Sierra Leone's Kush crisis: A socioeconomic emergency hiding in plain sight

Abstract

Sierra Leone’s Kush epidemic has been declared a national emergency, yet little systematic evidence exists on who uses the synthetic drug, why they start, and what it takes to help them stop. To fill this gap, we conducted a mixed-methods study of 400 active Kush users in Freetown, complemented by qualitative interviews with dealers, policymakers, and users’ families, and focus groups with 50 graduates of the government’s rehabilitation programme.

We report four key findings. First, Kush does not prey on the already impoverished — it creates impoverishment: two-thirds of active users were employed before first use and a further fifth were in school, yet nearly two-thirds now report unstable or very unstable income. Second, social networks rather than desperation drive initiation, with peer pressure cited by over 60% of users as their primary motivation for first use and one in six starting before age 18. Third, the financial and social costs spread far beyond the user: the median user spends more on Kush each week than the weekly minimum wage, and 91% report serious damage to family and social relationships. Fourth, the government’s rehabilitation programme shows promise but remains unproven — six batches have been completed without a rigorous assessment of what works, for whom, and why — and reintegration remains the missing piece, with 88% of programme graduates unemployed at the time of interview.

The brief draws out three urgent policy priorities: prioritising community and peer-level prevention that reaches young people before they first encounter the drug, commissioning a rigorous evaluation of the flagship rehabilitation programme, and treating social and economic reintegration as a core component of recovery rather than an add-on.