With help from other people, I have been relatively successful at planning ahead and being prepared. (I’ve often been able to plan ahead buy unable to be prepared either because I lacked the resources or because my symptoms prevented me from acting.) In Mexico, I learned how and where to get the medicines I need. Before leaving Mexico, I bought extra medication so that I would have time to learn how and where to buy medicines in Guatemala.
A quick tangent for some good news: I take two benzodiazepines, but only when my anxiety symptoms are so severe that I cannot accomplish anything. For two to three years, I have taken two to three doses of diazepam per day and two doses every three days of alprazolam. Despite the significant stress of the last two weeks, and despite the many unexpected plot twists, my need for the benzos is significantly less than before. That means that my anxiety symptoms are not affecting me as much as before. There are many reasons why I am coping better with my anxiety, and I might talk about them later, but for now, I want to share that the general trend of life improvement is continuing, and my reduced need for benzos is somewhat of a quantitative measurement of the improvement.
I do want to mention, for the 65,287 time, that my survival–and my current improvements–have only been possible because people have helped me in big ways and in small ways. The smallest amount of help, like when I got a two km ride up a steep hill during terrible heat, is very important to me. Thank you to everyone who has helped, and please don’t give up on me yet.
Back to the unexpected medicine situation in Guatemala. I currently have all of the medicine I need, but I only have one day of venlafaxine left. In Mexico, every pharmacy carried it. At least 50% of the pharmacies even had signs advertising it: it is a well-known, and affordable, medicine there, and it is sold over-the-counter. In Cairo, it was not as ubiquitous, but it was easy to find, affordable, OTC. In the US, the brand name is Effexor and Effexor XR is extremely well-known, but like too many medicines in the US, it requires a prescription.
Side note illustrating how the US FDA does not regulate drugs for the benefit of the public but rather for the benefit of the pharmaceutical industry: the OTC painkiller, acetaminophen (paracetamol in most parts of the world, commonly known by the brand name Tylenol), damages your liver at relatively low dosages, and is fatal if you take too many during one week, depending on who you ask, it kills upwards of 150 people per year in the US, and my favorite damning-statistic, as of 2006, the number of people who accidentally died from acetaminophen in the US has been greater than the number of people who have killed themselves with pills in the US. If you overdose on venlafaxine, you fall asleep, and you wake up. In you are under 18, the WHO says don’t take it. Prescription medicines are covered by insurance while OTC are not. Are you surprised that the patented Effexor XR is prescription only but the not patented acetaminophen is OTC?
Let us return to my search for venlafaxine in Panajachel, Solola, Guatemala. I have been to about 12 pharmacies, including all of the largest pharmacies here. None of them carry venlafaxine. One did have venlafaxine XR, but the price for the extended release (XR) version is six times that of the normal version. The pharmacies do not even have suppliers from which they can order the non-XR version of the medicine. That alone is not particularly crazy. This is a small town and apparently venlafaxine is not a major part of the medical culture here. I should be able to buy it in a larger town like Solola or a city like Guatemala City. While I was at the pharmacies, I asked about the prices of the other medications I take: I am planning ahead, you know?
Asking about diazepam (Valium) and alprazolam (Xanax) is where this situation become crazy. Not only does every pharmacy carry those two benzodiazepines, they carry most other benzos and Oxycontin, and I can purchase any of those medicines without a prescription. ¿Qué el fuchi?
The venlafaxine situation is not a crisis, but it will cost me a day or two of learning and searching and the price will be higher whether I have to buy the XR version or go to another town to purchase it. Not a big deal. I want to share this story because it is insane that I can buy Oxycontin OTC but I cannot easily purchase venlafaxine. I mean, no one around here needs benzos or Oxycontin. You can buy marijuana anywhere, and you could easily get high without smoking a joint if you merely stand in the right spot of some streets: the second-hand smoke will make you think you are Cheech Marin.
For what it is worth, I strongly support decriminalization and regulation of marijuana, and I strongly oppose the War on Drugs.
I say that as a human, as a citizen, and as a former prosecutor. I hate the smell of marijuana, however, and if I am around it for more than a minute, I get a horrible headache. Nevertheless, my personal dislike of marijuana is not a valid reason to prohibit you from using a substance that is far safer than alcohol or tobacco and even has proven medicinal effects. See my discussion of the US FDA, above, for some hints about why an unprocessed plant is criminalized.
