The use of psychoactive
prescription drugs (PPDs) by young people is part of a broader worldwide trend
towards the consumption of pharmaceuticals to improve social, emotional, and
sexual performance. Few studies have examined how young people use PPDs in
developing countries, where off-label use is likely to be greater due to weaker
market controls.
This study presents our findings on PPD use among sex workers
in Makassar, Indonesia. We focus on one potent painkiller, Somadril, which is
freely available over the counter in pharmacies. The sex workers we studied
used most of their earnings to purchase Somadril pills, which they used to feel
more confident and to make their work more palatable.
This paper also traces
the history of the active component in Somadril, carisoprodol. This was
developed in the United States, where it was soon used recreationally. We found
that knowledge of its effects seeped from health professionals into youth
networks, where it was spread by word of mouth. The flow of information on
carisoprodol's harmful effects, however, was less evident...
In Makassar's Losari Beach, the sex workers whom we
interviewed work freelance, finding customers through referrals from bellboys
and becak drivers. They live in a nocturnal peer group that
shares everything – food, lodging, and earnings from customers. They help each
other to find customers and then use the proceeds to buy food and drugs for
everybody. As we joined in their gatherings, especially on Wednesday and
Saturday evenings (the former is ladies’ night, the latter a popular evening
for young people to go out), it became clear to us that the priority in their
lives was Somadril. The sex workers in Makassar craved the drug. Whereas the
young women in Isidro got drunk on beer, sex workers in Makassar used Somadril
to get high.
The sex workers at Losari Beach consumed Somadril in
different ways. Some chewed it; others took it with Sprite (a soft drink
commonly used as a solvent for drugs in Indonesia). Others mixed it with red
label whiskey or Topi Roja, a local brand of vodka. As Rina told us: ‘If you mix
it with an alcoholic drink, the effect is sure to be great.’ Others mixed
Somadril with other PPDs such as Calmlet (alprazolam) or the painkiller
Tramadol. Hasan, reflecting on his mixing of Tramadol and Somadril, said it
made him ‘act like a mad man’. When they had enough money, they bought pedas (hot)
food, which they said makes them sweat and enhances the high. They also wore
warm jackets, and avoided the wind and cold drinks, which they said weakened
the effect of Somadril.
When they could not get enough Somadril, our informants
mixed or substituted it with cheaper PPDs such as ‘LL’ (also called ‘DoubleL’;
chemical content unknown), which was bought from street vendors in sachets of
around 10 pills and ‘Dextro’ (dextromethorphan, a cough medicine sold in
generic containers in pharmacies). To get high, they swallowed 20–30 Dextro or
several LL pills. Neither are very strong, they said. Mira was one of the sex
workers who kept a diary for us:
May 13 (2012): Last night I took only three pills of
Somadril. For me, only taking three pills gives me a bad headache, it feels
like my head will break into pieces.
May 14: I took five pills of Somad, and I added DoubleL,
and I felt like a fool. DoubleL makes us uncommunicative, and not friendly to
people. But, I like mixing Somad with DoubleL.
May 15: We didn’t have a supply of Somad, because we have
a debt with the seller. I took 15 pills of Dextro and added three pills of
DoubleL, and I felt like I had nothing … no worries, no debt, no sins…. But I
am worried that if I take too much, it won’t work. It will kill me.
May 16: I took five pills of Somad, and it gave me a
headache and I became sleepy…. Dextro makes me sweat like shabu-shabu
[methamphetamine], because the heat comes from inside [panas dalam]. It makes
me feel weak … but it can also make me feel confident if someone asks me for a
date.
May 17: I have taken 10 pills of DoubleL, because I am in
a bad mood, and I have nothing to do. DoubleL made me feel crazy, we laughed
about everything, even things that are not funny.
May 18: I have taken 9 pills of Somad and I also drank 2
bottles of beer, so it feels really good. It's balanced with beer. It makes me
sleepy, but I enjoy it because it makes me feel confident.
Dextro and LL are second-choice drugs among sex workers.
Dextro, our informants say, is used a lot among high school-aged young people
(below age 18, and not included in our study) who lack the money to buy more
expensive PPDs.
We were struck by the uniformity in the reported beneficial
effects of Somadril. All of the sex workers to whom we talked said using it
made them feel more pede (confident) and/or less malu (shy).
These are important qualities in attracting customers; the drug makes the sex
workers talkative and feel less inner resistance to their work. As Samsul notes
in his diary: ‘I took four pills of Somad and five pills of DoubleL because if
I am not taking Somad I have no confidence to accompany my clients, and no
desire to look for them.’ Another entry in his diary stresses the uselessness
of DoubleL for his work: ‘I didn’t have money to buy Somad, so finally a friend
gave me DoubleL, but my eyes blurred and I looked like a fool…. I just kept on
laughing, acting like a madman...
Full article
at:
By:
Amsterdam
Institute for Social Science Research, Nieuwe Achtergracht 166, 1018 WV
Amsterdam, The Netherlands
Anita P. Hardon: ln.avu@nodraH.P.A
More at: https://twitter.com/hiv_insight
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