How a nitazenes crisis becomes a “mysterious zombie drug epidemic”
Thursday, 23 May, 2025
A mysterious zombie drug epidemic in the 2016 movie “Train to Busan”.
When the media reports on either illicit drug use or social and political issues in the world’s poorest countries, stigma and sensationalism are depressingly common features. It’s not surprising that the reporting of an overdose crisis caused by kush, a new synthetic drug in Sierra Leone, is inaccurate and a bit off the wall. The sensationalism of the January 2024 UK Telegraph headline “Inside the ‘zombie’ drug epidemic sweeping West Africa” is typical.
The Telegraph headline sets the lurid tone for the article that follows: “Dressed in nothing but rags, they stand like zombies – shoulders slouched, heads cocked to the side – as they aimlessly shuffle in circles.”
And that’s just the second sentence.
A February 2024 article on the website of US National Public Radio is less sensationalist, but only slightly. According to the Telegraph kush is “a mixture of opioids, cannabis, disinfectant … fentanyl and tramadol are said to be ingredients,” while NPR describes it as a “synthetic cannabinoid … routinely cut with an array of additives including acetone, the opioid tramadol and formalin, a toxic chemical commonly used to preserve bodies in mortuaries.” Both descriptions are inaccurate.
An 11-minute report broadcast by Britain’s Channel 4 in January 2024 went further. According to the description on Channel 4’s website: “It’s so addictive, users become hooked after a single hit, then find themselves quickly trapped in a cycle of self-destruction. Kush is a mysterious new zombie drug that’s ravaging Sierra Leone – an epidemic described as the worst in Africa. And amid fears the crisis could destabilise the entire nation – a shocking new twist: the use of ground-up human bones as one of the drug’s cocktail of ingredients. A warning, this report contains some distressing images.” Almost none of this is true.
Synthetic cannabinoids and nitazenes
It is true that kush rapidly went from being a new drug on the market, to being Sierra Leone’s most popular drug, and has started being exported to neighbouring countries — in particular Guinea-Bissau, Liberia and Gambia. It is also true that after 2022 the number of overdose deaths became alarmingly high — by 4 April 2024, deaths were high enough for President Julius Maada Bio to declare a national emergency.
This overdose crisis was part of a wider global phenomenon. Starting around 2022, nitazenes, which are very strong synthetic opioids, became increasingly common in drug markets worldwide. Nitazenes have since been responsible for an increase in opioid overdoses in Europe and Australia, among other regions.
When kush first entered the drug market in Sierra Leone, in 2017, it was, in fact, synthetic cannabinoids sprayed onto smokeable plant matter — the same product that in Australia is known as ‘Kronic’, ‘K2’, ‘Kaos’ and ‘Spice’, but usually sold in pre-rolled joints. In the US, kronic is also known as kush, which is how the Sierra Leone product got its name.
Since 2022, another type of kush has been on the market, containing nitazenes sprayed onto smokeable plant matter, instead of synthetic cannabinoids. This is behind the epidemic of kush-related deaths that attracted the sensationalist media attention. Today, kush joints contain either synthetic cannabinoids or nitzenes, but not both, with about half of joints containing nitazenes and half synthetic cannabinoids.
Research
Despite the sensationalist misinformation that comprises most of the reporting of kush in Sierra Leone, there is some very good research data available, from what is perhaps an unexpected source — the Global Initiative Against Transnational Organized Crime (GI-TOC), a Geneva-based “independent civil-society organisation” with strong links to law enforcement. In collaboration with a Dutch government-funded think tank, GI-TOC released a report on 25 February 2025 into the manufacture, distribution and consumption of kush, based on rigorous field research in Sierra Leone and neighbouring countries.
People interviewed or surveyed in Sierra Leone included about 100 people who use drugs (PWUD), 25 people involved in various stages of the kush supply chain, 20 law enforcement personnel and 10 “gangsters/former combatants with relevant knowledge of security dynamics”, recruited from all parts of the capital, Freetown. Research was also conducted in Guinea, Guinea-Bissau and Liberia, neighbouring countries where the trade in kush has spread from Sierra Leone.
The researchers also collected, for detailed testing, retail samples from locations across Freetown as well as from Guinea-Bissau, and “official samples” provided by the Transnational Organised Crime Unit (TOCU) of the Sierra Leone Police (SLP), including drugs from consignments intercepted while being imported through Queen Elizabeth II Quay and Freetown International Airport. Such “official samples” were the only drugs from Sierra Leone ever tested before the GI-TOC study, and this lack of data contributed to the wild speculation and misinformation circulating about kush.
The results of the testing highlighted the inaccuracies in most of the media reporting. None of the samples tested contained fentanyl, phencyclidine (PCP), methamphetamine, tramadol — or human bones. Furthermore, the results showed that reports that kush contained an ever-changing cocktail of chemicals were false, and that its composition was relatively consistent, although has evolved over time.
The testing found that Kush did contain synthetic cannabinoids and nitazenes, although not in the same samples. Nitazenes were found in 53% of the samples, and synthetic cannabinoids in 47%. All the samples without nitazenes contained the synthetic cannabinoid MDMB-en-4-PINACA, although some samples contained other synthetic cannabinoids in addition to MDMB-en-4-PINACA.
In 2020, kush overtook cannabis as the most popular illicit drug in Sierra Leone, and the overall size of the market for illicit drugs was increasing. By 2022, to increase profits and decrease the risk of illicit imports being detected at the border, Sierra Leonean illegal drug networks began importing the legal plant matter in kush (marshmallow leaf) separately from the illegal psychoactive substances or their precursor chemicals. Cooks who synthesised kush became part of Freetown’s illegal drug business.
Because the emergence of domestic synthesis of kush in Sierra Leone coincided with the increase of nitazenes in drug markets worldwide, and with MDMB-en-4-PINACA (which is at the riskier and stronger end of the synthetic cannabinoid spectrum) becoming the default synthetic cannabinoid in most drug markets, the cooks had to learn their trade by experimenting with nitazenes and MDMB-en-4-PINACA. This, and the limitations of Sierra Leone’s extremely under-resourced healthcare sector, has caused the overdose crisis since 2022 to be grisly.
However, kush has increased in popularity since nitazenes or MDMB-en-4-PINACA became the default active ingredient of the pre-rolled joints, which are sold under different brand names that signify how strong they are. Interestingly, since the middle of 2024, the number of overdoses has been decreasing. The GI-TOC research suggests that as the cooks became more experienced, the quality of the product became more consistent, while some consumers developed an opioid tolerance at the same time. This has led to a decline in risk, although smoking kush remains a dangerous pastime.
Context (and a history of colonial violence)
Drug use and drug cultures are influenced by social context, as well as what drug cultures have existed previously. In Australia, synthetic cannabinoids first hit the market as “legal highs” — that is, it was marketed as being like cannabis (although it isn’t) but legal. However, it didn’t remain legal for long. In NSW, after a cat-and-mouse game in which specific synthetic cannabinoids would be banned, only for underground chemists to invent new ones, authorities had the idea of banning whole classes of chemicals. Due to this, all synthetic cannabinoids have been illegal since 2013, even ones that haven’t been invented yet.
Since then, kronic has sporadically become popular in the context of workplace drug testing, for example with fly-in-fly-out workers in the mining sector. In the absence of these external social and political factors, however, kronic has occupied a relatively niche place in the Australian drug market — it has its fans, but other drugs remain more popular. This is similar to other Western countries.
In Australia, the nitazene crisis has mainly manifested through nitazenes adulterating or substituting for other drugs, unknown to the user. Sometimes they are substituted for other opioids, which makes sense given their strength and the resulting increase in profit margins and decrease in risk of detection. They have also been found substituting for drugs as diverse as benzos, coke, ice, MDMA and cannabis vapes. Intentional use of nitazenes in Australia happens but is relatively uncommon.
In Sierra Leone, both synthetic cannabinoids and nitazenes are a more popular drug of choice than in Australia.
Behind the severity of the nitazene crisis in Sierra Leone, as well as the inaccurate “mysterious zombie drug made from human bones” narrative (which is found even in academia), is the fact that Sierra Leone is an extremely poor country with a traumatised population. And there’s a reason for the poverty and trauma — more than 500 years of violent exploitation by the West.
In fact, a large part of the origin story of Western capitalism and the modern world order was the Atlantic Slave Trade that economically and socially devastated Sierra Leone for 300 years. That was followed by 160 years of British colonial rule, which in addition to exploiting Sierra Leone’s population, began the plunder of the country’s natural resources. Diamonds were discovered in 1930, which has continued to enrich foreign interests and be a curse for Sierra Leone.
After gaining independence in 1961, the country went through 30 years of military coups and dictatorship before the brutal Civil War of the 1990s. The Western stereotypes about child soldiers, “blood diamonds” and horrific violence against civilians are not false, but hardly something for the West to feel superior about given that IMF austerity, geopolitics and the Western-dominated diamond and weapons trade were behind the horror. But it left Sierra Leone in bad shape. In the past 10 years, the main reason the country gets Western media attention is when there’s an Ebola Virus outbreak.
Some of the “distressing images” depicted in the reporting of kush in Sierra Leone are simply extreme poverty. Harm caused by kush is obviously exacerbated by very inadequate healthcare and other infrastructure, but it is not always possible to identify whether something is a drug-related or general poverty-related harm. Part of the mystery about what kush is, and the wild speculation about ingredients, reflects that autopsies in Sierra Leone might identify symptoms consistent with an opioid overdose, but they don’t have the resources to test for the presence of opioids or other drugs.
Drug Culture in Sierra Leone
Historically, the Sierra Leonean recreational substances of choice were alcohol — mainly artisanal tradition beverages such as poyo (palm wine) and omoly (a bit like gin) — and locally grown cannabis. After the Civil War broke out in 1991, commanders began giving their fighters not only alcohol and cannabis, but heroin and crack cocaine. As the militias did business with international criminal networks smuggling arms and diamonds, imported illicit drugs became easily available in Sierra Leone for the first time.
After the war ended in 2002, locally produced cannabis remained the most popular illicit drug. However, markets for imported drugs grew, and former commanders of the different forces in the war used their links in international smuggling networks to make Sierra Leone a transhipment point for cocaine going from South America to Europe. This increased the availability of crack locally, although it’s too expensive for most Sierra Leoneans.
Around 2008, contraband tramadol became the most popular opioid, although its use decreased after a 2016 crackdown. MDMA, amphetamines and methamphetamines are among the other imported illicit drugs that had become available in Sierra Leone by the time imported kush first appeared in 2017. Still, locally grown cannabis remained at the top until kush overtook it around 2020. The cannabis market has shrunk considerably since then, and most cannabis grown in Sierra Leone is now exported.
Despite the overdose crisis, kush continued to rise in popularity, particularly after 2022 when the MDMB-en-4-PINACA and nitazene kush came on the market. This reflects that a drug that is very strong and very cheap is appealing to people who are very poor, lacking in opportunities, and living in a society recovering from a horrific civil war. However, the Sierra Leonean reality contradicts a lot of assumptions about the relationship between illegal drug markets and violent crime.
Gangsters
Stereotypically, drugs attract violent criminal gangs, but the growing kush market has, if anything, mitigated violent crime in Sierra Leone. When the civil war ended, the various militias involved morphed into street gangs that continued to recruit young men in a context of poverty and unemployment. The business model that evolved was basically violence for hire, with competing politicians as their main clients. Before 2020, the gangs tended to be fiercely territorial and turf wars could be extremely brutal.
The Sierra Leonean kush industry developed independently of the gangs, but their activities intersect at various points. People who returned from the diaspora after the civil war with varying amounts of money play a major role throughout the supply chain. The connections with the producers of synthetic drugs and their precursor chemicals, in Britain, the Netherlands and China, were established by Sierra Leonean refugees deported from Britain, essentially creating the kush market in Sierra Leone.
The kush industry also provides a livelihood for former gangsters and unemployed young men that is more financially lucrative than violence for hire and that has been linked to a decrease in gang membership. Links between the gangs and the kush industry do exist — local gangs provide security at the venues where kush is sold and consumed, and gangsters are employed as muscle when disputes in the trade are being negotiated. However, it is accepted by both the gangsters and the kush producers, traffickers and sellers, that violence is bad for the business, and competition between industry players usually does not involve violence. Intriguingly, competing kush networks do not seek to control or monopolise supply over territory, competition is instead based on the reputation of the product quality of various retailers. This has been linked to a decline in turf wars between gangs.
What is to be done?
The recommendations in the GI-TOC report are refreshingly evidence-based. As would be expected from a law enforcement-linked think tank, one set of its recommendations are focused on supply disruption, but the other is on harm reduction. The report recognises that the much-publicised police crackdown that followed the 2024 national emergency declaration changed nothing other than causing a temporary spike in the price of kush, and the relocation of the venues where kush is sold and consumed to less visible locations (thereby increasing risks).
Therefore, the emphasis of the supply reduction recommendations is on better gathering of information, and law enforcement in the countries where the synthetic cannabinoids and nitazenes are imported from: Britain, the Netherlands and China. The recommendations on law enforcement in Sierra Leone relate mainly to border control and corruption.
Significantly, one of the recommendations in the harm reduction sections is to find alternatives to incarceration for PWUD (and that civil penalties shouldn’t be that alternative). Other harm reduction recommendations include increased availability of, and access to, treatment and support programmes — this includes opiate substitution treatment (which would require changing laws that currently criminalise opiate substitution treatment and needle exchanges); rolling out naloxone (the drug that reverses opioid overdoses); and enhancing the training of professionals treating PWUD.
Unfortunately, these sensible recommendations border on being utopian in the context of Sierra Leone’s extreme poverty and inadequate health industry. And this is likely to get worse. The history of colonial and neo-colonial exploitation, the devastation of the civil war, and post-war neoliberal austerity, means that the few health services that do exist are largely provided by international organisations and NGOs that rely on foreign funding. The cuts by the Trump administration in the USA to USAID and the World Health Organisation — along with cuts to international development aid by other Global North countries, such as Britain, that followed — could destroy what little health services Sierra Leone does have. This is also the case in many other poor countries.
Despite headlines about “zombie drug epidemics”, the harm reduction measures needed in Sierra Leone aren’t much different to what’s needed in Australia or anywhere else: things like supporting rather than punishing PWUD, access to adequate healthcare and treatment, availability of OTP drugs and naloxone, and services to test what’s in drugs. But the case of Sierra Leone illustrates something else that’s true everywhere, even if it’s not as obvious in some places — that harm reduction also involves addressing the violently-imposed hierarchies, inequalities and exploitative relationships both between and within nations. Stigmatisation of PWUD, poor people, and poor countries, all provide victim-blaming narratives that obscure the underlying exploitation and inequality present worldwide.