At midnight, Magreth Isaya (not her real name), a 40-year-old mother of one, began suffering from severe stomach ulcer pains. That night, she was rushed to hospital for treatment, where doctors administered a Tramadol injection to relieve her pain.
Magreth says she felt better after receiving the injection and was discharged three days later. However, about a month later, the severe stomach pains returned.
“I went back to the hospital and they injected me with Tramadol again and also gave me tablets. They gave me enough for five days and told me that whenever I felt pain, I should take one tablet twice a day, in the morning and in the evening,” she says. “So I received the injection and the tablets and then went back home.”
Tramadol is a pain-relief medication used to treat moderate to severe pain. It is commonly prescribed for patients suffering from cancer, sickle cell disease, and other illnesses that cause intense pain. Because of the immediate relief she experienced after using Tramadol, Magreth gradually turned its use into a habit. She no longer followed doctors’ instructions.
“Whenever I felt pain, I would just take the tablets. I realized that when my ulcers hurt, I could simply go and buy Tramadol and feel better,” Magreth told The Chanzo on January 19, 2026.
“Later on, I started going to buy the tablets on my own. Every day I would buy five tablets for 1,000 shillings. Instead of taking one tablet, I began taking two.”
“I would take two tablets in the morning and two in the evening, and I stopped going to the hospital altogether. Once I took the tablets, the ulcer pain disappeared completely. So I kept going to the pharmacy to buy them and taking them every morning and evening. “When I woke up, the first thing I had to do was take two tablets,” she explained to The Chanzo.
Addiction
Magreth recalls an incident when she took her mother to hospital. After observing her physical appearance, the doctor told her that she seemed to have a health problem.
“The doctor told me that I had a problem. I said I was fine, but he asked me to look at my hands and asked why they had unusual marks,” Magreth recounts. “I told him that it was true I had been receiving injections because I suffer from stomach ulcers. He asked which injection, and I told him Tramadol. He then asked me if I knew the side effects of Tramadol.”
“He told me that Tramadol is good medicine, but once you get used to it, it becomes addictive and you cannot stop using it. He said I had to stop the injections immediately. I told him I would not be able to, because the drug was giving me relief.”
Magreth recalled how she became dependent on Tramadol in order to function. Not a single day passed without using the drug.
“You cannot live without those medicines. You have to take the injection to feel okay and be able to work. Without Tramadol, I could not do any work at all. I would become angry and irritable. The doctor told me that I was lucky to come early, if I had delayed, I could have ended upeven using illicit drug, a pattern that was noted from many people,” she says.
In an effort to overcome the condition, Magreth was referred to a Pharmaceutical Technician for further treatment.
“After going there, I was told to return on Monday to begin treatment. I went to Itega, where they received me and explained the whole process. They tested how much Tramadol was in my body and then I started taking medication. I was very afraid. I did not know if I would manage to go even one day without using Tramadol,” she explains.
Magreth began using Tramadol in 2022 and stopped in 2025. At her peak, she spent between 10,000 and 15,000 shillings per day on Tramadol, compared to about 2,000 shillings when she first started.
Tramadol is one of the pain-relief medicines with addictive properties. When used without a doctor’s supervision or taken irresponsibly, it can cause effects similar to those experienced by users of illicit drugs. According to a 2023 report by the Tanzania’s Drug Control and Enforcement Authority, Tramadol has also been used by drug users as a substitute when they are unable to obtain illicit narcotics.
Silent Crisis
Bahati Simon (not her real name), 28, also used Tramadol for a period of 11 months. She began using the drug after undergoing an appendectomy.
“After the operation, I experienced severe pain. At first, I was given the medicine as a painkiller. But later the pain became more intense, and I started using Tramadol frequently to help relieve it,” she told The Chanzo on January 26, 2026.
Bahati initially took two Tramadol tablets a day, but her use escalated to as many as 10 tablets at once. “As time went on, ordinary painkillers no longer worked. The only medicine I could take when I was in pain was Tramadol. The real difficulty comes in the morning when you wake up and want to start working — you cannot work or touch anything unless you have taken the drug.”
“What happens to your body is that it feels as if it is burning, with pain in the legs. Even the mind becomes exhausted; your head feels heavy and cloudy,” she explains.
Bahati admits that Tramadol is sold freely, especially in some small pharmacies. “Pharmacies sell it secretly. When you go there, they don’t ask you anything, they just give it to you. Only a few, especially the big pharmacies, ask for a doctor’s prescription,” she says.
“We should not use medicine carelessly. Tramadol is dangerous and harmful. I lost weight and became very thin. When you use this drug, you lose your appetite completely. For us women, when trying to conceive, it causes hormone imbalance. It disrupts your life in many ways.”
A 2025 report by the United Nations Office on Drugs and Crime found that the non-medical use of Tramadol remains a serious problem, with West and Central African countries being the most affected in Africa. Tanzania governmnet in its report , noted a sharp increase of the use of Tramadol in the country.
On social media platforms, including Jamii Forums, many people have come forward to complain about addiction to Tramadol. In most cases they don’t describe or note the addiction, by the explains symptoms of dependence without realizing that they are already suffering from addiction. This has made the crisis a “silent crisis,” particularly because the drug is commonly used for legitimate medical treatment.
The Chanzo Investigation
On January 25, 2026, The Chanzo journalist Jackline Kuwanda conducted an investigation in the Dodoma region, where she visited several pharmacies to assess how Tramadol is being sold.
She inspected about five pharmacies located in densely populated residential areas, with the aim of observing firsthand how Tramadol is dispensed. At around 9:00 a.m., she entered one pharmacy posing as a patient seeking the drug.
“Good morning, How are you? Can I get Tramadol?”
“Yes, it’s available.”
“How much is it?”
“One pack is 2,000 shillings.”
“Is it for your own use?”
“Yes.”
“Were you prescribed how to take it — twice a day or three times?”
“I wasn’t prescribed, but I was advised to look for it.”
“Then take one tablet in the morning and one in the evening.”
The journalist was not asked to present a doctor’s prescription. The seller went straight to the medicine counter, provided the drug, and gave instructions on how to use it.
At the next pharmacy, after being told that the customer wanted Tramadol, the pharmacist looked at her and quietly asked, “Do you have a prescription?” She replied that she did not.
“Are you the one who will use it?”
“Yes.”
The pharmacist then gave her the medicine and explained how to use it when asked.
“How should I take it?”
“Twice a day.”
“In the morning and in the evening?”
“Yes.”
However, not all pharmacies dispensed the drug freely. Some adhered to professional ethics.
“Can I get Tramadol?”
“Yes, Tramadol is available.”
“How much is it?”
“2,000 shillings for 10 tablets.”
But when the journalist told the pharmacist that she did not have a doctor’s prescription, the pharmacist refused to sell the drug.
“Is your pains so severe that you need Tramadol? Tramadol is sold only under special conditions, meaning a doctor must prescribe it. These drugs can make a person addicted. Once you get used to Tramadol, you may find that your mind sometimes does not function properly,” the pharmacist warned.
Out of the five pharmacies visited by the The Chanzo journalist, only two required a doctor’s prescription and explained the potential dangers of using Tramadol.
The poor man’s cocaine
As non-medical use of Tramadol has grown into a major public health crisis, people in West Africa have nicknamed the drug “the cocaine of the poor.” This is due to its low cost, easy availability, and severe effects—comparable to cocaine when used irresponsibly without professional medical guidance.
Steward Njangaje, a pharmaceutical technologist, told The Chanzo on January 16, 2026, that one of the main drivers of Tramadol misuse is commercial interest combined with low public awareness.
“Many people go to drug shops and buy it without realizing that it should only be obtained through a doctor’s prescription. When they use it for a long time under such uncontrolled conditions, they develop addiction. This ends up causing serious harm to the human body, especially the brain,” Njangaje explained.
“Sometimes it is because the owner of a pharmacy pressures professionals to sell the drug without prescriptions. In the end, this creates a very serious problem.”
In Tanzania, about one million people each year seek treatment at various centers for addiction to narcotic drugs and addictive medical substances. Njangaje is one of the practitioners working at such facilities and shared his experience.
“I work at a national drug addiction treatment center called Itega. The government has established a system to treat people who have been affected by these drugs,” he said.
“We continue to provide these services, and we have many patients who are suffering from Tramadol addiction. We are treating them so that they can recover from these challenges.”
At the time of the interview, Njangaje was attending to about 20 patients who had come specifically for Tramadol addiction treatment.
“The government is urging health professionals to prescribe these medicines carefully. It is also educating citizens not to use these drugs carelessly. If there is a real need to use them, they must be prescribed by a doctor and all proper procedures must be followed,” he emphasized.
