Editor’s Note: This week’s Thought Leadership piece comes from Nigeria Health Watch’s Production Coordinator McHenry Igwe. He writes about a growing practice amongst young sexually active people in the Federal Capital Territory (FCT), using antibiotics as a form of contraception, the debilitating side-effects of this practice and how this is a symptom of a much larger problem for Nigeria.
Not too long ago the codeine crisis was one of the most talked about issues in the Nigerian health sector and highlighted the misuse of codeine-based cough syrups or seizures by the Ministry of Health in Nigeria, the syrup is not completely out of circulation. A visit to some Patent and Proprietary Medicine Vendors (PPMV) on the outskirts of the FCT reveals that the syrup is still in circulation and sold at between 3,500 to 5,000 naira. The fact that the price has sky-rocketed is not unexpected — the ban has essentially turned the codeine-based cough syrup into a coveted street drug. Prior to the ban it was sold for as low as 1,000 naira.
While the abuse of substances like alcohol, marijuana and cocaine are more generally known, less well-known is the fact that over-the-counter medications like some pain killers are some of the most commonly abused substances. Even those that are not meant to be sold without a prescription, such as Tramadol, are not difficult to get hold of by those who want to find them.
Antibiotics, though not supposed to be so easily available and sold over the counter, are also being misused through dangerous misconceptions about their effectiveness as a form of contraception by young people. In a conversation with three 30-years-old friends around after a football game in Kubwa, one of Abuja’s surburb towns, one of them noted that he did not like to use condoms. When asked if he was not concerned about getting his girlfriend pregnant, he pointed out that all he needed to do was to give her an antibiotic after having sexual intercourse. He said he believed that this particular antibiotic dissolves the sperm that is in the girl’s body, which prevents her from becoming pregnant. The conversation came up again, this time with a 27-years-old girl in Kubwa, and she affirmed the misconception, saying that she does not bother if her boyfriend wears a condom or not, she protects herself by taking the same antibiotic after sexual intercourse.
Pharm Akan Sunday who runs a pharmacy in Kubwa confirmed that he is aware of the practice of misusing antibiotics as a form of contraception, noting that young people were buying antibiotics at almost the same rate as codeine. He however, maintained that taking an antibiotic after having sex will not prevent pregnancy, and those taking it for that purpose were doing so at their own peril. ‘’Ampiclox is an antibiotic so it is used to fight bacterial infections. It is a semi-synthetic derivative of penicillin and is used to treat urinary tract infections, pneumonia, respiratory tract infections, meningitis, gonorrhea, infections of the stomach or intestines. It does not flush out sperm,’’ he said.
Obstetrician and Gynaecologist Dr. Godwin Ekunke of Kubwa General Hospital noted that the use of antibiotics as a form of contraception poses a great danger to the users themselves and there is a greater public health challenge as it can lead to antimicrobial resistance (AMR), which increases the risk of severe infections and complications if an individual needs surgery. “Antibiotics can in no way serve as contraceptives, they cannot stop pregnancy. That is misinformation. What can prevent pregnancy are the various methods of contraception available,” he reiterated.
While the specific physical and psychological effects of drug misuse varies, depending on the drug used, the general effects of addiction to any drug can be devastating. Most misused drugs, especially pain killers tends to lead to addiction and dependency. The longer they are misused, the more reliant the person becomes on them, in some cases preventing them from carrying out basic day to day tasks. Physiologically, drug misuse has detrimental effects on various organs of the body especially the liver and kidney. According to the United States National Institute of drug abuse, people who misuse drugs are twice as likely to experience mood and anxiety disorder than those who don’t.
The dispensing of antibiotics, should require a physician’s prescriptions however, they can easily be bought by anyone in most pharmacies and PPMVs in the FCT. This should not be the case. There needs to be tighter regulation and governance of pharmacies in the dispensing of antibiotics, and individuals who flout regulations should face strict sanctions. Nigeria is not short of statutory institutions whose duty it is to regulate drug use in the country and fight crimes related to drug abuse. The National Agency for Food and Drug Administration and Control (NAFDAC) and the Pharmacist Council of Nigeria (PCN) were created to serve these purposes. They should be held accountable to uphold regulation, distribution, sale, and use of drugs.
Lack of Knowledge — The Larger Problem
The fact that a young man in Kubwa can confidently assert that giving his girlfriend an antibiotic will prevent pregnancy points to a larger systemic problem — lack of proper knowledge and awareness about sexual health. We must look critically at the health knowledge, awareness and practices of Nigerian youth, as often, as in this case, they are rife with misinformation about sexual health issues. If misinformation about contraceptive choices prevails in communities like Kubwa, which is considered a semi-urban community and part of the FCT, it can only be imagined what misconceptions must exist in Nigeria’s rural communities among young people.
There is a critical gap that needs to be filled. We must pay attention to the places young people go to for sexual health information and create avenues through which they can be taught properly about their bodies and how they function. This also points to inadequate sexuality education in schools. Lagos State government will now integrate Comprehensive Sexuality Education (CSE) into the curriculum of non-formal vocational training schools as part of the Sustainable Development Goal (SDG) target. While this is commendable, it seems like a case of “medicine after death”. CSE is a shared responsibility between educational establishments and parents, from an age young people start going through puberty.
Healthcare institutions should also help in this fight by creating safe spaces for young people to come and seek health information, without the fear of being judged. Empowering young people with the right health information through the right channels will fortify them against misconceptions such as using antibiotics as a form of contraception. It will also build a culture of trust between young people and Nigeria’s health system, a potential game changer in the provision of sexual and reproductive health services for the nation’s youth.
Do you feel enough is being done to empower young people with sexuality education? What more do you think needs to be done? Please share your views with us.