Freetown, Sierra Leone - Leaning against a wall, his eyes red and glazed over, Patrick Hindowa described how he spends his days getting high. "I got no job here," he explained. "Whatever [drugs] I'm going to be able to do, I'm going to do. Because I really don't have nothing."

Huddled at the end of a narrow alleyway downtown, Hindowa and two friends shared stories of addiction and life on the street.

"My mother died, my father died," recalled Bakar Sesay. "Since then - since I was a kid - I chose the street life. Coke and all that." The 20-year-old said that he has used drugs since he was seven.

The group listed heroin as their favourite, with freebased cocaine a close second. When hard drugs were not available, they turn to marijuana, alcohol, amphetamines, or prescription pills - anything, really. "From the time we wake up, 'till the time we go to sleep," one said.

Substance abuse has long been a problem for the impoverished West African country. Throughout the 1990s, a civil war gained international notoriety for the role played by drug-fuelled teenagers, who committed atrocities and launched an anarchic attack on the capital. The effects of marijuana, alcohol, and amphetamines contributed to the violence. When the conflict ended in 2002, many combatants returned home addicted to those substances.

"These international traffickers don't work with money ... they pay people with the drugs, and that is how these drugs stay behind." - Dr Edward Nahim



In recent years, harder drugs - cocaine and, to a lesser extent, heroin - have become increasingly available, authorities and health practitioners say. They blame West Africa's growing role as a transit route for the global narcotics trade. Cocaine comes from Latin America and heroin from Southeast Asia, officials explained, and through such countries as Guinea-Bissau, Liberia, and Sierra Leone. The drugs then continue on to Europe and North America.

In one high-profile case in 2008, for example, Sierra Leone's Minister of Transport and Aviation was dismissed for his alleged involvement in the landing of an airplane carrying 700 kilograms of cocaine. And in December 2011, police seized a shipment of cocaine reportedly en route from Ecuador.

Spillover effect



As smuggling activity has increased, there's been a spillover effect. According to the United Nations' 2012 World Drug Report, "increasing trafficking of cocaine through the coastal countries of West Africa is leading to an increase in cocaine use… with cocaine use possibly emerging alongside heroin use as a major problem".

Dr Edward Nahim, an adviser to the Sierra Leone National Drug Enforcement Agency, explained that it is common for drug handlers to be paid with portions of the product they're moving, which is contributing to a growing proliferation of those narcotics in Sierra Leone.

"These international traffickers don't work with money; that is the problem," Nahim said. "They pay people with the drugs, and that is how these drugs stay behind."

The only certified psychiatrist in the country, Nahim estimated that 80 percent of the patients he sees are suffering from "drug-induced psychotic disorders". He noted that for now, the majority of those cases stem from heavy abuse of alcohol and high-grade marijuana, but that he is also observing an increase in the use of cocaine and heroin.

Ibrahim Samura, assistant superintendent for Sierra Leone's national police force, also said that drug abuse is on the rise. He described the situation as "alarming," and linked it to "an increase in gangsterism".

"They use [drugs] more than is necessary, and it spurs them to behave abnormally and do things they wouldn't do in their right senses," he said. "They kill, they rape, they smoke marijuana, they carry weapons and do criminal activities."

Samura called attention to legislation passed in 2009 that created stiffer penalties for drug trafficking. In March 2010, the UN secretary-general's representative to Sierra Leone praised such efforts, but argued that to effectively tackle Sierra Leone's drug problem, the country's high unemployment rate for young people must first be addressed. Some seventy percent of youth were unemployed or underemployed in 2010, according to government statistics.

Hidden in a congested area of downtown Freetown is the so-called "Lumley Street Cartel Ground". Down a narrow entrance, barely visible amid a throng of market stalls, the collection of shacks is a hub for the distribution and use of drugs in the capital city.

Sitting on a chair off to one side of the unadorned space was an old woman - reportedly the wife of a police officer - with a long scar running down one side of her face. She refused to speak to journalists, but directed two of her dealers to act as escorts. For the next 30 minutes, the men moved though a labyrinthine network of alleys and side streets, to join a small group of youths who were willing to talk about how drugs were affecting their lives and communities.

Pastor Morie Ngobeh has helped people in Sierra Leone struggling with addiction since 1985 [Travis Lupick/Al Jazeera]



'I gotta do drugs ... to wake me up'



Alimu Kamara said that everything he has goes to drugs. "I won't come out of there [drug dens] with one penny," the 24-year-old said. "All I do is smoke smoke smoke da brown-brown [heroin]."

Kamara and two childhood friends shared tattoos marking them as members of a gang called "Cens Coast Hood", which they said distributed drugs across the country. The young men said they didn't know where the relatively recent influxes of cocaine or heroin were coming from. "By plane, by boat - I don't know," one shrugged. Their only concern was the immediate need to get high, a priority they said was common among street-level dealers.

"I gotta do drugs to move around, to wake me up," Kamara complained. "When I don't have something, it's hopeless."

Asked if there was anything he would like to say on behalf of young people struggling with drugs, Kamara politely declined to answer. "I don't feel like I can," he explained. "I want to change myself first. Then I can say something."

Though few options exist, there are places in Sierra Leone where individuals struggling with drugs can get help.

One is Nahim's clinic in Freetown, though the psychiatrist noted that treating severe cases remained difficult. He explained that in a poor country such as Sierra Leone, medicines used to treat addiction, such as methadone, are prohibitively expensive. Nahim said he therefore employed the "cold turkey method", despite it often entailing painful withdrawal symptoms. "We restrain you physically," he said. "Then we give you very strong tranquilising drugs that will keep you asleep during that period, maybe for one or two days."

Another option is "City of Rest", the only dedicated mental health facility in Sierra Leone. There, Pastor Morie Ngobeh has helped men and women struggling with addiction and other disorders since 1985. He said that 25 of 40 beds provided for in-patient care were currently occupied by people with problems related to drugs and alcohol.

"In the 1980s, drug problems were very rare," Ngobeh said. "Now, all kinds of drugs are in this country."

Nahim and Ngobeh each have decades of experience working with addiction. In separate interviews, they both cited a lack of options for meaningful work as a primary factor driving young people to drugs.

"They are in the ghettos all day long, and for hours at night as well," Nahim said. "And that's on a regular, daily basis." He argued that to begin to solve the country's drug problem, it is this group of especially vulnerable people that must be made a priority.

Ngobeh echoed Nahim's words. "When these young people are frustrated or depressed, they easily go to drugs," he said. "They want to forget their problems. But they don't forget… and that's how most of them become addicted."



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