In pain and overdue for a dose, Grace Kudzu (35) prepares to inject herself with 100mg of tramadol in the front seat of a friend's car. She explains that she prefers to be seen to by a medical professional, but sometimes injects herself of necessity when this is not practical.
Grace suffers from sickle cell disease, during a 'sickle cell crises', which in Grace's case may occur twice a month and last a week or more, she is heavily dependent on the opioid painkiller tramadol. However, because illicit and falsified tramadol is widely abused for non-medical purposes in the region, consideration is being given to scheduling it internationally in the manner of other opioid analgesics such as morphine. Some experts are of the opinion that this will further reduce the already limited pain management options for people like Grace, while doing little to curb illicit use.