Bellingcat and Newslaundry found that Indian pharmaceutical companies shipped over 320 million tapentadol pills to West Africa between 2023 and 2026, with more than half being high-strength doses not approved in India itself. The investigation documents 1,400+ shipments to a region that lacks regulatory oversight of these synthetic opioids, creating a public health pipeline that circumvents approval processes. This matters because tapentadol is a potent opioid similar in strength to morphine—the scale of unregulated exports suggests deliberate regulatory arbitrage, where companies exploit the difference between strict Indian domestic rules and minimal West African enforcement. The reporting raises questions about pharmaceutical export enforcement and whether Indian regulatory bodies are monitoring the destination and approval status of domestic manufacturing before exports.