India bans two opioids behind crisis in West Africa

Indian authorities have banned two highly addictive opioids in response to a BBC investigation that uncovered their role in fueling a public health crisis in parts of West Africa.

In a letter reviewed by the BBC, Dr. Rajeev Singh Raghuvanshi, India's Drugs Controller General, confirmed the withdrawal of permission for the manufacture and export of these drugs.

The BBC's "Eye" investigation revealed that Aveo, a pharmaceutical company, had been illegally exporting a dangerous combination of tapentadol and carisoprodol to countries like Ghana, Nigeria, and Côte d'Ivoire. Following this, India's Food and Drug Administration raided the company's Mumbai factory and seized all its stock.

The ban, effective immediately, was issued based on Dr. Raghuvanshi's circular dated Friday. It highlighted the BBC investigation and the concerns over the drugs' potential for abuse and their harmful impact on public health.

Tapentadol is a potent opioid, while carisoprodol is a muscle relaxant so addictive that it is banned in Europe. Though approved for short-term use in the U.S., carisoprodol can lead to withdrawal symptoms such as anxiety, insomnia, and hallucinations. The combination of these drugs is not authorized anywhere globally due to the severe risks, including breathing difficulties, seizures, and the potential for fatal overdose.

Despite these dangers, the opioids have become popular street drugs in many West African nations, largely due to their low cost and easy availability.

Export records reveal that Aveo Pharmaceuticals, along with its sister company Westfin International, has shipped millions of tablets to Ghana and other West African countries.

The BBC World Service also discovered packets of these pills, bearing the Aveo logo, being sold on the streets in Nigeria and towns across Côte d'Ivoire.

Nigeria, with a population of 225 million, represents the largest market for these opioids. The country's National Bureau of Statistics estimates that around four million Nigerians are affected by opioid abuse.

As part of its investigation, the BBC sent an undercover operative—posing as an African businessman seeking to supply opioids to Nigeria—into one of Aveo's factories in India. There, they captured footage of Aveo's director, Vinod Sharma, showcasing the same dangerous products that were found being sold across West Africa.

In the secretly recorded footage, the undercover operative tells Vinod Sharma that he plans to sell the pills to teenagers in Nigeria, "who all love this product." Sharma responds with an "OK" before explaining that taking two or three pills at once will help users "relax" and admitting they can get "high."

As the meeting concludes, Sharma acknowledges the dangers of the product, stating, "This is very harmful for the health," but adds, "nowadays, this is business."

Both Sharma and Aveo Pharmaceuticals did not respond to the BBC's request for comment when the investigation was first published.

In a statement on Friday, India's Food and Drug Administration revealed that a sting operation had led to the seizure of Aveo's entire stock, with production now halted. The agency announced that further legal action would be pursued against the company.

The FDA also stated that it is "fully prepared" to take action against anyone involved in "illegal activities that tarnish the reputation of the country" and has been instructed to carry out additional inspections to prevent the continued supply of these drugs.