Photo: Informative sign, Kep National Park.

A few weeks ago an American working for one of the Phnom Penh English-language newspapers died of what is widely believed to have been a drug overdose. Another three of the newspaper’s employees also overdosed, but luckily survived. Each year at least a few foreigners are found dead in Phnom Penh guesthouses of an accidental overdose. The main reason? Buying cocaine that is actually heroin.

Cocaine in Cambodia is expensive — more expensive than heroin. Because heroin is produced in Southeast Asia, it’s cheap and far more pure than what’s available in the West. Often dealers in Phnom Penh will agree to sell cocaine but will actually deliver heroin — whether it’s due to stupidity or a gruesome cost-saving method is unknown. In 2009 this tragic trend made the headlines when David Hunt and Mark Ganley, two Britons on holiday in Cambodia, died after taking heroin that they thought was cocaine. Although this case is well known, many more die each year in cases that do not make the headlines.

“Do ‘cocaine’ in Phnom Penh with extreme caution and always have somebody on hand should things go wrong,” Dr Nick Walsh, who works at one of the international clinics in Phnom Penh, told me via email. He’s aware of six accidental overdoses and one death in the last month alone.

Because both drugs can be white powders, users often unknowingly ingest heroin in quantities larger than even a seasoned heroin user would. When one has no tolerance to opiates, this is a recipe for an overdose and overdoses in Cambodia more often result in deaths than in the West due to inadequate medical care. “Medical services in Cambodia are not of the same standard as in the developed world and overdose antidotes like naloxone for heroin will not be available,” Dr Walsh said. “Ambulance services will not be able to treat on the scene as their main role is transportation, and their training is inadequate.”

I spoke with one man who barely survived such an incident in Cambodia. Already inebriated, he assumed a white powder in front of him was cocaine and took what most people would describe as a whole lot. He was evacuated to Bangkok. “They did an MRI scan and my brain was fried, the doctors wanted to pull the plug,” he told me, asking that I not use his name. “They had never seen so much smack in someone’s system before.” He was on life support for weeks in the Thai capital before being stable enough to be transferred to his home country.

There are a lot of reasons to not take drugs in Cambodia: drug laws are growing increasingly draconian and taking drugs puts one at greater risk for muggings and assaults. Of more immediate concern is the lack of a reliable source. Suppliers of various nationalities have sold heroin disguised as cocaine.

If you decide to ignore my advice and take drugs anyway, try and reduce your risk. Caitlin Padgett, a harm reduction and public health consultant who has worked extensively in Cambodia, advises users to taste the drugs that they purchase. “Put a teeny bit in your mouth and gums and see what it feels like,” she said. Cocaine has a numbing effect on the gums while heroin has a more bitter taste to it. “Only ever do a small bump first; never line up a big fat rail if you haven’t tasted and tried a little, or seen someone else use the exact same stuff.” If it tastes wrong, don’t do it.


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