SSHAP West Africa Hub: Addressing the Kush Epidemic in Sierra Leone

Sierra Leone has seen a sharp rise in the use of ‘kush’ – a relatively new drug formed through mixing several constituent drugs, including opioids, which is proving highly addictive and is having serious negative health and social consequences. In April 2024, the government declared a public health emergency resulting from high levels of kush use, with security services launching crackdowns.1 Limited data on kush use presents challenges to understanding the scale of the problem. The lack of evidence has hampered the government’s response to the kush crisis. This has contributed to a misunderstanding of the problem and a response that has negatively impacted those people using the drug. The composition of kush is similarly unclear; it is described as a combination of cannabis, fentanyl, tramadol,2 formaldehyde,3 disinfectants4 and – according to some media reports – ground human bones.3,5 Tests by the Global Initiative against Transnational Organized Crime6 found that the drug contains synthetic cannabinoids and nitazenes.6 Youth are thought to be major consumers of the drug.4 The response to this emergency has been primarily punitive with dealers and addicts being arrested by security forces and placed in detention centres or rudimentary mental health facilities.7–9 This brief contextualises and provides insight into the ongoing kush epidemic. While kush use in Sierra Leone has reached crisis levels – requiring urgent action – it is symptomatic of deeper, long-standing issues of poverty, unemployment and limited opportunities for youth. These issues require sustained and comprehensive solutions beyond immediate emergency measures. This brief draws on academic and grey literature as well as consultations with practitioners working with regulatory authorities in Sierra Leone. There is currently little research on kush use in Sierra Leone, especially on the perspectives of users and the circumstances of their use. Due to the lack of social science evidence that articulates the drivers of substance use in Sierra Leone, what is presented in this brief is an attempt to identify factors likely to be shaping the epidemic and is thus speculative in nature. Ultimately, this brief aims to catalyse a dialogue that supports more effective responses to the crisis, including a multidisciplinary response to the epidemic and harm reduction approaches that focus on mitigating the dangers associated with drug use.