The lack of pain relief medication available in Thailand

[rwill]

arcoxia is available in pharmacies also.  It is 'the son of vioxx' after that was taken off the market.  It's a pretty good painkiller.

 

[Groove]

No Sheryl, rest assured, it's for people that are dying, that the Thais will give morphine injections to, (as long as they can pay for it) no problem, but you have to have the money for it &/or have a good health cover plan, as I have seen some poor Thais, and because they hadn't got the money, die in agony of the pain that a cancer eating away at someone's body causes, so yes, if you're dying and you've got the money &/or a good health plan, they should give you all the morphine you ask for, and ask for plenty and die happy. I mean 20 years ago I had a severe agricutral accident while working on a farm in Australia (almost slashed my foot off), the 1st stitch up looked good, but was not cleaned enough inside, got infected and a week later I was having my laceration cut open in the operating theater under a general anethestic, after the anesthetic wore off the pain of this serious laceration was horendous and I caught golden staff nad the drip fed antibiotics had to be changed 5 times before one was found that would kill the bugs, but plenty of shots of morphine fixed the pain up anyway, so much so, that under the extremely pleasant effects of morphine, I didn't even care if I lived or died, so don't be afraid if you die of cancer because you'll die in an extremely pleasant "care free" state, but spare a thought for the poor Thais who haven't got a welfare service and if they die of cancer and have no money for morphine, no, they die in agony.  Others on this subject suggested Ultracet , & another suggested Arcoxia. Now I hear that the Ultracet contains a lot of Paracetemol, well I suffer from congestive heart failure & irregular heart beat, as well as gout, and I think Paracetol hinders the effects of Warfarin that I take to thin my blood, is that right? As after my heart arterie was blocked causing mio Cardio infarction or heart attack, but with all my gout & heart medication that I have to take, my mind forgets the advice in regards Paracetemol, so does anyone know, does the Paracetemol in Ultracet stop the blood thinning effects of Wafarin?

[lopburi3]

27 minutes ago, Groove said:

and I think Paracetol hinders the effects of Warfarin that I take to thin my blood, is that right?

The Tylenol 8 hour inset in front of me says

"ask a doctor or pharmacist before use if you are taking the blood thinning drug warfarin."

[Sheryl]

No Sheryl, rest assured, it's for people that are dying, that the Thais will give morphine injections to, (as long as they can pay for it) no problem, but you have to have the money for it &/or have a good health cover plan, as I have seen some poor Thais, and because they hadn't got the money, die in agony of the pain that a cancer eating away at someone's body causes, so yes, if you're dying and you've got the money &/or a good health plan, they should give you all the morphine you ask for, and ask for plenty and die happy. I mean 20 years ago I had a severe agricutral accident while working on a farm in Australia (almost slashed my foot off), the 1st stitch up looked good, but was not cleaned enough inside, got infected and a week later I was having my laceration cut open in the operating theater under a general anethestic, after the anesthetic wore off the pain of this serious laceration was horendous and I caught golden staff nad the drip fed antibiotics had to be changed 5 times before one was found that would kill the bugs, but plenty of shots of morphine fixed the pain up anyway, so much so, that under the extremely pleasant effects of morphine, I didn't even care if I lived or died, so don't be afraid if you die of cancer because you'll die in an extremely pleasant "care free" state, but spare a thought for the poor Thais who haven't got a welfare service and if they die of cancer and have no money for morphine, no, they die in agony.  Others on this subject suggested Ultracet , & another suggested Arcoxia. Now I hear that the Ultracet contains a lot of Paracetemol, well I suffer from congestive heart failure & irregular heart beat, as well as gout, and I think Paracetol hinders the effects of Warfarin that I take to thin my blood, is that right? As after my heart arterie was blocked causing mio Cardio infarction or heart attack, but with all my gout & heart medication that I have to take, my mind forgets the advice in regards Paracetemol, so does anyone know, does the Paracetemol in Ultracet stop the blood thinning effects of Wafarin?

There is universal free health care for Thais and they do not have to pay anything for morphine. If an inpatient in the hospital and if there is a clear need they usually receive it but there may be delays due to limited staff. Private hospitals certainly tend to do a better job of medicating for pain but what you describe (Thais dying of cancer in agony for lack of ability to pay) is not the case.

 

Outpatient narcotics is another matter.

 

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[NancyL]

19 hours ago, Sheryl said:

There is universal free health care for Thais and they do not have to pay anything for morphine. If an inpatient in the hospital and if there is a clear need they usually receive it but there may be delays due to limited staff. Private hospitals certainly tend to do a better job of medicating for pain but what you describe (Thais dying of cancer in agony for lack of ability to pay) is not the case.

 

Outpatient narcotics is another matter.

 

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I have seen foreigners dying of cancer in agony due to lack of ability to pay, but not Thai people.  Even when the foreigner comes to the hospital with what "appears" to be end stage cancer they can be denied pain killers if they can't afford the appropriate diagnostic tests to confirm they have cancer and the extent or stage of the cancer because the health care providers don't want to supply "addictive" drugs to someone on a long-term basis.  With their universal health care system, Thai people wouldn't die this way.

 

 

[unblocktheplanet]

This is particularly so for those suffering cancer pain. Is govt worried they'd create addicts in the afterlife?!?

 

The fact is, heroin, fentanyl, and all other pain relief should be legal and used in hospitals.

[simoh1490]

On 9/24/2018 at 11:32 AM, NancyL said:

I have seen foreigners dying of cancer in agony due to lack of ability to pay, but not Thai people.  Even when the foreigner comes to the hospital with what "appears" to be end stage cancer they can be denied pain killers if they can't afford the appropriate diagnostic tests to confirm they have cancer and the extent or stage of the cancer because the health care providers don't want to supply "addictive" drugs to someone on a long-term basis.  With their universal health care system, Thai people wouldn't die this way.

 

 

This is quite frightening to think a health care provider would act this way, actually, it's bordering on barbaric.

[NancyL]

20 minutes ago, unblocktheplanet said:

This is particularly so for those suffering cancer pain. Is govt worried they'd create addicts in the afterlife?!?

 

The fact is, heroin, fentanyl, and all other pain relief should be legal and used in hospitals.

Morphine and fentanyl and other forms of pain relief are legal and available here and Thai people receive free medical care here.  Foreigners do not.  Foreigners can die in pain here if they lack the financial resources to have their cancer adequately "staged", i.e. tested, so that it's evident to the doctor just how much longer the patient is expected to live.  Also, some pain medications can only be given in a hospital or nursing home by qualified staff, but not in a residential setting by untrained people. 

[metisdead]

An inflammatory post using ALL CAPS has been removed. 

[uhuh]

Rural Thais and poor urban Thais are often sent home for their final days,  to die at home. 

There will be no painkillers except paracetamol. And even this only as tablets, no i.v. drip.

They die in agony.

Seen it more than once, Bangkok and upcountry.

 

[Rimmer]

Off topic troll post and a reply removed

[Deerculler]

There are pain clinics in most hospitals here.
Get your Doctor to give you an apointment.
I have found them to be very helpful.
You have to go through a Dr. to get to the pain clinic.


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[Sheryl]

Rural Thais and poor urban Thais are often sent home for their final days,  to die at home. 

There will be no painkillers except paracetamol. And even this only as tablets, no i.v. drip.

They die in agony.

Seen it more than once, Bangkok and upcountry.

 

I have seen many cases where cancer patients were sent home with morphine. 

 

Being under the care of a palliative specialist/pain clinic (which most large hospitals have) is key. Also the patient/family need to be assertive which many Thais find hard to do. They have to speak up and report it when pain meds aren't adequate.

 

True however that no drips at home, unlike in the West and there is also no longer a suppository form of morphine. This means that in very final stages when the person cannot swallow one may have to come into the hospital to get adequate pain relief, unless fentanyl patches do the trick. I really hope this changes before my time comes as I would much prefer to die in my own home.

 

There are doctors who specifically specialize in palliative care. Not many, and only in major hospitals. Getting under their care as one's primary physician - not just as a consultant to say the oncologist - is critical.

 

 

[dennis123]

On 9/21/2018 at 5:26 PM, oobar said:

You are getting ripped off.  A sheet of 10 tramadol capsules (50mg) is available for as low as 25 baht.  Have never paid more than 35 baht.  Paracetamol is even cheaper.  Find another pharmacy. 

Is that 25 baht/pill or 25 baht/strip. I don't even remember where I got it but I got 5 strips of Tramadol, maybe I got it in Laos, my memory really sucks, and purely for recreational use, and I think I paid around 25-30 baht/pill, same price as Clonazepam, also 30 baht/pill.

[how241]

A strip of 10 tramadol usually cost from 50-100 baht in Pattaya.  Price varies so you need to shop around. 

[wpcoe]

On 12/30/2018 at 4:51 PM, how241 said:

A strip of 10 tramadol usually cost from 50-100 baht in Pattaya.  Price varies so you need to shop around. 

Also take note of the size of the pill/tablet/capsule.  Off the top of my head, I think I've seen 50mg and 100mg pills/capsules.  Some is immediate-acting and some is time release, I believe.

[HAKAPALITA]

I use Hospial issued Ultracet sparingly, bit of Tramadol in them but not enough to send you into a Cannabis Clown Mode.. Seen friends get Kidney/Liver damage from over use so i just take the edge off the pain and stop, As for poor Thais dieing in agony, utter rubbish generally.

[how241]

9 hours ago, wpcoe said:

Also take note of the size of the pill/tablet/capsule.  Off the top of my head, I think I've seen 50mg and 100mg pills/capsules.  Some is immediate-acting and some is time release, I believe.

Usually the pharmacy has a 50 mg capsule, yellow and green. Immediate release.

[uhuh]

Now it has even become difficult to buy Ultracet in Bangkok. 

 

There is a Thai brand of Ultracet, which is still 4 times more expensive than Tramadol used to be. 

Both brands can only be sold if the pharmacy writes down your name.

Can only buy 20 tablets.

Most pharmacies just don't bother to stock it.

Same problem as with Tramadol (which very few pharmacies still sell. )

[JimmyJ]

On 9/21/2018 at 3:00 AM, Sheryl said:

You can get a permit allowing you to bring it in with you. Go to

www.permitfortravelers.fda.moph.go.th

TV members who have gone through this process report it to be pretty smooth with quick response from the FDA.

Then no need to worry.

30 day supply is the rule but if it is prescribed as say " every 12 hrs if needed" that is 2× 30 = 60.

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www.permitfortravelers.fda.moph.go.th is not working.

 

Does anyone have a current link for getting permission to bring pain pills / prescribed controlled substance out of the US into Thailand?

 

Since the above link includes "fda", that has to be a USA form for moving it out of the USA into Thailand.

Is a Thai form required also?

 

What do expats do when going out of Thailand to another country and want to take along the pills which were carried in from the US and brought into Thailand?

Does the USA form suffice?

 

 

Edited April 18, 2019 by JimmyJ

[faraday]

It's a Thai site - note 'th' at the end.

 

Then look at #5/#6 on the Information Forms.

 

As for taking Controlled Drugs from here to another country, I don't know.

[JimmyJ]

33 minutes ago, JimmyJ said:

 

www.permitfortravelers.fda.moph.go.th is not working.

 

Does anyone have a current link for getting permission to bring pain pills / prescribed controlled substance out of the US into Thailand?

 

Since the above link includes "fda", that has to be a USA form for moving it out of the USA into Thailand.

Is a Thai form required also?

 

What do expats do when going out of Thailand to another country and want to take along the pills which were carried in from the US and brought into Thailand?

Does the USA form suffice?

 

 

I found the website:

http://permitfortraveler.fda.moph.go.th/

 

it's permitfortraveler rather than travelerS

 

And you are correct faraday, it is a Thai form, my mistake.

 

I'm considering not taking them in, as I feel submitting this form may cause more scrutiny on me than there would normally be.

Also I'm planning to go there and stay there while the form asks for an exit date.

 

I'm thinking now of just hoping I don't need them (had an operation 2 weeks ago) and if I do - for that or something else in the future - trying to hunt some down if necessary.

Edited April 18, 2019 by JimmyJ

[Sheryl]

Wondering if its ok to bring some medicine from Germany to Thailand. Since i will stay soon in bkk for 6 months with my wife.

 

Last time when we stayed i had a pretty bad cold and everything i was asking for in the pharmacy was not available or they didnt know that medicine.

 

(Me showing a picture and getting a mai mi dont have in response)

 

Im thinking about ibuprofen 400/600

 

And some cold medicine like gripposdad cold & flu relief

(CAFFEINE / PARACETAMOL / PHENYLEPHRINE HYDROCHLORIDE)

 

 

ACC akkut 600

These medications are readily available in all Thai pharmacies and cheap. No reason to bring them with you.

 

Next time write down the names and show them that. Pictures may cause confusion because the brands here are different. Different brand names and different appearance.

 

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[Sheryl]

I found the website:

http://permitfortraveler.fda.moph.go.th/

 

it's permitfortraveler rather than travelerS

 

And you are correct faraday, it is a Thai form, my mistake.

 

I'm considering not taking them in, as I feel submitting this form may cause more scrutiny on me than there would normally be.

Also I'm planning to go there and stay there while the form asks for an exit date.

 

I'm thinking now of just hoping I don't need them (had an operation 2 weeks ago) and if I do - for that or something else in the future - trying to hunt some down if necessary.

Getting the permit will not cause you any special scrutiny or problem.

 

Just go through the green channel as usual. If bags checked at that point produce the permit.

 

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[JimmyJ]

17 hours ago, Sheryl said:

Getting the permit will not cause you any special scrutiny or problem.

 

Just go through the green channel as usual. If bags checked at that point produce the permit.

 

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Thank you for your input.

 

The instructions state:

"Supplementary information to

Narcotics Control Division Food and Drug Administration Ministry of Public Health Nonthaburi 11000, THAILAND Tel : 66 2590 7346, Fax : 66 2591 8471"

 

and this is to be included in the documents sent to them:

 

"1.3 Certificate issued by the competent authority of the country of departure to confirm the patient’s legal authority to carry medications for personal use."

 

If it was just carrying the filled out form and showing it at Thai Immigration if necessary that would be fine with me.

But it seems I also need a document of some sort from the US Government, and then submitting it to the Thai Narcotics FDA.

 

 

 

 

 

 

 

Edited April 19, 2019 by JimmyJ

[lopburi3]

4 hours ago, JimmyJ said:

But it seems I also need a document of some sort from the US Government, and then submitting it to the Thai Narcotics FDA.

Suspect that is your doctors prescription slip.

[Sheryl]

Yes, "competent authority" = your doctor.

Prescription.

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