This article is the result of a collaboration with Indian media outlet Newslaundry. You can find Newslaundry’s editorially independent coverage here.

Indian companies have shipped more than 320 million synthetic opioid pills to West Africa – where they have not been approved by regulators – over the past three years, a Bellingcat investigation has found.

Export records from trade data provider 52wmb show that more than 1,400 consignments of tapentadol worth almost USD $130 million were sent from India to West Africa between January 2023 and December 2025.

Tapentadol, a painkiller two to three times more potent than tramadol, has not been approved for use in most West African countries, where some nations are grappling with an escalating opioid abuse epidemic.

However, this investigation shows that dozens of Indian suppliers have flooded the region with tapentadol over the past three years. Where dosages were listed, more than half the pills were in powerful strengths of 200mg or more – dosages that are not even approved in India.

The exports, cross-checked against records provided by trade data aggregator ImportGenius, show most tapentadol pills sent between 2023 and 2025 had the coastal nations of Sierra Leone and Ghana listed as their declared destinations.

The two West African countries were collectively marked as the destination for more than 80 per cent of the total value of tapentadol sent to the region.

Experts have documented how drug traffickers adapt quickly to international regulations and law enforcement efforts. In 2018, India tightened export controls around the opioid tramadol, one of the most trafficked synthetic drugs to West Africa.

In 2021, the International Narcotics Control Board (INCB) said large-scale tapentadol trafficking had been identified, particularly in consignments destined for Africa. It had previously noted that India’s strengthened tramadol controls could lead traffickers to substitute the drug with other potent synthetic opioids.

A BBC investigation last year revealed that Indian company Aveo Pharmaceuticals was illegally exporting tablets containing a mix of tapentadol and the muscle relaxant carisoprodol to West Africa. This led India’s drug regulator, the Central Drugs Standard Control Organisation (CDSCO), to ban the manufacture and export of all combinations of the two drugs.

Bellingcat’s investigation, in collaboration with Indian publishing partner Newslaundry, reveals that the supply of tapentadol pills from India to West Africa has surged in recent years.

Export data from 52wmb shows the value of tapentadol sent to the region has risen from about USD $27 million in the three year period from 2020 to 2022, to almost USD $130 million from 2023 to 2025.

Julius Maada Bio, Sierra Leone’s president, in 2024 declared a national emergency over rampant drug abuse and branded kush – a toxic blend of psychoactive substances including cannabis and synthetic opioids – a “death trap”.

Authorities in Sierra Leone have intercepted illegal tapentadol, including last July when the National Revenue Authority (NRA) said it thwarted a smuggling operation near its north-west border with Guinea.

The NRA and other agencies including the Transnational Organised Crime Unit, National Drug Law Enforcement Agency, and the Pharmacy Board of Sierra Leone did not respond to Bellingcat’s requests for comment.

Ghana’s Narcotics Control Commission (NACOC) said the illegal importation of tapentadol was first recorded in 2022 after international efforts to curb the tramadol crisis resulted in criminal networks shifting production to other pharmaceutical opioids including tapentadol, tafrodol and carisoprodol.

The agency has recorded a “steady rise” in tapentadol trafficking over the past three years, with authorities seizing more than 3.7 million tablets (250mg strength). Most were traced back to India, it said.

“NACOC investigations confirm that the bulk of tapentadol is trafficked into Ghana through seaports and by air, via express courier services,” a spokesperson said. “At the ports, the drug is concealed in containerized cargo falsely declared as pharmaceuticals, electrical materials or household goods. Express courier services are used for smaller, high-value quantities, often packed alongside legitimate consignments to avoid detection.”

NACOC said Ghana had emerged as both a destination and transit hub for tapentadol, with the majority of intercepted consignments bound for Niger, Mali, Burkina Faso and Nigeria. When sold domestically, it said the street drug was promoted as a tramadol substitute.

Ghana’s Food and Drugs Authority (FDA) said last year that the abuse of pharmaceutical opioids such as tapentadol — commonly known on the street as “Red” — was on the rise.

The FDA told Bellingcat it had “never issued any permit” for the manufacture or importation of tapentadol, in any strength, to any importer or to any country. It said any tapentadol shipments to Ghana were for “trans-shipment to neighbouring country”.

Import data for Ghana shows that no tapentadol entered the country between 2023 and 2025, which supports NACOC’s position that the drugs are being concealed and falsely declared. Import data for Sierra Leone was not available through 52wmb.

India’s drug and pharmaceutical exports have grown to more than $30 billion a year, according to the Pharmaceuticals Export Promotion Council of India (Pharmexcil), a division of the ministry of commerce and industry.

While tapentadol is available in India on prescription in strengths of up to 100mg (immediate release) and 200mg (extended release), authorities are aware of its risk of misuse. Last year, the Indian drug regulator’s Technical Advisory Board said the Department of Revenue may be requested to schedule the painkiller under the Narcotic Drugs and Psychotropic Substances Act, which would tighten rules around its export.

To export pharmaceutical products at strengths that are not approved in India, exporters are required to obtain an export “no objection certificate” (NOC) from the CDSCO, for which they have to submit proof of the drug’s approval in the importing country. Publicly available information shows tapentadol is not approved for use in any of the West African nations identified as part of this investigation.

The CDSCO did not respond to questions from Bellingcat or our publishing partner, Newslaundry.

In response to “Right to Information” requests submitted by Newslaundry, the CDSCO said only two companies had been granted authorisation to manufacture tapentadol for export between 2019 and 2024. However, the trade data analysed by Bellingcat did not list either company as an exporter of tapentadol to West Africa.

The CDSCO also said it had issued export NOCs for tapentadol to 51 companies since 2024, but that these were not for export to West African countries.

Meanwhile, Bellingcat’s analysis of trade data shows that more than 60 Indian suppliers have exported tapentadol to West Africa since 2023. The exporters are mostly pharmaceutical companies but also include smaller operations, such as one company owned by a Nigerian man who sent more than US $4 million of tapentadol to Niger and Ghana.

Dinesh Thakur, co-author of the book Truth Pill, told Newslaundry there were gaps in India’s drug regulatory framework that made it possible for potentially unsafe medicines to be manufactured and exported without proper oversight.

“There is no regulatory framework which checks a genuine importer and counterfeit importer between countries,” said Thakur, a former pharmaceutical executive who now works as a public health activist.

Mohammed Adinoyi Usman, a consultant anaesthetist at Rasheed Shekoni Federal University Teaching Hospital in Nigeria, said tackling Africa’s opioid crisis was complicated by a lack of resources across the region, weak government responses, and inaction by law enforcement agencies.

He said more collaboration and intelligence sharing was needed, especially across West African countries, to combat the problem. “We see so many opioids coming into our region because of a range of factors including under-funded institutions like customs and drug agencies, weak border controls and corruption,” he said.

“Africa is different. Even southern Africa is different from western Africa – each region has its peculiarities. In Nigeria, we don’t have well-functioning institutions to help control it. But our government is trying.”

Dr Usman said access to prescription opioids in Africa was inadequate, and pointed to research showing the disparity in distribution of legal opioids to low-income countries compared to high-income nations that consume the bulk of the world’s pain relief medication. He said opioid abuse was linked to crime and negative health outcomes.

“Sadly, access to prescription opioids is very limited in Africa,” Dr Usman said, “but the costs of illegal use are high.”