Drug Abuse Among People With Disabilities: The Hidden Crisis Nigeria Is Yet to Address.

By George Omagbemi Sylvester | Published by saharaweeklyng.com

“Neglect, stigma and policy gaps are fueling substance misuse among Nigeria’s most vulnerable and silence is costing lives.”

 

Nigeria likes to talk about inclusion, but talk without action has a human cost and one that is rarely counted. Behind closed doors and in the margins of health statistics, drug and substance misuse is wreaking havoc on people with disabilities (PWDs) across the country. This is not an unfortunate footnote; it is a predictable outcome of exclusion (social, medical and legal) that we have chosen to ignore.

Global and local evidence points to the same uncomfortable truth: people with disabilities are at higher risk of substance use and are less likely to receive appropriate treatment. International studies show that adults with disabilities report disproportionately high rates of substance use and adverse mental health symptoms compared with their non-disabled peers. These patterns are mediated by chronic pain, untreated mental-health disorders, social isolation and poverty with all conditions common among Nigerian PWDs.

Why this happens is painfully simple. Many people with disabilities live with chronic pain or long-term health conditions for which medication is necessary; others face untreated depression, anxiety and trauma. When health systems are inaccessible, poorly resourced, or openly hostile, self-medication becomes an easy (and dangerous) option. Add stigma and social exclusion and the risk escalates: illicit substances, alcohol, codeine-laden cough syrups and diverted prescription drugs become stopgap “TREATMENTS” for pain, loneliness and despair. The World Health Organization explicitly warns that persons with disabilities are more likely to face risk factors for tobacco, alcohol and drug use because they are often left out of public health interventions.

In Nigeria the problem has particular features. National-level surveys and UN estimates indicate that drug use is widespread in the country: a sizeable share of Nigerians between 15 and 64 (measured in millions) are affected by drug misuse, and substances such as tramadol and codeine-based syrups have become common in both urban and rural settings. Meanwhile, enforcement-focused headlines about drug seizures and legislative crackdowns obscure the human reality: far too many people who need treatment cannot access it. UN reporting notes that globally only about one in eleven people with drug use disorders receive treatment — an equity gap that hits PWDs especially hard.

There are three converging failures driving this hidden crisis in Nigeria.

1. Health systems and services are inaccessible or ill-equipped.
Rehabilitation, mental-health care and substance-use treatment services in Nigeria are chronically underfunded and concentrated in a handful of urban centres. Even where services exist, they are rarely adapted for persons with sensory, cognitive or mobility impairments — meaning that facilities, intake procedures, therapy methods and communication approaches exclude those who most need help. Research in multiple settings has shown that substance-use screening and treatment must include disability accommodations and comprehensive pain management; otherwise, PWDs fall through the cracks.

2. Stigma and social isolation push vulnerable people into substance use.
Violence, neglect and discrimination against children and adults with disabilities are well documented. International studies report alarmingly high rates of abuse and neglect of disabled children and teenagers — environments that predispose survivors to substance misuse later in life. In Nigeria, cultural stigma combined with poverty and lack of social protection amplifies the risk: ostracised individuals may turn to substances to cope with trauma and exclusion.

3. Policy and legal frameworks exist but are not implemented or aligned.
Nigeria’s Discrimination Against Persons with Disabilities (Prohibition) Act 2018 created legal obligations to integrate and protect PWDs. That law, however, has not been matched by robust investment in disability-aware mental-health services, nor by targeted substance-use programs for PWDs. At the same time, the country’s current public conversation often leans toward punitive measures against drug offenders rather than public-health strategies that address addiction as a medical and social problem. Recent moves in the legislature to stiffen criminal penalties for trafficking, while addressing supply-side harms, risk further marginalising people who need treatment rather than punishment.

What must be done is clear, if politically uncomfortable: treat this as a public-health and human-rights emergency, not an embarrassing exception to be hidden.

First, expand access to disability-inclusive treatment. Health facilities and substance-use programs must be made physically and clinically accessible. That means ramps and sign-language interpretation, yes — but also adapting clinical screening tools, counseling approaches and pain-management strategies to different impairment types. International evidence shows that substance-use interventions that account for pain and comorbid mental disorders reduce misuse and improve outcomes; Nigeria must tailor these approaches and scale them beyond elite urban clinics.

Second, invest in community-based prevention and social protection. Poverty, unemployment and social isolation are key drivers. Cash transfers, supported employment schemes, community rehabilitation programs and family support can reduce the conditions that lead people to self-medicate. Civil-society organisations and disabled-persons organisations (DPOs) are best placed to guide culturally appropriate prevention work — they must be funded and partnered with, not sidelined.

Third, collect the right data. You cannot manage what you do not measure. National surveys and drug-control reports must disaggregate by disability status, impairment type and gender. That data gap means policymakers have no reliable estimate of the scale of the problem among PWDs — and therefore no political imperative to act. Recent Nigerian and international studies give us indications; what we need is systematic, routine surveillance integrated into national drug and health surveys.

Fourth, shift from punishment to treatment. Public policy must rebalance from criminalisation toward evidence-based treatment and harm reduction. Where trafficking and organised crime require law enforcement, do so — but not at the cost of denying care to people with addiction who are also living with disabilities. The human-rights implications of mandatory incarceration for people with mental-health comorbidities must be taken seriously.

Finally, we must break the silence. Families, communities and politicians treat disability as a private tragedy. Addiction among PWDs becomes doubly invisible: the stigma of disability plus the stigma of drug use. Nigeria’s media, universities and policy forums must expose this reality and hold leaders accountable for the gap between the law’s promise and the lived experience of millions.

To the policymakers reading this: the Discrimination Against Persons with Disabilities Act 2018 is not a placard to be posted on ministry walls — it is a legal platform that demands resources, enforcement and services. To the NDLEA and health ministries: seize the moment to partner with DPOs, donors and community groups to pilot disability-inclusive treatment models that can be scaled nationwide. To civil society: press for data, for pilots and for funding that reaches grassroots organisations.

Addiction among people with disabilities is not a “special interest” issue — it is a test of our humanity. If a nation claims to value inclusion, then it must protect the most vulnerable from a tide of substances, neglect and institutional failure. Anything less is hypocrisy.

If Nigeria does not act, the toll will grow: more lives shortened, families broken and talents wasted. But if we choose compassion, transparency and evidence, we can transform a hidden crisis into a model of inclusive care. The legislation is on the books; now let our actions prove that we meant it.