“It’s not difficult to lose yourself, because Cambodia is often a country where people go to run away. People are either running away from something, or running to something,” he says.

 

Drug use across Cambodia

AsiaLife | 2 Feb. 2014

Drug use across Cambodia has skyrocketed in the last 15 years. Marissa Carruthers discovers one man’s story of abuse, and meets several organisations helping people escape the dark grips of addiction. Photography by Conor Wall.

“I felt like I could take on the world,” Matthew Tay* says, describing the incredible highs of his two-and-a-half year crystal meth addiction. “I had these amazing feelings that I could never experience when I was sober, and I wanted more.”

But what comes up must come down, and soon the lows began to outweigh the highs. Tay’s life quickly spiralled out of control, his debts mounted, and friends abandoned him. Then there was his health. Flashing a photograph of himself at the peak of his habit, he is barely recognisable – a skeleton compared to how he looks today, one year after beating his addiction.

A Black Hole

Like many, Tay fell into drugs after being introduced to crystal methamphetamine, commonly called ice, by friends. What started as an occasional high rapidly developed into a full-blown addiction, with the expat reaching for his pipe daily during the peak of his $1,000-a-week habit.

“I realised after doing it what my mind could create,” says the 36-year-old. “I was able to make money through this new creativity, but then I’d spend it on meth, and soon I found I was always in deficit. I’d make good money and I’d lose even more.”

After a year of seeing some of the “best” days of his life combined with lows akin to being in the gutter, Tay decided to kick the habit. He left Vietnam, where he was first introduced to the drug, and headed to Cambodia. He dreamed of a fresh life away from the drugs that had seen him so desperate for his next hit that at one point he sold his own passport for $50.

Determined to stay clean, he kept himself busy setting up a new home in Phnom Penh, making new friends and finding work. But within two months, he was offered crystal meth in a grotty bar off Riverside.

It didn’t take long for addiction to take hold, and Tay’s life was once again spinning out of control.

“It’s not difficult to lose yourself, because Cambodia is often a country where people go to run away. People are either running away from something, or running to something,” he says.

Following a path familiar with many expats who have fallen into the clutches of drug abuse, Tay fell in with an addict crowd. He smoked ice in “scummy drug dens” and luxury penthouse apartments alike, with some acquaintances carrying out robberies and even stealing cash from him to feed their habit.

“Just like birds flock together, drug addicts do the same and that’s what happened, which made the situation worse,” he says, shaking his head in shame while recalling some of the situations that his addiction led him into.

Once, having failed to settle drug debts of $2,500, he found himself with a gun pointed to his head. “These people are ruthless, and in Cambodia it’s easy to just disappear off the radar without anyone noticing.”

Flood Gates Open

But Tay‘s story is far from unusual. Each year, expats and locals fall into the black hole that is drug abuse. With Cambodia sitting close to the Golden Triangle of Laos, Myanmar and Thailand – a huge opium-producing area since the 1920s – there is easy access to cheap, high-quality drugs.

Before the Khmer Rouge rule of 1975 to 1979, experts say there was only evidence of small-scale substance abuse, mostly marijuana, made illegal in 1999, and alcohol, with small pockets of opium use. But once the borders re-opened in the 1990s following years of civil war, the floodgates opened.

A culture of solvent sniffing quickly spread among street kids living along the border with Thailand, especially in Poipet. By 1999, Friends International, an organisation that works extensively with marginalised youth, noticed a growing trend of young street workers abusing substances in Phnom Penh.

A street survey conducted the next year revealed that 30 percent of those questioned admitted to regularly using glue. “That was all within one year of the first cases of substance abuse being seen,” explains David Harding, Friends’ drug treatment officer.

A new wave of drugs, in the form of methamphetamine and heroin, soon arrived in Cambodia. By 2000/01, a growing number of heroin addicts were injecting the drug, fuelling HIV/Aids rates, while yaba, the pill form of methamphetamine, had fast become a drug of choice. A follow-up survey carried out by Friends in 2004 revealed that a staggering 53 percent of those quizzed regularly used substances.

The introduction of the “significantly stronger” crystal-form of methamphetamine led to a further rise in misuse. “We’d have two or three cases a year,” Harding says. “That was up until about 2006, when Cambodia felt the kickback effect of the war on drugs in Thailand.” 

With Thailand taking a tough stance on drugs, and the majority being trafficked into the Kingdom from Myanmar via Thailand, experts says heroin and methamphetamine supplies froze across the region. But despite the disruption of established supply routes, Friends quickly noticed a sudden rush of crystal meth into Cambodia.

“The market here was suddenly flooded with crystal meth despite the freeze, which we felt signified the first evidence of drug production in Cambodia,” Harding says.

The use of ice rocketed between 2006 and 2008, and it continues to be a major problem in Cambodia today. United Nations Office on Drugs and Crime (UNODC) drug treatment officer Clay Nayton, who works with users in rural areas, estimates that today more than 90 percent of Cambodian drug users are battling a meth addiction.

Escaping the Pain

Just yards from the bustling riverside, a group of street kids gather at dusk before another long night of work targeting tourists. On a good day, they’ll make up to $10, of which it is unlikely they will see a cent.

They squabble as one of them tries to grab a meth pipe from the other’s hands for a hit to keep them going during the long and at times dangerous night ahead. Harding says this is not an uncommon picture for Friends, which offers support, rehabilitation and treatment to the many street kids caught up in substance abuse — the majority of whom use it to escape the pain of their daily lives.

The average drug-user that Friends deals with is aged in their mid-teens or older, but the organisation has seen youngsters aged five battling solvent abuse. Children under the age of 10 are often caught up with crystal meth, and the youngest heroin user that the organisation has helped was aged 13.

“There are usually four reasons why people abuse drugs,” Harding explains. “Because they want to feel, because they don’t want to feel and numb themselves, to forget, and then belong.”

Outside the capital, Nayton explains that many male workers turn to crystal meth to keep them going for longer. With the problem rife along the country’s borders, he says the typical user is a man aged between 21 and 26. More than 50 percent work in service industries, with a large proportion also involved in the entertainment industry.

A worrying recent development is an increased use of crystal meth by high-school students living on the borders with Thailand and Laos, where drugs flood into the country. “Reports show the issue is growing very rapidly in high schools, particularly in Battambang,” Nayton says, adding that UNODC workers are working with schools, students, teachers and communities to tackle the problem and find out the reasons behind it.

And with the emerging middle class boasting more expendable income, Harding adds that another rising risk is youngsters taking more “exotic drugs”, such as cocaine and ecstasy. In recent years, experts say there has been an increase in the trafficking of these substances, believed to be destined for the Thai market, through Cambodia.

“We’re concerned it’s only a matter of time before Cambodia and Phnom Penh are viewed as lucrative [markets]. That will have a major impact,” says Harding.

“My biggest fear is that crack cocaine comes to Cambodia,” he says. “This is a very risky drug for a culture such as this. The availability of crack could be devastating.”

Road to Rehabilitation

With drug abuse relatively new to Cambodia, a major challenge has been the lack of professionally trained experts, treatment centres and rehabilitation programmes. Nevertheless, a handful of NGOs and other groups have launched a variety of treatment programmes and centres.

In response to the lack of facilities, Friends started developing its “comprehensive continuum of care” in 2000, which set out a rounded approach to supporting drug users. This included training professional care staff for dedicated treatment centres, individual and group support, and support and education for friends and relatives.

Friends went on to launch the country’s first needle exchange and syringe programme. By 2004, it had developed the first voluntary drug withdrawal treatment centre. It provides users with a place of refuge where they can seek help and support to kick their addiction, as well as building a brighter future by equipping youths with vocational skills through a range of training programmes.

Under the scheme, which has already helped thousands of Cambodian youths, social workers also spend time with relatives to inform them on how to help reintegrate former addicts back into their community and help them continue a drug-free life.

UNODC also carries out a range of outreach projects, including a needle exchange to help users in Battambang, Banteay Meanchey and Strung Treng provinces, as well as working with law enforcers to educate them on the importance of recognising when criminals are battling

an addiction and referring them to the relevant agencies for help rather than throwing them in prison.

But for the majority, there’s little support out there, and what exists is either stretched or inadequate. “It’s the NGOs who are providing most of the work,” Nayton says. “They provide counselling services and social workers and put together treatment plans with health centres, which hold discussion sessions, a bit like AA [Alcoholics Anonymous].”

Other primary means of treatment are state-run drug centres, which have been mired in controversy, and a methadone program launched in 2010. There are currently eight government-run drug detention centres based in Phnom Penh and Battambang, Banteay Meanchey, Siem Reap, and Koh Kong provinces.

In December, Human Rights Watch released a report based on interviews with 33 patients that claimed the centres, which were built to treat drug dependency, were illegally holding inmates who were being subjected to abuse, including torture, sexual violence and forced labour.

Kicking the Habit

In Tay’s case, he hit rock bottom in a country far away from friends and family and vividly remembers the day that the reality of his situation hit. Sitting in a bar in the capital, a former friend walked in. “I saw her face. The disgust and disappointment; I’ll never forget that face. It made me so uncomfortable and I realised then that this had to stop.”

With just a handful of expensive treatment options available to foreigners in the region, Tay was forced to go cold turkey and battle his addiction alone. He moved to the outskirts of Phnom Penh and set up a farm to keep his mind busy. Mustering all of his strength, he managed to kick his addiction and eventually moved to Singapore.

“In Cambodia, things became worse because I was feeling more and more unhappy. I felt very low, because I was alone,” he says. “Ultimately, I’d say go back home. Cambodia is not the right place to try and overcome an addiction like this.”

Dr Richard Jefferson, director of counselling centre Indigo in Phnom Penh, says Cambodia is a common place for expats to fall into the trap of drugs. “Society as a whole has very little or no safety nets,” he says. “Suddenly you’re given an open field with very few restrictions — the restriction here must come from within.”

With little help available in terms of treatment centres for expats, the psychologist advises seeking help from friends or support groups such as Alcoholics Anonymous. 

“There is very little help in Southeast Asia for an expat with drug problems and no money,” he adds. “If the issue is really getting out of hand, then returning to their home country for a while to figure things out is best. If you have a history of alcohol or drug use, Cambodia may be a difficult place to live. ”