In Nigeria’s public hospitals, the management of pain has become one of the most overlooked aspects of healthcare. Patients undergoing cancer treatment, recovering from major surgery, or facing terminal illness are often left in avoidable agony, not because medicine cannot help, but because access to effective pain relief is blocked.
One of the voices drawing national attention to this crisis is Aisha Isa, a public health researcher and clinical associate in the American Cancer Society’s Treat the Pain initiative at the National Hospital in Abuja. From her work alongside clinicians, Isa has described the lack of access to opioids as “a silent emergency that continues to deny patients dignity in their most vulnerable moments.”
The statistics reflect the gravity of the problem. According to Human Rights Watch and Treat the Pain, Nigeria receives only 0.2 percent of the morphine equivalent opioids required to meet its medical needs. Meanwhile, the United Nations Office on Drugs and Crime reports that 14.4 percent of Nigerians between the ages of 15 and 64 used drugs in the past year, nearly three times the global average.
“This contradiction is heartbreaking,” Isa explained. “Inside hospitals, patients who desperately need morphine after surgery are denied access. Yet outside, tramadol, codeine, and other opioids are being misused widely. Patients are trapped in the middle of a broken system.”
Her testimony is not theoretical. Isa recalls a patient recovering from abdominal surgery who rated his pain as “eight out of ten” on a standard pain scale. Despite his obvious distress, he was prescribed only paracetamol and a low dose of tramadol. “That experience stayed with me,” she said. “It reflects a larger systemic failure, not an isolated case.”
Experts agree that morphine remains one of the most effective and affordable treatments for moderate to severe pain. Yet in Nigeria, fear of addiction often outweighs clinical judgment, leading many providers to avoid prescribing it altogether. Isa and other advocates argue that this hesitation undermines the ethical responsibility of healthcare professionals to relieve suffering.
Her call is for Nigeria to adopt an ethical and evidence based opioid framework, one that ensures access for patients with genuine need while safeguarding against misuse. Such a framework would require opioid stewardship programs within hospitals, emphasizing rational prescribing, regular audit, and interprofessional collaboration between pharmacists, physicians, and nurses. It would also require provider education, standardized prescribing protocols, tighter supply chain oversight, and public awareness campaigns.
Isa believes that opioid stewardship should be integrated into every level of Nigeria’s healthcare system, from medical education to hospital governance, ensuring that opioids are prescribed appropriately, monitored effectively, and used responsibly to balance compassion with control.
There are proven models that Nigeria can follow. Uganda’s national morphine program, which empowers trained nurses to administer pain relief across both rural and urban communities, has been praised internationally for balancing access with safety. “Nigeria can adapt this model and save countless patients from needless suffering,” Isa noted.
For Isa, the issue is not only about medicine but about justice. “A health system that allows patients to suffer in silence is not fulfilling its duty,” she told The Nation. “Relief should not be a privilege. It should be the standard.”
Her call for reform reflects a broader truth: that pain management is a measure of humanity in healthcare. As Nigeria continues to expand its health system, Isa and other advocates insist that closing the pain gap must be a national priority. The knowledge, the tools, and the urgency already exist; what is needed now is the political will to act.