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Charlene said she was on the "highest levels" of fentanyl, tramadol, ketamine and took between 20 and 30 pills every day in her recovery.

In 2018, following a BBC Africa Eye investigation into the sale of opioids as street drugs, Nigerian authorities tried to get a grip on a widely abused opioid painkiller called tramadol.

The government banned the sale of tramadol without prescription, imposed strict limits on the maximum dose, and cracked down on imports of illegal pills.

At the same time, Indian authorities tightened export regulations on tramadol.

West African officials are warning that opioid exporters appear to be using these new combination pills as a substitute for tramadol and to evade the crackdown.