Several West African countries have reported that tramadol is one of the most widely used drugs for non-medical purposes after cannabis, which remains by far the most popular globally. 

“Some consume tramadol for its calming, analgesic and anti-fatigue effects in order to improve intellectual, physical and working performances, and to lessen the need for sleep and decrease appetite,” the report said.

“In farming communities, there are reports of tramadol being used by humans and fed to cattle to enable them to work under extreme conditions. Others use tramadol as a recreational drug on account of its stimulant and euphoric effects, or to improve sexual stamina.”

The U.N. Office on Drugs and Crime said that in 2017 the estimated number of people using opioids – an umbrella term for drugs ranging from opium and derivatives such as heroin to synthetics like fentanyl and tramadol was 56% higher than in 2016.

Surveys in Nigeria and India, also highlighted the scale of the problem despite a drought-related fall in opium production last year in the world’s biggest producer, Afghanistan.

Synthetic opioids like fentanyl continue to be the main cause of opioid overdose deaths in the United States, which rose 13% to more than 47,000 in 2017, further illustrating what President Donald Trump has declared a public health emergency.