'Abnormal' Prescriptions Of Cold Medicines Across Thailand

[webfact]

'Abnormal' prescriptions of cold medicines

The Nation

BANGKOK: -- The Public Health Ministry disclosed yesterday that many hospitals across the country were allegedly prescribing large amounts of cold medicines that contain a precursor chemical used to make amphetamines.

"These large prescriptions are abnormal," the Public Health Ministry's Pasit Sakdanarong, who chairs a panel set up to suppress, prevent and rehabilitate drug abusers, said.

"We will keep a close eye on who might be involved in these abnormalities. Preliminary investigation shows that some people had brought this cold medicine to produce yaba and 'ice' to sell in late-night venues," he added.

Meanwhile, Public Health Minister Witthaya Buranasiri said the ministry had also found that some state hospitals had prescribed large amounts of cold medication, but upon closer look it did not turn out to be abnormal.

"The medicines were prescribed for out-patients and in-patients in a Samut Sakhon hospital, and most of the patients were migrant workers," he said.

Following a report that a senior pharmacist at an Udon Thani hospital had been found guilty of prescribing huge amounts of cold medicines, Witthaya said police would soon be seeking an arrest warrant against the unnamed 40-year-old man. The pharmacist allegedly forged documents declaring that 65,000 tablets of pseudoephedrine-based medicine, contained in 130 bottles, had been delivered to a hospital at tambon level, when in reality he had sold them.

Witthaya added that the ministry would expand its investigation now that it has learned that the medicines were being exported to neighbouring countries.

-- The Nation 2012-03-02

[Pib]

When visiting a doctor/clinic/hospital/pharmacy in Thailand a person can walk away with pounds of pills....the pills may or may not have anything to do with your condition but you have pounds of pills. I guess issuing out a bunch of pills is cheaper than running tests or dedicating more diagnosis time to determine what is actually wrong with you. Sooner or later Thailand is going to start requiring doctor subscriptions to get many types of medications....personally, I hope that day is way down the road because it will just drive up the cost of medications and the cost of medical care...both of which are pretty cheap in Thailand.

[noitom]

Most people working in so called pharmacies in Thailand hardly ever know about basic medicines beyond the name and often don't know anything more about them. They even have a very difficult time looking anything up in the PDR. They rarely if ever are familiar with generics and hardly ever are able to recommend alternatives. Most pharmacies in Thailand don't have proper air temperature control and most of them are bacteria prone.

Think of all the time that you've bought a simple over the counter type medication like benadryl. Watch the majority of Thai pharmacy workers take out that same old metal tray and pour a handful of those caps out of a large bottle. Then they reach into a box or drawer or just pick up from another part of the counter, the metal "separator" and then they start to count off your order. It never occurs to them that the same instruments have been used for days or weeks without ever cleaning them. Often you can see the fingerprints and often the customers pick up and/or touch these instruments. Then the pharmacist counts out money with the same hands going all day without ever washing, and then repeats the process again and again.

It's too bad that the Thais don't recognize that this is a "corruption and graft problem" as well as a stolen property probblem and not so much as a drug problem. If hospital workers and local regulators/officals/police/security weren't corruptible, you wouldn't have these false orders and diverted shipments and pickups. This is a case of "amateur" dealers bribing hospital officials/security and police. The professional dealers and narco drug rings would never need "hospital supply." Nor would they be so stupid to rely on weak links in the chain. They use their own network, their own labs, and their own bribed army and police.

It's also too bad that pseudoephedrine based medicine is being removed from the adult Thailand residents' portfolio of allergy and cold remedies. Thai pharmacies offer no effective alternative. As phenylephrine based remedies are virtually useless against powerful plant life and the polluted air around Thailand. With all the bacteria and pollution around Thailand, coughing without covering mouths, picking noses and rarely if ever washing hands, Thailand pharmacies should be well stocked with pseudoephedrine based medication like Actifed and Clarinase for adult allergy sufferers and colds.

Thailand is shifting the gangsterism from the amateur briber of hospital workers and local police to the hospital police at Bumrungrad who control most of the so called prescription required medications. Bumrungrad has a monopoly on many of the prescribed type 2 medicines in Thailand. It's virtually impossible to get a prescription for some medicines unless you go through a many visit procedure at Bumrungrad. It's a ripoff.

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[toybits]

Anti-histamines don't work as well as pseudoephedrine. But now I cannot purchase this to relieve my chronic sinusitis.

[anselpixel]

My friendly neighborhood pharmacist refused to give me my usual decongestant about three weeks ago, and replaced it with one containing no pseudophed. He told me to go to a hospital if I wanted the real thing, as he's afraid someone may be watching him.

The new one doesn't work as well, but I no longer need anything to help me sleep.

[AlaskaDave]

I trued to buy some baby aspirin the other day at a pharmacy in the Airport Plaza in Chiangmai and was told pahrmacies no longer carry it. I cannot believe this has anything to do with the pseudoephedrine or other precursors to yaba but then it is Thailand and one never knows.

Anybody have any info on this?

[allan michaud]

I always find I have to hand back half the drugs the doctors issue here. Last time we took our son to a doc (he just had flu or cold but mum insisted) the doc (and this was Khon Kaens biggest and best hospital) gave us 5 different sets of pills. I was furious and refused just taking one set that was actually appropriate. Why do Thais feel they need to take so many pills? the doctors are only doing this to make money its ridiculous.

[sirchai]

"We will keep a close eye on who might be involved in these abnormalities."

"We will keep a closed eye on who might be involved in these abnormalities".

[belg]

maybe a- it is the dirty air from all the garbage burning that keeps people for trying to get over with it with cold medicine or b- drug dealers which use it to make whatever

[sirchai]

I always find I have to hand back half the drugs the doctors issue here. Last time we took our son to a doc (he just had flu or cold but mum insisted) the doc (and this was Khon Kaens biggest and best hospital) gave us 5 different sets of pills. I was furious and refused just taking one set that was actually appropriate. Why do Thais feel they need to take so many pills? the doctors are only doing this to make money its ridiculous.

The side affects might solve all problems,some of them will never get sick again. A friend of us got killed by a doctor, only having an urine tract infection. They injected Antibiotics intravenous, the whole dose for three days at one time. He died having an allergic shock after injecting it.

He was only 22 years old. I went to the hospital, but all I could do was that some of them came to show respect when they burned his body. Land of Whys..

[IAMHERE]

Anti-histamines don't work as well as pseudoephedrine. But now I cannot purchase this to relieve my chronic sinusitis.

Yes, it is a shame when everyone has to be punished because of the few. Druggie's are not much better than terrorist in the problems that they cause the general populations. I am just waiting til the first person at the airport gets a 10,000 baht fine for bringing in a package of pseudoephedrine they bought at their local Walmart-Tesco-Carrefour.

[Gandalf8353]

Can we say Meth? That's where pseudo-ephedrine goes in the States.

[curtklay]

Can we say Meth? That's where pseudo-ephedrine goes in the States.

Not when you have a stuffy nose.

[atyclb]

In the days before they knew a street drug could be made with sudafed one or 2 tablets helped greatly with cold/sinus symptoms. I had never heard about anyone getting addicted to pseudophedrine.

Seems strange that in Thailand this otc pill would be so tightly controlled. In the US it is not a controlled substance, just not kept on the shelf and has limited per customer availability.

Too bad they dont find a way to combine it with something that renders it incapable of producing yaba.

[atyclb]

In the days before they knew a street drug could be made with sudafed one or 2 tablets helped greatly with cold/sinus symptoms. I had never heard about anyone getting addicted to pseudophedrine.

Seems strange that in Thailand this otc pill would be so tightly controlled. In the US it is not a controlled substance, just not kept on the shelf and has limited per customer availability.

Too bad they dont find a way to combine it with something that renders it incapable of producing yaba.

[MILT]

Most people working in so called pharmacies in Thailand hardly ever know about basic medicines beyond the name and often don't know anything more about them. They even have a very difficult time looking anything up in the PDR. They rarely if ever are familiar with generics and hardly ever are able to recommend alternatives. Most pharmacies in Thailand don't have proper air temperature control and most of them are bacteria prone.

Think of all the time that you've bought a simple over the counter type medication like benadryl. Watch the majority of Thai pharmacy workers take out that same old metal tray and pour a handful of those caps out of a large bottle. Then they reach into a box or drawer or just pick up from another part of the counter, the metal "separator" and then they start to count off your order. It never occurs to them that the same instruments have been used for days or weeks without ever cleaning them. Often you can see the fingerprints and often the customers pick up and/or touch these instruments. Then the pharmacist counts out money with the same hands going all day without ever washing, and then repeats the process again and again.

It's too bad that the Thais don't recognize that this is a "corruption and graft problem" as well as a stolen property probblem and not so much as a drug problem. If hospital workers and local regulators/officals/police/security weren't corruptible, you wouldn't have these false orders and diverted shipments and pickups. This is a case of "amateur" dealers bribing hospital officials/security and police. The professional dealers and narco drug rings would never need "hospital supply." Nor would they be so stupid to rely on weak links in the chain. They use their own network, their own labs, and their own bribed army and police.

It's also too bad that pseudoephedrine based medicine is being removed from the adult Thailand residents' portfolio of allergy and cold remedies. Thai pharmacies offer no effective alternative. As phenylephrine based remedies are virtually useless against powerful plant life and the polluted air around Thailand. With all the bacteria and pollution around Thailand, coughing without covering mouths, picking noses and rarely if ever washing hands, Thailand pharmacies should be well stocked with pseudoephedrine based medication like Actifed and Clarinase for adult allergy sufferers and colds.

Thailand is shifting the gangsterism from the amateur briber of hospital workers and local police to the hospital police at Bumrungrad who control most of the so called prescription required medications. Bumrungrad has a monopoly on many of the prescribed type 2 medicines in Thailand. It's virtually impossible to get a prescription for some medicines unless you go through a many visit procedure at Bumrungrad. It's a ripoff.

• Quote
  

Huh?

[bendejo]

Anti-histamines don't work as well as pseudoephedrine. But now I cannot purchase this to relieve my chronic sinusitis.

Same here. They sold me phenylephrine with some other stuff and it worked when I had a sinus infection. I still have some pseudoef which I only take sparingly when I feel a sinus irritation. It's been illegal in Malaysia for some years, but if you shop around maybe a small shop will stock it.

The absurd thing is that in the US, where medical organizations would require a prescription for everything if they had their way, you can buy pseudoefedrine products right off the shelf.

[anterian]

Nasolin, contains 60mg pseudoephedrine plus 2.5 mg of triprolidine seems to be still available. I object that genuine users are being victimised because the police cannot cope with the drub pushers. Incidently, contrary to many comments, I find Thai pharmacists quite knowledgeable, as long as I know the chemical name they understand me. The first time I needed a nasal spray they did not recognise "otrovine" but they knew oxymetazoline.

[ParadiseLost]

Anti-histamines don't work as well as pseudoephedrine. But now I cannot purchase this to relieve my chronic sinusitis.

Yes, it is a shame when everyone has to be punished because of the few. Druggie's are not much better than terrorist in the problems that they cause the general populations. I am just waiting til the first person at the airport gets a 10,000 baht fine for bringing in a package of pseudoephedrine they bought at their local Walmart-Tesco-Carrefour.

Dubai paranoia to come...

I understand your relating druggies to terrorists, but personally I feel the real problem here is people are so open to corruption they will sell their souls for money. Heck, they sell their daughters and even minors into prostitution.

Try buying 20k pseudoephadrine tabs from a pharmacy/hospital in the US or UK and see the reaction from the pharmacist. I am not saying it doesn't happen, but here it wouldn't take much persuasion at all...

[atyclb]

removed double post

Edited March 2, 2012 by atyclb

[poach]

Is this related to why I see so many Thais sniffing a type of nose inhaler?

[tragickingdom]

How convenient to put the blame on "migrant workers". Migrant workers might be simply more vulnerable to influenza as their food is less good, they work much longer hours and live in appalling conditions. On top of that they have to pay the authorities from their meager salaries. Instead of pointing to migrant workers it would be better to point to the Thai doctors and hospital staff....

[NastyNick]

Pharmacies still sell pseudo-ephedrine suspended in syrup or suspended in jell caps. There are so many additives that exacting the pseudo is no longer practical for the cooks.

In January, a completely original method to synthesize pseudo-ephedrine was published in some Chemistry Journal, which uses meth-amphetamine as the initial ingredient and reduces it to pure pseudo-ephedrine. (http://heterodoxy.cc/meowdocs/pseudo/pseudosynth.pdf).

[easybullet3]

I trued to buy some baby aspirin the other day at a pharmacy in the Airport Plaza in Chiangmai and was told pahrmacies no longer carry it. I cannot believe this has anything to do with the pseudoephedrine or other precursors to yaba but then it is Thailand and one never knows.

Anybody have any info on this?

- just a piece of trivia: if you are referring to the 'low dose' aspirins (to help with 'blood thinning') then if they are coated (to help protect from stomach ulcers), they are less effective in thinning your blood (compared to un-coated aspirins).

i read about it a long time ago, here is an article I just found online about it (if you are interested)

http://www.news-medical.net/news/2004/05/19/1697.aspx

[NastyNick]

It's interesting that in Cambodia the government also pulled all the pseudo-ephedrine products. Codeine, Xanax, Valium, Ketamine and Morphine are still sold over the counter though. US Government probably 'asked' both countries to ban it.

[Gello]

Pseudoephedrine has been restricted in the UK now for several years following concerns of its use in the manufacture of methyl amphetamine. The Medicines and Healthcare products Regulatory Agency (MHRA) were proposing in 2007 to restrict it to prescription only (POM) status and not allow any sales from pharmacies but following consultation and a backlash from pharmacies, consumers and manufacturers, it can still be sold in pharmacies but is now legally limited to one sale of 720mg pseudoephedrine (effectively 12 x 60mg tablets) and any strange requests for it to be reported.

They say it has reduced the problem. Not sure by how much, but enough to allow it to still be sold.

In the UK, there aren't really any other effective oral decongestants other than pseudoephedrine, so if it had been restricted there would have been nothing of note to use for colds/blocked sinuses other than nasal sprays.

Unfortunately, rightly or wrongly, it sometimes takes a ban or restriction on a product when a minority abuse it and spoil it for everyone else. However, despite the heavy restrictions on sale, some GPs still prescribe large quantities of a 100 tablets or so, and whilst probably for legitimate use, it means there are large enough quantities still available on the open market. While most GPs prescribe wisely, some will ignore or not be aware of latest advice, and do what they want to. Another problem being the large quantities of codeine and diazepam available on the open market. The only place this generally comes from is over prescribing!

So while restricting it's sale and the way it is freely available may help or reduce the problem to a lesser or greater extent, it will never go away, as there will always be other sources, however legitimate. Any fraudulent, corrupt or illegal behaviour should still be punished though.

[AlaskaDave]

@easybullet3 -- No, I did not know that but I wonder if it makes any difference seeing as the idea is to keep a low dosage of aspirin or thinner in your blood stream at all times. Could it be possible that the coated varieties are better?

@NastyNick - You can be sure the long arm of the U.S. has reached into these countries and has had its way with them. As an American I wish our governemtn would butt out of other countries' internal affairs. Hah. That would be like pissing into the wind and hoping to stay dry.

[surangw]

The thai pharmacies are a danger for sure.

I sent my daughter out to get some pepto bismo ( or pink pismith) for a mild case of the runs. ( I had the problem )

The Local druggist sold her some Vancomycin. ( antibotic of last resort, with sever side effects )

[bina]

tiffy's is still available? the cold/allergy mixed with paracetamol pill? its with antihistamine and sudafed mixed

[Danielsiam]

Why no body speak about the Tramadol can buy in freedom in Thailand ?

That's so crazy can buy everywhere in Thailand the TRAMADOL also in Boots at Suvarnabumi you can buy it.. Without prescriptions.

It's very very addictive drugs.. effect near morphine / opium / heroin family, the Tramadol make you so happy..

just cost 20 baths the 10 tablets the thai Tramadol... but if you're caught with Xanax, you're going to jail & deported, but some pharmacies in Pattaya sell the Xanax !!