Bureau of Statistics estimates that approximately 4 million Nigerians abuse some form of opioid. As part of the investigation, the BBC also sent an undercover operative—posing as an African businessman looking to supply opioids to Nigeria—into an Aveo factory in India, where they filmed Vinod Sharma, a director at Aveo, showcasing the same dangerous products that the BBC had found across West Africa.

In the secretly recorded video, the undercover operative told Sharma that his plan was to sell the pills to teenagers in Nigeria, "they all love this product." Sharma responded "okay," before explaining that if users took two to three pills at a time, they could "relax" and agreed that they could "get high." At the end of the meeting, Sharma said: "This is very harmful for health," adding "now, this is business," highlighting the company's prioritization of profit over public safety.

At the time of the BBC's initial investigation, Sharma and Aveo Pharmaceuticals did not respond to requests for comment. The Indian Food and Drug Administration said in a statement on Friday that a sting operation had resulted in the seizure of all of Aveo's stock and the cessation of further production. The statement added that further legal action would be taken against the company. The agency said it was "fully prepared" to take action against anyone involved in "illegal activities that damage the reputation of the country." The Food and Drug Administration has been instructed to conduct further inspections to prevent the supply of these drugs.