The Journal of the Siam Society Vol. LXXII, Part 1-2, 1984 - Khamkoo

J. Westermeyer, Poppies, Pipes and People : Opium and Its Use in Laos (University
of California Press, 1982), 366 pp. incl. index, gloss. and bibliog. 12 black-andwhite
ill.
Professor Westermeyer's book represents research in Laos over a ten-year period
between 1965 and 1975, in addition to which he has had the opportunity of following
up individual cases among Laotion refugees within the United States.
He worked in
Laos under WHO and USAID as a physician and public health worker, and holds joint
professorships in anthropology, psychology and psychiatry at the University of Minnesota
and its associated hospital.
What is remarkable about his intensive cross-cultural
study of opiate addiction (which also includes an examination of the related uses of
tobacco, betel, alcohol and cannabis), is its enlightened marriage of a practical concern
with medicine and medical issues, with a knowledge of the social background and
cultural context in which these issues· occur.
Ten major hypotheses are examined, ranging from whether ethnicity is a prime
determinant of opium use (with more Sinitic peoples tending to undergo greater addiction
than others) and whether opium can be used regularly on a non-addictive basis, to
whether current treatments of opiate addiction are at all effective, and what the most
effective means of eliminating opium addiction may be. Another primary hypothesis
tested is whether the view of opium addiction as a medical illness rather than a social
habit is not due to an imported, Western conceptual framework. While Prof. Westermeyer's
conclusion on this point may not be final, it is useful to have the question
raised in a scientific context.
One of the most interesting passages of the book is that dealing with the
increase in police corruption and dramatic rise in the consumption of heroin caused by
the passing of the anti-opium law in Laos in 1971 (after considerable international
pressure).
Detailed comparisons are made between heroin and opium addiction
syndromes, while the author's fundamental concern with questions of cultural background
and ethnicity has led him to include members of Caucasian as well as Laotian,
Hmong and other groups in his sampling of cases.
to be considerably informative,
The results are sufficiently varied
Prof. Westermeyer approaches his task professionally and competently. The
data is well arranged and statistically presented. The results of numerous field trips
to the more remote areas in Laos, as well as his own work at the National Narcotic
Detoxification Centre in Vientiane, are analysed. Perhaps the most attractive feature
of the book is that analysis of a sometimes dry and tedious kind is leavened by extensive
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