“Here in Ghana hard work don’t deserve money”: The uncertainty and precarity of youth who use tramadol

Abstract

There has been a global rise in problematic non-medical use of prescription medication. In West Africa, recent media reports have highlighted increases in the use of tramadol especially among youth. In Ghana, current framings of this issue have described the (ab)use of tramadol as symptomatic of moral laxity among youth. Several academic and media publications portray tramadol use as a form of deviance by youth while ignoring structural drivers of abuse. Through a Ghanaian case study, this research briefly explored media framings of tramadol abuse vis à vis the lived experiences of youth who currently use tramadol. Through a discourse analysis of 295 media articles and 15 interviews (11 with youth who use tramadol and 4 with health system stakeholders), this study drew on the theoretical perspective of structural violence and key theoretical literature on precarity, uncertainty and anxiety in Africa to describe the contexts that fuel tramadol use among youth. The evidence reveals that while government responses to tramadol use have focused mainly on arrests and victim blaming, poor conditions of work, weakened social and health systems due to neoliberal transformations and anxiety and uncertainty also explain tramadol use. A policy reorientation towards establishment of rehabilitation facilities, improving the living conditions of vulnerable youth and improved working conditions should be considered in responding to problematic use of tramadol among youth as these social factors rather than moral deviance resonate with the lived experiences of youth who use tramadol.