On August 9, Tiekan Joseph, a 29-year-old teacher, rolled into Accra on a bicycle after pedalling all the way from Jirapa in the Upper West Region, urging young Ghanaians along the route to stay away from drugs and protect their futures.
Among the towns he passed through was Babile, the same community where weeks earlier, a young man named Kukura, died, attempting to swallow ten tablets of tramadol in a contest with his friends.
Joseph likely did not plan this overlap.
But it captures, more honestly than any statistic could, where Ghana now stands: a country pedalling hard to raise awareness of a crisis that, in the United States, is already the leading cause of death among adults under 45.
Joseph's campaign is not an isolated effort.
The Narcotics Control Commission (NACOC) and the University of Professional Studies, Accra (UPSA) marked this year’s World Drug Day with a research forum in Accra; NACOC and schools across the Ho Municipality held youth sensitisation events; the Voice Centre for Inclusive Communities, a youth-focused non-governmental organisation based in Accra, convened its Rise and Shine Summit; and the Food and Drugs Authority (FDA) partnered the Musicians Union of Ghana (MUSIGA) artists on the “Daabi ‒ Say No to Drugs” campaign.
Ghana, in other words, is a nation that is talking, but the harder question is whether it is building.
Joseph's ride is one of awareness: catching the young person who has already said yes and keeping them alive long enough to find a better way.
In December 2025, the Ghana West Africa Programme to Combat AIDS and STI (WAPCAS) Plus, the Ghana Health Service and the Ghana AIDS Commission, working with NACOC, finalised Ghana's first National Harm Reduction Guidelines, formally naming naloxone, methadone and needle-and-syringe programmes as tools the health system should use to keep people who use drugs alive.
The guidelines lay out, in stark terms, why this matters ‒ yet, naloxone and other harm reduction infrastructure remain unavailable across most of the country, and Opioid Agonist Therapy (OAT) medicines are still absent from Ghana's essential medicines list, despite WHO recommendation.
It is obvious that Ghana has formally recognised what must be done to reduce drug-related harms and prevent overdose deaths, but it has not yet translated that policy recognition into widespread, accessible services for the people who need them.
Gap
To close the gap between what Ghana now recognises must be done and what people who use drugs can actually access, we need to be honest about why young Ghanaians reach for tramadol, “shisha” and “Kush” in the first place.
Research in the Upper West Region found tramadol so embedded in farm labour that some farmers nicknamed it “farm and buy cow.”
Elsewhere in the country, users describe taking opioids not merely for the thrill, but for strength to endure gruelling, informal work or to numb the frustration of unemployment.
There is a second, quieter driver too: Ghanaian research increasingly links drug use to untreated mental distress.
Stigma around mental illness is severe enough that people routinely hide their suffering rather than seek care and studies on youth substance use describe drugs and alcohol being used to self-medicate depression and anxiety that families and communities never learn about.
A young person who cannot safely say “I am struggling” to a parent, pastor or nurse will often find another way to numb it and tramadol asks no questions.
This tells us that awareness campaigns alone, however numerous and well-intended, cannot solve a crisis rooted in poverty, labour conditions, and untreated shame.
As Mr Worlanyo Fianu, NACOC's Volta Regional Commander, puts it, “We cannot arrest our way out of a problem rooted in poverty, idle hands, and lack of opportunity.”
3 things
Moving forward with care and health at the centre means three things.
First, fund the National Harm Reduction Guidelines into full national practice, so naloxone becomes as familiar to a nurse in Gomoa Abaasa as a malaria test kit.
Secondly, pair every awareness campaign with a real, local place to get help, so a young person moved by the “Daabi” message in the morning has somewhere to turn to by afternoon.
Thirdly, resource our churches, mosques and health workers to respond to both mental distress and drug use with compassion rather than judgement.
Tiekan Joseph's ride will end, as all rides do and the “Daabi” refrain may fade.
But the young man who died in Babile, and the many others we cannot account for, will never come back.
Tens of thousands like him are already caught in this cycle, still waiting.
Obviously, Ghana does not lack people willing to pedal, march, compose and preach against this crisis.
What it still needs is the funded, compassionate infrastructure to meet them before the next Kukura.
The writer is a health communicator/Project ECHO-certified Hepatitis and Harm Reduction Specialist/PhD student, Transborder and Global Human Dynamics, New Mexico State University. E-mail:
