More than 320 million tablets of tapentadol — a synthetic opioid two to three times more potent than tramadol — were exported from India to West Africa between 2023 and 2025, according to a joint investigation by Bellingcat and Indian outlet Newslaundry. The shipments, valued at nearly $130 million, were largely destined for Sierra Leone and Ghana, where the painkiller has not been approved by regulators, and where authorities say criminal networks have increasingly turned to tapentadol after India tightened controls on tramadol trafficking in 2018. The findings raise serious questions about regulatory oversight in India, where more than 60 suppliers are identified as having exported the drug despite rules requiring proof of approval in the destination country before such shipments can proceed.