While the White Lotus resort in Koh Samui seems like paradise, my time on this island taught me about the dangers of drug-induced psychosis.
Arriving in Bangkok was utter chaos, so I was relieved when I tracked down my friend David (not his real name) in an Irish bar on the popular backpacker strip of Khao San Road. Even though this was years ago, the street still had the seedy underbelly portrayed on HBO’s The White Lotus, which Frank (Sam Rockwell) and Rick (Walton Goggins) enjoyed.
David and I had met in Australia and lived together. I didn’t hesitate when he invited me to join him and another of my housemates, Steven (not his real name), on their trip to Thailand.
“We’re going to meet my friend Jim [not his real name] down in Koh Samui,” David said. “If you want to come?”
“Sure, why not?” I was 18 and happy to go with the flow.
After one night in Bangkok, the three of us took a bus and boat down to the Southern Peninsula to Chaweng Beach on Samui, another popular backpacker haunt that was a far cry from the tranquility of the White Lotus. It was filled with bars and beach huts, but we didn’t care because we were there to party.
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Another pull of Samui is the party island of Koh Pha Ngan–it’s where Saxon (Patrick Schwarzenegger), Chloe (Charlotte Le Bon), Chelsea (Aimee Lou Wood), and Lochlan (Sam Nivola) go in the fifth episode to experience one of the famous Full Moon parties. Tourists frequently venture to Koh Pha Ngan to take drugs. And what could possibly go wrong that? I found the answer to that question in less than a week of arriving in Thailand. That’s when I watched Jim enter a world of nightmares that I have no idea if he ever left.
Meeting Jim
On the truck to Samui’s Chaweng Beach, the three of us made friends with two Canadian women and a Scottish guy, so the six of us decided to share a cabin. Jim staggered up the beach to join us later.
He’d been partying with some friends before we’d even gotten there, so I never met him when he was sober. He told me stories about waking up in bed with Kathoey and staying out all night with the people he apparently knew on the island.
One night he fell asleep outside the door of our hut and I tried to get him inside, but he was too heavy for me to carry. In the morning, he was covered in mosquito bites, but he just wouldn’t (or couldn’t) stop. When we all went for a meal on the beach, he bought a monster mask from a hawker and ran up and down the sand while we ate.
He took so many drugs that he would buy lithium from the local pharmacy to come down. It was as if he were trying to distill years of suppressed rebellion into a few weeks in Thailand.
‘Don’t Panic!’
Unfortunately, my friends were leaving, but Jim had another week before his flight–and so did I. He suggested staying at his cousin’s beach hut in Phuket, an island on the western side of the country, so we had to take a boat and bus to get there.
It was on this 11-hour journey that I realized something was very wrong with him. He claimed to be able to play the guitar and forced someone on the bus to give him theirs, only to surprise himself when he could not muster a note. It became more disturbing when he told me that the police were after us and that we shouldn’t panic.
We arrived in Phuket at night, and we couldn’t get into his cousin’s beach hut as he hadn’t actually contacted her. Instead, we stayed in a different cabin at Bang Tao Beach, which Jim ran in and out of all night long, forcing me to lock the door behind him every time.
He grabbed my bra strap and told me that he liked me, but he was so out of it that I worried I would be assaulted. I was so scared that I slept in a gap between the bed and the wall to try to keep myself safe. The next day, I moved to another cabin to get away from him, and then he disappeared.
Meeting His Family
“Are you okay?” I wasn’t expecting someone to ask me that question when I picked up the phone, as I’d been busy trying to get hold of David or someone back home. The person on the line was Jim’s cousin, who said he was in the hospital, telling everyone that I was dead. They’d informed the British Embassy that I was missing.
She’d flown over from Hong Kong, and Jim’s dad followed from Europe the next day to be with him. Jim had been diagnosed with drug-induced psychosis, so they wanted to ask me a few questions. I agreed to come to the hospital to reassure him that I was okay.
When I arrived, they asked me who’d given him the drugs, and it was an uncomfortable conversation as I had to tell them he’d gone out every night taking them himself. Even though he may have met unscrupulous dealers, this was a problem everywhere for anyone putting themselves in such a vulnerable position of taking unknown substances from strangers.
The doctors said he’d been given a “Thai torture drug.” It’s possible that he could have had “yaba” (which translates to “crazy medicine” in Thai) in his system, a strong methamphetamine mixed with caffeine that can cause violent behavior, insomnia, paranoia, anxiety, and even death.
How Dangerous Is Drug-Induced Psychosis?
When I left Jim and his family in the hospital, he’d been awake and in psychosis for 10 days. The doctors said that it was possible that he could remain in that state or he could get better. Whether or not a person develops a psychotic disorder or schizophrenia after psychosis can depend on the length and intensity of drug use, the form of the drug, a person’s individual psychology, and genetic predispositions.
In the U.S., around 7-25% of the general population has their first episode of psychosis due to substance abuse (this can be intoxication like Jim or withdrawal). Symptoms include hallucinations of sight, sound, smell, touch, and taste, as well as delusions and confused speech. It is believed to be caused by an increase in neurotransmitter activity in the brain, so treatment can include reducing the amount of dopamine with antipsychotic medication.
Thankfully for Jim, Phuket has good hospitals, and Bangkok, Chiang Mai, and Pattaya also have good facilities for long-term care, according to official U.S. travel advice. However, there are strict penalties for drug possession, even in small amounts, so there are legal implications as well as psychological ones.
As he took a local drug, it was useful for him to be treated in Thailand, where they know more about how this particular substance can affect people. It is important to find a medical provider straightaway, as they will be able to advise on where to take someone who is suffering from psychosis and get them transferred. Incidents like this are another reason travel insurance is so important to cover these kinds of expenses.
If a person is missing, contact local police and your embassy, who can help look for the person or put out communications to help find them. While it’s likely that the person will be found and sent to the hospital, as Jim was, it’s important to cover all bases when a person is in a vulnerable state. It is so important to enlist help, as I was physically unable to help Jim, so I was glad that an Australian man stepped in to take him to the hospital.
Now that I’m older, I always tell backpackers to be safe. I know because I’ve visited 89 countries and have seen some awful things. My advice is to look after yourselves and look after others. I only wish I could have done more at the time.
