Pain Killers

[Jessi]

I had a failed disc fusion on my back

About 30 years ago I herniated a disc, but never had the back operation having heard so many war stories, similar to yours. However, I was in pain until one doctor in the US told me to swim. He explained that swimming (free style) strengthens the supporting muscles in the back while the water doesn't put any pressure on the back while exercising. I thought he was crazy, but figured I had nothing to lose. After about a month or two (can't remember exactly), all (and I mean all) the pain went away.

I still swim. It is a great exercise anyway, but has the added benefit for the back.

Great advice about the swimming. Everything is either being banned or cracked down on in Thailand. (Sue google) makes me laugh who do these Thais think they are.

If you want to try a TENS machine they are for sale on the ground floor of Panthip Plaza. I paid about 3,000B for a good quality one.

Hope that helps.

Jessi

[sabaijai]

My similar experience recently with my broken leg and two surgeries was an extremely tight reign on morphine which was quickly supplanted by the physician with Ultracet. Manufactured in the U.S., it consists of 35 mg. of Tramadol and 300 mg of Paracetamol.

As soon as I got out of the hopital, I went to my local pharmacy and found generic Tramadol in 50 mg capsules and of course the usual paracetamol in 500 mg. tablets. Used them to great effect for the first month, until no longer needed. Cost was very low compared to the hospital charges for Ultracet.

The Ultracet I've seen distributed at Thai hospitals (my girlfriend has a prescription for monthlies) says on the label that's it's made in the UK. The US version contains acetaminophen rather than paracetamol.

Codeine in combo with paracetamol is still available in some local pharmacies, at least in Chiang Mai.

[naklang]

Got 100mg/tab TRAMAL from a pharmacy in Siem Reap. Those did the trick nicely for my osteo in my left hip. Don't combine w/ any other opiate (codeine etc.) within 48 hours or you will be dope sick and VERY unhappy. Also don't take more than 400mg/day or possible seizure. I also read the other poster was prescribed fentanyl patch and MSContin? Whoa! Don't even THINK about mixing those. Can you say respiratory arrest?

[A_Traveller]

I had a failed disc fusion on my back

About 30 years ago I herniated a disc, but never had the back operation having heard so many war stories, similar to yours. However, I was in pain until one doctor in the US told me to swim. He explained that swimming (free style) strengthens the supporting muscles in the back while the water doesn't put any pressure on the back while exercising. I thought he was crazy, but figured I had nothing to lose. After about a month or two (can't remember exactly), all (and I mean all) the pain went away.

I still swim. It is a great exercise anyway, but has the added benefit for the back.

Great advice about the swimming. Everything is either being banned or cracked down on in Thailand. (Sue google) makes me laugh who do these Thais think they are.

If you want to try a TENS machine they are for sale on the ground floor of Panthip Plaza. I paid about 3,000B for a good quality one.

Hope that helps.

Jessi

Where about in Panthip? I've never seen them there.

Regards

[ratchabuild]

I had a failed disc fusion on my back

About 30 years ago I herniated a disc, but never had the back operation having heard so many war stories, similar to yours. However, I was in pain until one doctor in the US told me to swim. He explained that swimming (free style) strengthens the supporting muscles in the back while the water doesn't put any pressure on the back while exercising. I thought he was crazy, but figured I had nothing to lose. After about a month or two (can't remember exactly), all (and I mean all) the pain went away.

I still swim. It is a great exercise anyway, but has the added benefit for the back.

Great advice about the swimming. Everything is either being banned or cracked down on in Thailand. (Sue google) makes me laugh who do these Thais think they are.

If you want to try a TENS machine they are for sale on the ground floor of Panthip Plaza. I paid about 3,000B for a good quality one.

Hope that helps.

Jessi

Where about in Panthip? I've never seen them there.

Regards

Always try a tens machine first. All drugs have side effects. Try Tens. You would be crazy to opt for drugs before trying TENS

[Sheryl]

You can buy TENS online if you have trouble finding in Thailand, that's how I got mine. And they are indeed very helpful.

[rockhardbkk]

Re Cambodia:

1) You can get a large assortment of medications over the counter there but not "everything"...certainly not morphine. In terms of pain killers, the only widely available is codein in vaiious formulations. May be able to find tramadol and temegesic with some difficulty, not sure.

2) There are only a handful of pharmacies that can be trusted not to have counterfeit drugs. Best is Pharmacie de la Gare, near the train station. Elsewhere you run a good chance that the drug is fake.

If you don't know what you're talking about Sheryl, you probably should refrain from giving answers.

1) Morphine, Tramadol, and Temgesic are all available. You need to go to the right pharmacies but there are at least 5 that I can think of off the top of my head that carry those drugs. Morphine is available in 30 mg pills normally, 60 mg not so easily.

As far as the counterfeit pills...yes, this can be a problem but not nearly as much as what you say. From what you wrote, the Pharmacy Le Gare is the only decent pharmacy in the country. Not so - there are a good 10 reputable pharmacies; Olympic, Vimol (former name), Sang Vath, and a handful that are on Street 136.

Believe me, what you wrote is misleading.

[Sheryl]

I did not say Le Gare was the only decent pharamcy. I said it is the best, an opinion I still stand by (based not only on quality of the drugs but also breadth of inventory and knowledgability of the pharmacist there.)

Morphine is definitely not legal to sell OTC and not widely available, the fact that a few places (apparently known to you) may sell it does not change this.

Not only I, but several doctors I know -- both foreign and Cambodian (including one in fairly high position at the MoH) -- have had great difficulty sourcing it in the past. Apparently I and they do not frequent the "right" places. Anyhow should I ever again be helping someone with terminal cancer and need morphine, I will PM you as to source.

I was also quite recently unable to get temegesic, altho granted I didn't scour the entire city for it, just tried about 10 places. Not only could not get it but was told by all the pharmacists that it is not legal for sale OTC either.

[rockhardbkk]

I did not say Le Gare was the only decent pharamcy. I said it is the best, an opinion I still stand by (based not only on quality of the drugs but also breadth of inventory and knowledgability of the pharmacist there.)

Morphine is definitely not legal to sell OTC and not widely available, the fact that a few places (apparently known to you) may sell it does not change this.

Not only I, but several doctors I know -- both foreign and Cambodian (including one in fairly high position at the MoH) -- have had great difficulty sourcing it in the past. Apparently I and they do not frequent the "right" places. Anyhow should I ever again be helping someone with terminal cancer and need morphine, I will PM you as to source.

I was also quite recently unable to get temegesic, altho granted I didn't scour the entire city for it, just tried about 10 places. Not only could not get it but was told by all the pharmacists that it is not legal for sale OTC either.

Whether it's legal or not is irrelevant really. I personally don't like Tramadol or Temgesic as it doesn't reduce my pain but that's my own preference. With regards to Morphine - go to the Olympic pharmacy - they've sold me 30 and 60 mgs. of it. In addition, go to 2 or 3 of the pharmacies on Street 136. For whatever reason, they sell it to me and I rarely have a problem getting it. Codeine in Phnom Penh can be found at many of pharmacies with very little trouble.

There are only a handful of pharmacies that can be trusted not to have counterfeit drugs. Best is Pharmacie de la Gare, near the train station. Elsewhere you run a good chance that the drug is fake.

Elsewhere there is a good chance the drug is a fake?

The Pharmacy Le Gare certainly has a good reputation but there are quite a few other places to go that are also reputable and WON'T sell you counterfeits. That was my point - it's not the only pharmacy in Phnom Penh that is trustworthy.

[ukrules]

The Ultracet I've seen distributed at Thai hospitals (my girlfriend has a prescription for monthlies) says on the label that's it's made in the UK. The US version contains acetaminophen rather than paracetamol.

Codeine in combo with paracetamol is still available in some local pharmacies, at least in Chiang Mai.

You might find this useful when looking for drugs - Acetaminophen is paracetamol - same thing - different name.

From my experience it's known as Acetaminophen in the US and Paracetamol most other places.

[YaiJung]

In Phnom Penh, Pharmacy Le Gare is ok, but I went there for a nasal spray for a cold and they tried to sell me $40 worth of nonsense when all I needed was a $1 item. I got it, but they tried their best to get me to buy more expensive meds and had about 6 options before finally showing me the one I came in for. Also refused to sell me Diazepam several yrs ago. Le Gare is in all the tourist books, but I would never send anybody there.

I went down to the block of Pharmacies near the Olympic Stadium and found the Diazepam and other meds, including opiates. One tip I can give is to look for pharmacies with aircon. The meds tend to be in better shape. Btw, I bought real Valium made in France by Roche for 1/3 the price I paid in Thailand for Thai generics(which sucked and barely worked).

[RealRyguy]

So can I go into a Watson or Boots in a mall and find Morphine, Tramadol, and Temgesic ?

I used Morphine in the states. Is Tramadol and Temgesic the same as morphine? Does it feel the same?

How much would you expect to pay for how many pills?

[Sheryl]

So can I go into a Watson or Boots in a mall and find Morphine, Tramadol, and Temgesic ?

I used Morphine in the states. Is Tramadol and Temgesic the same as morphine? Does it feel the same?

How much would you expect to pay for how many pills?

You can buy Tramadol OTC easily in both Thailand and Cambodia.

Buprenorphine and morphine are controlled drugs in both countries, not legal for sale over the counter. Hospital pharmacies only. In Cambodia morphine is rare even in hospitals. Potential posters please spare us boasts about how you managed to obtain these nonetheless, discussion of illegal activities is not allowed.

Codeine is OTC in Cambodia but not in Thailand. Diazepam is also OTC in Cambodia, not in Thailand. I have no idea why one poster says he was unable to purchase it except that there have been problems (and arrests) due to foreigners trying to buy large quantitites to take or ship out of the country which may have made pharmacies wary of foreign customers they don't know/haven't seen before or who look/act (by their standards) fishy or are asking for large amounts.

No Boots and Watsons in Cambodia but other chains (eg U Care) and plenty of pharmacies. Counterfeits and heat-inactivated drugs can be a problem so coose with care.

[syd barrett]

Buprenorphine and morphine are controlled drugs in both countries, not legal for sale over the counter. Hospital pharmacies only.

Buprenorphine makes me vomit within 30 mins.

It was a good painkiller for post-operative pain but I can't seem to tolerate it any more.

It always seems strange to me that local pharmacies shy away from selling diazepam yet don't seem to worry about selling alprazolam.

I think pain management in Thailand is acceptable, because a personal friend who had painful terminal cancer was prescribed morphine tablets (from the hospital pharmacy) albeit only 21 tablets at a time.

[Sheryl]

Buprenorphine and morphine are controlled drugs in both countries, not legal for sale over the counter. Hospital pharmacies only.

It always seems strange to me that local pharmacies shy away from selling diazepam yet don't seem to worry about selling alprazolam.

Both diazepam and alprazolam, and all other benzos, are controlled drugs illegal to buy or sell over the counter

My guess would be that perhaps the staff in question are not pharmacists (a common occurrence) and don't realize what they are selling as diazepam is better known among lay people.

Doesn't protect the buyer from possible legal consequences, tho http://www.thaivisa.com/forum/Valium-Bust-...l&hl=valium

[RealRyguy]

You can buy Tramadol OTC easily in both Thailand and Cambodia.

So is Tramadol any strong or is it just a tylenol. What "western" pill would you associate with tramadol?

Percocet? vicodin? oxycontin?

Edited February 14, 2010 by RealRyguy

[Loz]

I THINK Tramadol is a synthetic Codene replacement. Non opiate. Is that right?

I too was looking for Vicodin recently and when I explained its chemical compostion was told that I meant Paracetamol. Had a hard time explaining that It was a BIT stronger than that. It was the Aceteminophen and Hydrocodone that threw them. they here the first bit and blert out SARA SARA!!

I've found tramdol 50mg works for severe neckpain. Doc gave me choice of the pills with norgesic (muscle relaxant) or a shot in the neck of something more "deliberate". up until this weekend I have found the pills ok. But I was close to going back to the hospital for that shot. Glad I read this as I will not be looking for anything stronger than tramadol now. Its good to know the score. I'm sure it cross the mind of at least one pharmacist that I was "dodgy".

I'm not by the way.

[Sheryl]

A post discussing pain killers in a recreational sense has been deleted. This forum is not he place for that type of thing. And neither is Thailand unless you are prepared to spend a very long time in solitary confinement or worse.

The interest of a minority of foreigners in using Thailand as a playground for "recreational" drug use is exactly what often makes it hard for foreigners with genuine pain to obtain appropriate medication.

End of rant, response to the last 2 posts:

1. The western medication Tramadol would correspond to is tramadol. It is widely uised in the West.

2. Tramadol is stronger than tylenol/paracetemol. It can also be combined with it or with an NSAID for extra pain relief (the latter subjest to appropriate precuations i.e. take with food and not if history of bleeding problems or ulcer or on an anticoagulant).

3. Percocet is available here as paracetemol (tylenol) + codeine, which is basically what percocet is. Controlled substance, only from hospitals. Vicodin is not, closest relative would be the aforementioned paracetemol + codeine.

Tramadol is an opiate agonist, not an opiate. It mimics the analgesic action of opiates but is not an opiate itself. (Opiates themselves are endorphin agonists, they mimic the analgesic action of endorphins, tho along with some other effects which from a medical point of view are undesirable. )

Because it does not share many of the non-analgesic effects of opiates it has lower abuse potential. Hence its OTC availability in Thailand. In the West, it is a prescription drug but not as tightly scheduled as opiates.

As with any medication, people vary in their response, and there are side effects, which anyone using it or contemplating using it should read up on.

[relentless]

"dihydrocodeinone"?

Doubt they're very keen on these here as they have a very high potential for misuse and dependency.

*EDIT* You can buy Tramadol from just about any pharmacy, although it does make you a little high.

Suppose that would be depending on your pain. I am on Tramadol and take it from the moment I get up till the time I go to bed. I have diabetes with neuropathy and I am always in pain.

[Ulysses G.]

He tells me he thinks ms contin is good, reads in the "bible" the quick description that it is for acute pain in cancer patients. He looks at the 50 mcg dosage for fentanyl patch and laughs and says that is way too small ( the book didn't list mcg at all BTW - just 25mg, 50mg and 100 mg).

We decide I'll try both and see which works better. The 25mg he decides is too weak for me so Im testing the 50mg patches now and then ms contin if needed.

MS Codin is mophine, isn't it? Is it available in Thailand?

[Sheryl]

He tells me he thinks ms contin is good, reads in the "bible" the quick description that it is for acute pain in cancer patients. He looks at the 50 mcg dosage for fentanyl patch and laughs and says that is way too small ( the book didn't list mcg at all BTW - just 25mg, 50mg and 100 mg).

We decide I'll try both and see which works better. The 25mg he decides is too weak for me so Im testing the 50mg patches now and then ms contin if needed.

MS Codin is mophine, isn't it? Is it available in Thailand?

MS Contin is a sustained release form of oral morphine.

Morphine is available in Thailand only from hospital pharmacies and sales are strictly controlled.

[Ulysses G.]

Thanks. I was watching a documentary about morphine for those in severe pain recently and am glad that it is available in Thailand. It seems to me that banning it because of the war on drug is a crime when some patients need pain relief desperately and it is so cheap to produce.

[snooky]

I have a bulging disc which about every six to eight years acts up . This time, it started last Song Kran and has been with me since. Ultracet and other meds they have given me here do little. I was back in the US and received a supply of vicodin which does not give me a high but enables me to function/walk normally for 4-6 hours but I only use it when I know I will be out and about. And, of course, since I stay here long term, I cannot have the prescription renewed.

The other alternative a pain doctor in the US suggested was some kind of shot into the back/spine area which, if effective lasts three or more months. I was scheduled to leave the US the day after seeing this doctor so could not have it done there. Is there anyone with experience with this procedure here in Thailand. Am somewhat suspicious of many doctor's claims as quite a few are only trying to make money for themselves and/or the hospitals they work for.

[Sheryl]

It would help to know what type of injection was recommended -- a steroid to reduce the inflammation, or a temporary nerve block?

Try to get this info from the US doc if you can along with a medical summary that indicates what they thought was the source of the pain. Bulging disks don't "act up" every so many years, the natural history of them is that they resolve over about 6 months. More likely there is a bone spur or permanent narrowing of the space where nerve exits bone leading to compression.

A medical summary from the US with clear recommendation will greatly facilitate my being able to point you in the right direction and your getting what was recommended.

I assume it has been determined that the problem is not amenable to surgery or that you are not a good surgical candidate?

[snooky]

Thanks so much for your reply!!~! I called the doctor's office and they said the injection is normally a steroid epidural type. I am looking through my papers trying to find the actual xray reports from the VA in the US. Can't have an MRI as I have a pacemaker.