Inside the ‘zombie’ drug epidemic sweeping West Africa
Experts say kush, a synthetic, cannabinoid-like drug is as dangerous as heroin and cocaine – and it’s killing around a dozen users a week
Those that have yet to reach this catatonic state pass a joint between themselves. It’s a mixture of opioids, cannabis, disinfectant and, locals say, ground-down human bones that have been dug up from graves. They inhale the fumes, slowly breathe out, and wait for euphoria’s embrace.
Amara Kallon, a 21-year-old school dropout, is among the addicts here. He comes daily for his hit of “kush” – a synthetic, cannabinoid-like drug that is sweeping through the youth of Sierra Leone’s capital. It induces a long-lasting, hypnotic high which can detach users from reality for several hours.
“When I smoke kush, I forget my problems. It usually takes me to ecstasy,” says Amara, who is homeless.
“I used to smoke a couple of slings of marijuana a day but after I was introduced to kush by friends, I never turned back. I sold my clothes and books to satisfy my addiction. I started stealing house-hold items, phones, pots and dishes to buy drugs.”
Kush first emerged in Sierra Leone half a dozen or so years ago. Manufactured and distributed by criminal gangs, the drug typically costs 5 leones (20p) per joint – though many users will spend around £8 a day, a small fortune for a country with an average per capita income of under £400 a year.
The composition of the drug varies from place to place. Fentanyl and tramadol are said to be ingredients, as is formalin, a disinfectant. There are also several media reports of human bones being crushed up and added to kush, though there is no evidence to substantiate this.
The drug has become commonplace across Sierra Leone, with whole neighbourhoods and communities addicted to the narcotic. But putting a precise figure on usage rates is difficult.
The Sierra Leone Psychiatric Teaching Hospital in Freetown says it has been overwhelmed with addicts in recent years. The number of referrals keeps rising on a daily basis, and many are sedated upon arrival at the facility due to their violent tendencies.
“We have already recorded nearly 2,000 cases of kush addicts in 2023 at the hospital. Many are dying in homes and on the streets,” says Dr Jusu Mattia, acting medical superintendent at the centre. In 2020, it identified 47 people as users. In 2022, it was 1,101. Most of the patients are men between 18 and 25.
“The kush drug crisis is everywhere, but only a few are referred and most of those treated end up relapsing,” adds Dr Mattia.
The Teaching Hospital provides isolation treatment, which lasts between three to six weeks, and antipsychotic drugs to help wean patients off their addiction. But it is the only facility of its kind offering active care to kush patients in Sierra Leone.
Indeed, there are just five psychiatrists in the entire country, home to roughly 8.4 million, according to the World Health Organisation, making it impossible to tackle the spiralling epidemic.
Sierra Leone’s youth unemployment rate – which stands at 60 per cent, one of the highest in the world – is further compounding the issue, experts say. Jobless people like Amara are turning to kush in order to “escape the harsh realities of life”.
“I love it,” he adds. “It makes me feel happy for a moment, enough to forget my worries and societal problems.”
As ‘dangerous’ as heroin or cocaine
For some users, kush addiction can fuel serious psychiatric issues. There have also been reports of people developing swelling and infections, leading to open wounds on their legs, but there is no clear medical explanation for this.
The drug can also prove fatal. When high, users have been known to bang their heads repeatedly against walls, walk into traffic or fall from high places. Amara has lost several of his friends and relatives while high on kush, including one who fell over and hit his head on a rock – a blow which killed him.
There is no official data available for deaths related to the drug, but health experts estimate around a dozen kush users die weekly in Sierra Leone, with their bodies often recovered from the streets and slums.
But it’s not just Sierra Leone which is grappling with the fallout from kush. A wave of addiction is slowly moving across West Africa, with the horrors of Freetown now being repeated in the urban centres of Liberia and Guinea. Estimates suggest more than a million people from the region are now addicted.
“Kush is a very dangerous drug like heroin or cocaine, it’s strong, cheap and easily available, there is weak regulation and control over the sale of the drug and it’s becoming widespread in West Africa,” says Dr Edward Nahim, a consultant psychiatrist at the Sierra Leone Psychiatric Teaching Hospital.
“The lack of jobs and opportunities is a driving force leading many youths into drug addiction after the disruption of economies by the Covid pandemic.”
Like in Sierra Leone, unemployment among the young is fuelling addiction in Liberia. Yet the high prevalence of post-traumatic stress disorder in the population – an estimated 3.4 people suffer from the condition, a by-product of the nation’s bloody civil war throughout the 1990s – is also a factor.
Liberia’s limited health resources – practically non-existent in parts of the country – have been unable to accommodate this huge psychological need. Many have subsequently turned to kush instead.
The country’s struggles with the drug have notably turned political. During the nation’s recent election campaign, outgoing president George Weah, the former AC Milan and Chelsea footballer, was accused of tolerating the use and sale of the drug in the country.
“Weah lost the election to Joseph Baokai [the next president] partly because of the drug problem and the rampant corruption,” says Emmanuel Degleh, a local journalist based in Monrovia, the capital of Liberia.
His government has done very little to address the crisis, adds Degleh. In 2021, just US$20,000 from Liberia’s annual budget is alleged to have been spent on mental healthcare provision. This funding was channelled into the ES Grant Mental Health Hospital, a psychiatric facility in Monrovia.
There are a handful of other organisations dedicated to providing short-term rehabilitation and integration programmes, but it’s simply not enough in the face of a mounting drugs epidemic.
“Liberian youths need help to address the social and economic problem which is the leading cause of the widespread use of drugs,” says Degleh. “Government intervention is critical in supporting the rehabilitation and integration of addicts to become useful citizens in society.”
Guinea is similarly battling to contain a large increase in the consumption of kush over the past three years, according to the country’s health ministry.
As with Liberia and Sierra Leone, the nation’s healthcare services are severely limited – there is just one specialised centre, based in Conakry, the capital of Guinea, that provides treatment for alcohol and drug abuse.
Authorities in Guinea claim the kush drug is imported into the country from Sierra Leone through porous borders.
According to police sources, several vehicles have been intercepted attempting to cross the border between Sierra Leone and Guinea laden with a substantial amount of narcotics, specifically kush and cannabis hidden in garri bags and palm oil containers.
Sierra Leone’s Kambia district, which runs along the border with Guinea, has emerged as a notable hotspot for the trafficking of drugs and is becoming a key point of focus for local police.
Across Sierra Leone, more than 100 drug users and dealers have been convicted, with dozens of cartels shut down by police.
But Dr Mattia said that “the issue of youth intoxicating themselves with kush is not a criminal justice problem, but rather a health and social related problems that need to be addressed holistically”.
In November, government officials, religious leaders, civil society groups and youth-focused organisations met at a Freetown hotel to develop a workable and more responsible solution to Sierra Leone’s drug crisis.
During the UN-sponsored meeting, Melrose Karminty, the Minister of Social Welfare, revealed that the government was seeking to decriminalise and rehabilitate users, rather than punish them.
“The government plans to establish a rehab centre to support the rehabilitation of and recovery of substance abuse victims,” she told the audience gathered at the New Brookfields Hotel.
“We want to give meaningful life to victims after they have been treated and institute remedies to rehabilitate and reintegrate them into their respective communities.”
But whether such measures will ever come to fruition and drive meaningful change, remains to be seen.
Among the testimonies given during the meeting was Mohamed, who said he had quit his job, withdrawn his savings from the bank, sold his property, and abandoned his wife and children to satisfy his addiction to kush.
“Our youths are suffering, many are dying in isolation,” he said. “We need help.”