I was delusional in Siem Reap. My self-medication story.

The year was 2015 and I had come down with a terrible stomach bug or sickness. Probably triggered by dehydration. I was staying in a small guest house. On the tuesday night I went to bed at 9:00pm and I never woke up until 9:00 am, not 12 hours later: a full 36 hours later.  I still felt groggy, and I needed some kind of suitable medication, so I got dressed, went downstairs on wobbly legs, and found a tuk-tuk to take me to a Pharmacy.

I didn’t speak Khmer and the staff were having trouble with my Kiwi accent. The answer was to let me make my own selection. I never expected the results.

When I went in the three staff were stocking the shelves and chatting lightly.  One of the young women came to the counter and asked if she could help.  I tried explaining about my upset stomach but also my headaches and the alarming 36 hour blackout.  In my rambling kiwi accent however, I probably sounded drunk, I couldn’t convey what sort of medication might help.  What did she suggest?

The assistant kindly invited me around to her side of the counter and gave me the freedom to find the medication that I needed. There was a whole wall of unfamiliar bottles and creams and boxes.  here’s where my problems multiplied.  I’d forgotten to bring my glasses.  The labels all looked like a blur.  I tried my best to make words from the fuzzy shapes.  I could see from the names that many prescription drugs were made in India, and reasoned that these were probably knock-offs of well proven western medicines.

I looked for anything that might relate to stomach, or head-aches or fever.  If you use Dr Google you’ll know the same feeling.  You start by typing in a brief symptom, a sniffle, and before you know it you’re scrolling through the awful possibility of leprosy or gangrene.

My fuzzy-eyesight obviously took me to these same uncertain places, right here in the pharmacy.  Still, after 20 minutes I felt I’d found two bottles of pills that would do the trick.  I paid the shop assistant and went by tuk-tuk back to the guest house.  I was dying for sleep once more so I took two of each type of tablet and drifted off.

Well 12 hours later I woke feeling very weird.  My stomach was settled but I felt, well, just out of sorts.  I felt – I can’t describe it – but somehow strange. An out-of-body feeling. What were those tablets I’d taken?

This time I put on my glasses. Bingo – one of the bottles contained tablets for the relief of upset stomachs.  Smart choice.  But the other bottle? Well it wasn’t what I expected and may well have caused my disorientation.  It was a bottle of female hormone tablets.

PS. Incidentally in 2017 the Cambodian Ministry of Health placed a ban on selling anti-biotics without a prescription.  It seems I was not the only one rocking up to a pharmacy and buying stuff without a prescription. The concern was raised by doctors that if the population kept using enough antibiotics, then the population would lose their resistance to serious infection: a case where less is better than too much.

For another true story from my Brush with Medicine files: click here.

For a local health issue see a report on Cambodia’s fight against smoking: click here .

 

 

 

 

 

A rumination on dope in Cambodia

February – Police raid uncovers green harvest. Takeo province.

In my life I’ve visited jails only three times. Each time was to visit one or other friend who was serving time for marijuana possession. The crackdown on ganja continues and since 2017 almost 20,000 mostly young people have been imprisoned on similar charges – most to do with marijuana rather than harder drugs such as heroin. There are many facets to the story of cannabis in Cambodia.

One angle is the historic use of marijuana in Cambodia, mostly as a kind of chewing tobacco – I’ve been told how farmers would place some between their gum and their lip and would benefit from the stimulus. In cooking it was used as a herb.

But, despite one tourist blogger describing marijuana as ‘semi-legal’ for years it hasn’t actually been legal at all since 1961 (in line with an international treaty.) The law was first applied in 1992 when Cambodia was just opening up, but this remained mostly unenforced.  For many years a blind eye was turned to casual usage.

In this context we see the rise of the backpacker trail and the rise of the “Happy Pizza” in Cambodia.  By the early 2000s Happy Pizzas were served from small restaurants, many laced with cannabis, but others merely dining out on the reputation and allure of the real thing.

Backpacker word of mouth about leniency towards dope smoking soon spread. Word of mouth is powerful stuff, and it did not take long for Cambodia’s reputation to reach travellers who wanted a liberal place to visit.

To lift a few lines from the Cannabis Culture website:

Since Cambodia began opening up to tourists and foreign residents in 1992, this unique country has earned a stellar reputation for the availability, affordability and tolerance of marijuana. Grass is enjoyed openly in bars, restaurants and guesthouses all over Phnom Penh.

At a typical guesthouse you will almost always find community marijuana lying on the porch table. Scott, an English teacher living at a guesthouse, explains: “Marijuana is so cheap that it doesn’t make sense to be possessive. We just leave some on the table to save people the trouble of going to their rooms to get their stash.”

This reputation is still being pushed. A story on the fast growing and popular Culture Trip website goes under the headline: Why Phnom Penh, Cambodia is The New Marijuana Hotspot. That was published January 2018 – after the current crackdown had begun.

Or look up Trip Advisor. Says one tourist of a beach in Sihanoukville: “Beautiful beach and a paradise for weed smokers.”

The politics of marijuana are complex. Now it is being traded legally in many States of the USA, and now that possession is decriminalised is many nations, it is interesting that the Cambodian Government is meanwhile dialling up their war on drugs. They’re coming down hard on users, and further up the chain to the suppliers.

Example: recently I heard from a Cambodian, a non-user, who was picked up at a party along with 10 others; all young men. There had been dope smoked at the party, and back at the station, the policeman handling the case liberally used his baton – forcing confessions of usage or supply by cracking the skulls of the detainees.  One guy after another. Even those who confessed got a baton slammed into the side of their skulls. A paradise for these weed smokers.

And in the news this last month – at least as reported by the Cambodia News English, major raids have resulted in significant plantations being destroyed by police.

Takeo province: According to a preliminary report, 1,398 ganja trees were torched on a 979 square meters plantation in Chroeung commune, Bakong commune, Kirivong district, Takeo province on February 17, 2019.

The green fingered horticulturalists had already fled by the time the cops arrived. They are now being hunted by law enforcement.

The Cambodian government, which is working with leaders in the six Mekong countries (Cambodia, China, Laos, Vietnam, Myanmar and Thailand) have agreed on a regional drug policy.  So the recent war on drugs is not isolated to Cambodia.

There appears to be a concern amongst SE Asian governments that the real problem is not actually about marijuana, but about organised crime in general. As best as anyone can guess, there’s a link between the supply and distribution of weed in Cambodia and the supply and delivery of harder, more addictive drugs.  Don’t confuse this with the “Gateway Drug” theory that posits that if you smoke dope, then you are more likely to try harder drugs. This has been debunked.

But at the supplier level there’s a nexus between dealing with soft drugs and harder stuff. The tuk tuk driver who offers you ganja is also in a position to offer something harder. Methamphetamine  perhaps.  That’s the bigger problem.

This report from the July 18th 2018 edition of This Week in Asia:

On New Year’s Day, [2018] Cambodian Prime Minister Hun Sen launched a six-month crackdown on the drug scourge that he said had become an increasing grievance for the country’s people. His announcement came shortly after a state visit by Philippine President Rodrigo Duterte, who in 2016 launched a violent anti-drugs campaign in his own country that went on to kill 7,000 people in seven months….Perhaps [it is] not surprising that Hun Sen, after the first spike in detentions in February, rushed to assure Cambodians that his campaign would not be bloody.

Doubts about the true effectiveness of the crackdown have been voiced widely.  On the one hand the high number of arrests has placed a strain on the prison system. On the other hand there are fears that the crackdown might potentially facilitate more police corruption.  And who pays for all of this?

Well, there have been serious suggestions that drug suspects should have their possessions sold by the state to fund more rehab centres.  Users pay?  Though remember, you go to jail as a suspect – and have yet to be proven guilty. Human Rights representatives have voiced concern about the plan.

It saddens me that so many young people have been swept up in police raids, and equally it bothers me that non-Cambodians are still talking of Cambodia as a drug paradise.  Those tuk-tuk drivers who offer you ganja, or something harder – are kept in business by tourists – and it is seldom the foreigners who pay the price. That said, in April last year the Australian owner of the Soul Train Reggae Bar was arrested for possession and she faces years in prison.

Personally I’m not interested in cannabis, I tried to inhale once, as a student, but the spliff that got passed to me was too soggy to inhale anything. So I’m a Bill-(But I didn’t inhale)-Clinton-in-reverse on this one.  I tried to inhale.

But it bothers me that perhaps through the interaction with the west, what had once been a simple herb has now become a black market business.  Where there’s money in something illegal then you get corruption, crime, and – ultimately – people who lose everything.

We can argue the merits of decriminalisation, (I’m all for it) rehabilitation (essential!), and whether or not cannabis is actually harmless (I personally think it is harmful to functions such as memory,) but park that to one side.

In the given situation of Cambodia today, I don’t see how cannabis usage by anyone is doing anything other than fuel a problem.  What do you think?

Click here for an account of one of my prison visits. – what was it like? Actually very moving.

Your comments and feedback are welcome.  Write me a note!