Confronting the KUSH Crisis in Sierra Leone: Strategies for Intervention and Prevention
The parliamentary public hearing (held on 18 March 2024) to discuss the Kush crisis in Sierra Leone was a welcome move towards a unified battle against this epidemic. Representatives from the Government included the Inspector General of Police (William Fayia Sellu), Commissioner General of the National Revenue Authority (Jeneba Kpaka-Bangura), Executive Director of the National Drug Law Enforcement Agency (Andrew Jaiah Kai Kai), the Ministry of Health, and the Chief Medical Officer. This hearing came in response to the extensive public outcry calling on the government to give attention to this social, economic, and public health problem that is taking the country by storm.
What is KUSH?
Kush is a synthetic psychoactive substance (drug) that is a crushed dried leaf mixed with a cocktail of chemicals. Also known as “Spice” and “Jagaban” on the streets of Sierra Leone, a single puff of the smoking substance is enough to get someone high, which lasts only few minutes.
The Kush (also called K2) that is made in Sierra Leone is composed of a mixture of cannabis/marijuana (locally grown in the country); fentanyl (an extremely potent opioid, likely originating outside the country); tramadol (another opioid, originating from illegal labs in Asia); formaldehyde (known to cause hallucinations); Acetone and Marshmallow (also sourced from outside the country).
In addition to these chemicals, there is a controversial claim that ground human bones, stolen from graveyards, are part of the mixture for some of the Kush being sold on the streets.
The rumor is that human bones contain a concentration of sulfur which can make someone high when inhaled in high amount. However, there is no evidence to suggest this is true. In fact, inhaling or smoking sulfur could lead to sulfur dioxide poisoning.
Kush is very cheap. It is estimated that a roll of Kush (called a joint) costs around 5 Leones (equivalent to $0.25 cents USD and £0.20 pence GBP). This makes it affordable when compared to other drugs. Kush is now called “King” of the street as it has overtaken other illegal street drugs that are more expensive like Tramadol.
For example, a recently published study that examined substance abuse among commercial motorbike riders in the Kambia District found that Kush (29.1%) and marijuana (22%) are the two most commonly abused drugs.
While it is widely available and manufactured, the origin of this potent drug remains a mystery. But one thing is clear: Kush came to the spotlight about six years ago. Government officials believe the raw materials used to make Kush are coming from outside the country.
Cross-border Issues
Sierra Leone has the highest prevalence of Kush utilization in the Manor River Union (comprising of Sierra Leone, Liberia, Guinea, and Côte d’Ivoire). The use of Kush is two times higher in Sierra Leone than any country in the region.
Guinea and the Gambia have accused Sierra Leone of contributing to the prevalence of Kush in their countries. Liberia is also experiencing a rise in Kush usage.
While more needs to be done now to deal with the Kush epidemic in Sierra Leone, neighboring countries also need to work harder to stem drug trafficking. This is very challenging due to the porous nature of the borders and lack of political will to do so. If this issue is not tackled, West Africa is at high risk of having a regional problem with Kush.
Impact on Users and the Country
The Kush epidemic has the potential to severely impact the country’s development. Drug abuse imposes economic, health, and social costs on the individual users, their families and communities, as well the social fabric of society and the economy as a whole.
Kush is destroying the youth of the country who should be future doctors, lawyers, school teachers, bankers, engineers, political leaders, entrepreneurs, parents, and thus productive members of society. Sierra Leone’s population is young with a median age of 18.5 years, therefore, addressing the Kush crisis will determine the future of the country.
Effects on the Human Body: Physical and Mental Well-Being
- It is estimated that about a dozen people (mainly youth aged 18–25 years old) die on a weekly basis with thousands being hospitalized. The only psychiatric hospital in the country — The Sierra Leone Psychiatric Teaching Hospital in Freetown — estimates that about 85% of its patients are Kush users.
- The side effects of getting high from Kush include falling asleep while walking, falling over, banging one’s head against hard surfaces, walking into moving traffic, dizziness, headaches, drowsiness, acting abnormally, and self-injury. Using Kush also leads to a pounding sensation in the head and pain in the neck and joints.
- Kush can weaken the immune system, which puts users at risk of other health problems. Many users complain of sores; severe swelling in the feet and lower legs; and liver, kidney and respiratory problems.
- Kush also disturbs mental health, causing anxiety and depression.
While the overall impact on the individual user varies based on the Kush content, these are the effects of the different mixtures:
- Cannabis induces euphoria, relaxation, and altered consciousness.
- Fentanyl causes euphoria, confusion, and sleepiness.
- Tramadol results in feeling spaced-out, disconnected, and sleepy.
- Formaldehyde (which can also be listed as Formalin, a toxic chemical commonly used to preserve bodies in mortuaries), can cause hallucinations.
When a Kush joint contains a combination of these chemicals, it becomes dangerous and fatal as a result of the combined side effects kicking in at once.
Sierra Leone: Trapped by highly addictive drug ‘kush’, youth is ‘dying’ (youtube.com)
Destruction of Individuals and Families
- Like most drugs, using Kush has resulted in a severe addiction crisis. Addiction leads to other malpractices. For example, the requirement to finance this addiction is often achieved through prostitution and criminal activities such as robbery, or misuse of money intended for school lunch and school fees. Instead of using the money that parents give to their children to buy food, some use it to buy Kush. This in turn leaves them hungry, which exacerbates the effect of the drug on their body.
Social disruption
- Kush robs the users from their livelihoods and results in lost dreams (education, careers, productivity), as well as incapacitating young people to the point where they are not able to live a normal life.
- Kush destroys families and creates friction between loved ones. For example, parents cast away their children because of Kush. This has resulted in hundreds of young people, if not thousands, becoming homeless, living on the streets and in public marketplaces like Bombay, Mabayla, and Mamba Ridge PWD east end in Freetown.
- Sadly, girls are forced to sell sex to make money to buy Kush. Some have reported gender-based violence such as rape and physical abuse.
With all the negative consequences that stem from Kush, one begs the question why so many young people in Sierra Leone choose to go on this destructive path. At the heart of this problem is youth marginalization that characterizes the lives of young people. As a result, young people have developed coping strategies to help weather their daily struggles, including expressive popular culture, migration, entrepreneurship, as well as the use of illicit substances.
Young people use drugs to help them escape social and economic problems. Most youth reported that the lack of job opportunities plays a significant role in their need to look for something that can help them deal with the severe stress and depression that comes with being jobless and not being able to take care of themselves and/or their family. It is estimated that 60% of youth in the country are unemployed, which is one of the highest unemployment rates in West Africa.
Young people feel hopeless in that there is nothing for them to do to help contribute to their own livelihoods and to that of their families. So, Kush serves as a gate-way to relieve their stress. Many users reported that Kush takes them to a happier place. One user said: “Kush takes you to another world, where you don’t know yourself.” Even some Kush dealers blame the lack of jobs as the main reason for selling the drug. It is the only means for them to survive and make money.
Current Actions to Tackle the Kush Problem
While multiple public agencies are attempting to fight the Kush epidemic, there needs to be a nationwide coordinated effort to effectively tackle this issue. Here are ways some institutions are contributing to the fight against Kush.
- The Sierra Leone Police continue to arrest and raid places suspected of dealing in Kush. So far, more than 100 drug users and dealers have been convicted, with dozens of cartels shut down by police across the country. However, corruption within the police force is hampering their efforts. It is well known in Sierra Leone that many police officers receive bribes, while others use the same illegal drugs they are supposed to fight against.
- The national Drug Law Enforcement Agency raids places suspected of housing Kush and arrests drug dealers. They also engage in community outreach. But their enforcement is not successful as evident by the increasing trend of Kush usage. The lack of adequate resources (personnel, logistics, and finance) is blamed for the shortcoming of the agency.
- The Sierra Leone Psychiatric Teaching Hospital in Freetown is treating youth affected by Kush and is planning to provide drug detox in the near future.
- The City of Rest Rehabilitation Centre provides addiction services to young people affected by Kush. However, the demand for their services is beyond capacity due to limited resources and personnel.
- The Mental Health Coalition provides counselling services and also refer patients for medical treatment when needed.
The country as a whole suffers from an extremely limited supply of capacity for drug treatment and rehabilitation. Moreover, there is an uncoordinated response from the government. This was evident in the public hearing that Parliament held on 14 March 2024. Representatives of the agencies blamed each other for the ineffective response to the fight against Kush. For example, the Inspector General of Police accused the Judiciary of Sierra Leone for lack of effective enforcement of the law against drug dealers, whereas the National Drug Law Enforcement Agency noted the lack of resources, which hampers its efforts to do its job.
Government agencies need to coordinate their activities. Such coordination could be spearheaded by the National Drug Law Enforcement Agency and/or the Ministry of Health. The Ministry of Information and Civic Education could facilitate a massive nationwide public awareness and social mobilization for a holistic sensitization campaign to foster knowledge and empowerment of families and communities across the country to help with the fight against Kush. Parliament should continue to provide oversight of public agencies and provide funding to help secure the needed resources and logistics necessary to address the Kush problem.
A Holistic Approach to Address the Kush Epidemic
There is hope in this sad story of Kush. Most of the addicted users want to heal from addiction and return to their normal lives. But they cannot do this on their own. This is where the country must step in to fight this epidemic.
Sierra Leone needs to take a multi-sectoral approach to defeat Kush. This approach must consist of community health/social workers led by the Ministry of Health; The Media (for public awareness/education); Civil society organizations; The Government through policy, drug enforcement, expertise and resources, and funding for therapy/rehabilitation services; and nationwide community engagement (families, community and religious leaders).
Addressing the rampant addiction among young people requires clinical intervention and social support. Without social support, it would be impossible to rehabilitate the individuals addicted to this potent drug. There needs to be a concerted effort to engage families and communities on the benefits of providing support to addicted individuals, rather than casting them out of the family unit.
Parents need to be empowered and educated on the issues of addiction, so they can be part of the solution in saving their children and loved ones from addiction. A recent study conducted by a lecturer at the University of Sierra Leone (Fourah Bay College) on the sociology of the use of narcotics in the country, including Kush, concludes that a multi-stakeholder response is critical to dealing with the substance abuse crisis plaguing the country. However, this can be a challenging task, mainly because drug use is not commonly accepted by family members in this part of the world. This is a result of religious and cultural beliefs and the illegality of substance use.
Sierra Leone needs to take a carrot-stick response. This means that drug dealers and importers should face the full force of the law because they are the ones inflicting this debilitating harm on people and the country. But individual users who fall victim to Kush should not be punished. Instead, they should be treated for their addiction. This problem cannot be resolved by imprisonment. The focus should be on providing rehabilitation and counselling services to the addicted youth.
Most importantly, former Kush users who have successfully overcome their addiction can play a significant role to create public awareness about the dangers of this drug. They can show other users that it is possible to be treated and return to normal life. They can become trusted messengers and ambassadors for the fight against Kush in their respective communities and towns.
Finally, the country needs to urgently address the root cause of the Kush epidemic. Some solutions include fostering youth employment opportunities, skills training, active engagement in civic and political decision making, as well as youth engagement at all levels of society. We need to end the marginalization of young people, lest we are only waiting for a newer drug to emerge and be abused by young people. Addiction to Kush is a public health and social problem that requires a holistic approach to resolve it. As the common saying in Sierra Leone goes “We are a resilient people.” But resiliency cannot last forever. We cannot continue on this destructive path. We MUST ACT now.
