I have met with hundreds of drug users and their answer was they switched to using Kush rather than that of marijuana. Few of them really want to get off it but how? And where can they go? Who will support them? All the Commercial Sex Workers (CSWs) that live in the streets and I am pretty sure the “elite sex workers” are also on Kush. When you hear their stories, as to why they use Kush, they will say “sometimes, I need to numb myself so that I will not be bothered for sex”! There are specific locations where homeless drug users exist and are raided by police, been imprisoned, or jailed at one point or another.

I have heard from CSWs that are homeless, say that when they are caught by a Police Officer, if they do not have money to give, the Police ask for sex in return! The questions that bounce into my mind are? How many of these Police Officers are involved in these kinds of act? Are they infected with HIV, Hepatitis B or other sexually transmitted diseases that predisposes them to chronic infectious diseases? Many CSWs attest to the fact that sometimes they do not use condoms, because it is requested by their clients not to. Have they not heard of HIV? The problem is when they are on drugs, their cognitive response is dampened!

Drug users and CSWs represent one of the high-risk groups for HIV, Hepatitis B and C. Most drug users that are homeless in Sierra Leone inhale drugs, they do not inject drugs, unlike the elite ones who do. The gloomiest fact is many youngsters, college students that have a bright future ahead of them are also on drugs. Who do we hold accountable for this and who will save them from the ditch they have placed themselves into? At least the elite drug users can afford to travel abroad for rehabilitation, how about the teenage CSWs, that are homeless, helpless, and vulnerable- who will save them?

What is Kush?

To simplify things here, we have the naturally occurring Kush which is a specific strain of cannabis that originated from the Hindu Kush mountains located near the border of Afghanistan, India, and Pakistan. The leaves are darker, fuller, and rounder than the sativa plant. The buds tend to grow in clumps. Cannabis has two main subspecies indica and sativa. Kush mainly falls into the indica-hybrid category rather than Sativa, but there are many hybrid Kush strains produced through cross breeding.

Mind you, the Kush that is smuggled into Sierra Leone (SL) is a synthetic weed otherwise known as Kush, spice, k2, and many other funny names. These synthetic cannabinoids can be very harmful and life threatening as it is 100 times more potent than that of natural marijuana. Kush is a mixture of “plant matter” sprayed with an ever-altering host of chemicals, in sometimes dangerously high proportions. The original formula was invented by a chemist who had no idea that his research, would be used to mass-market dangerous drugs around the world.

How do we recognize fake weed/ Kush or synthetic Cannabinoids?

Synthetic marijuana often contains a mixture of dried leaves from traditional herbal plants. They are various colours, including green, brown, blonde, and red, and often sold in small packets approximately two by three inches. The packets are often colourful foil packs or plastic zip bags.
How is Kush used?

In SL it is mostly smoked with or without tobacco, placed in e-cigarettes or pipes. What made people start using it in SL?

Probably due to its flamboyant euphoric effect and tranquilizing effect it produces, well its effect varies among individuals.
How is it sold? And by whom?
Kush is sold per ounce and be packaged as “bull”, sold at Le 5000/bull. From what I was told, it arrives from Columbia, sold by ghettos, mostly by bars, gambling places and slum areas. They are hence sold by Sierra Leoneans and brought in by Sierra Leoneans through Guinea.

Common Side Effects

Many people believe that synthetic marijuana can be safe because its “legal” and contains natural substances. However, this is false, as it resulted in severe bleeding, bruising, and some deaths. God only knows how our youths are just dying in Sierra Leone, with some committing suicide! Side effects of the drug include elevated mood, relaxation, altered perception, symptoms of psychosis, extreme anxiety, confusion, paranoia, hallucinations, violent behaviour, suicidal thoughts, rapid heart rate, raised blood pressure, vomiting, kidney damage, and seizures.

Overdoses can cause fatal heart attacks.

Is it dangerous to mix with other drugs?

Mixing Kush with alcohol or other drugs can be especially dangerous. It can exaggerate the risks of both drugs and can lead to a greater risk of accidents or death.
Also, because synthetic cannabinoids can over stimulate the serotonin system, it is important to avoid mixing them with antidepressants, as they both stimulate serotonin response in the brain- which can lead to serotonin syndrome, causing high fever, rapid pulse, sweating, agitation, confusion, convulsions, organ failure, coma and even death.

What are the long-term consequences?

This includes increase in blood pressure, seizures, tremors, anxiety and of course addiction.

What are the withdrawal symptoms if you stop taking Kush?

The withdrawals can include cravings for synthetic cannabinoids, irritability, mood changes, loss of appetite, weight loss, difficulty sleeping and even sweating, shaking and diarrhea.

Take home messages

Though “naturally occurring marijuana” is still available for recreational use and regarded as “natural”, and despite its medicinal uses, that does not make it safe. Marijuana is addictive. In countries with good health information systems and surveillance, it is known that since marijuana has been legalized for recreational use, emergency room visits have skyrocketed.

Where are we heading?

For a socioeconomic disaster, our youths, the future generation that is supposed to build a new Sierra Leone is getting high, rather than building a bright future! Mind you the brain is not fully developed until after 25 years old, DO NOT MESS it up with drugs! A well-equipped rehab and addiction centre needs to be established in Sierra Leone, with trained and qualified health staffs.

Need help?

Due to societal pressure, Kush and other substances of abuse can be difficult to give up. Having it in my mind that you can beat the addiction and ready to face the temporary withdrawal symptoms could be a good start. Do not be shy or embarrassed to seek help! You should visit the psychiatric hospital at Kissy which has trained psychiatric staffs that can help you get the care you need. You are not alone, and you cannot do this alone!

Manal Ghazzzawi- is a Doctor of Pharmacy, a public health specialist and a consultant clinical pharmacist. She is a health entrepreneur, CEO of Citiglobe Pharmacies Ltd, and a laureate for women in Africa Entrepreneurs 2020 and has won many awards as the most outstanding pharmacist in Sierra Leone. Dr. Ghazzawi is a foundation fellow of the newly established Postgraduate College of Health Specialists in Sierra Leone.