The study assessed the economic burden of neuro-tropic substance use ( tramadol+ codeine) among commercial bus drivers who presented as head injury victims in a prestigious tertiary center in Ibadan, Nigeria, Sub-saharan Africa. The study adopted a snowballing/purposive sampling method to obtain data. The interview was done with 386 road traffic injury victims( commercial bus drivers) admitted over a 4- month period to the randomly selected study center using a structured questionairre. The result showed that average cost per patient for road traffic head injury treatment( neuro-trauma care) was 346 US dollars with an average of 30 US dollars on tramadol+ codeine purchase aside the medical expenditure. Prevalence of catastrophic out-of-pocket spending was over 90% thereby rendering victims impoverished. It is recommended that clinical neuro-toxicology units be established in hospitals for routine and emergency toxicology screens for licensure to qualify or be disqualified from public commercial driving and for neuro-rehabs follow-up care alongside medical insurance for the citizenry with implemented laws and regulations guiding use of codeine+tramadol and other neuro-tropic medications of public health concern.

Keywords : mroad traffic injury, neuro-toxicology, codeine+tramadol, neurotropic substances, neurotrauma.