Pain Killers - Here we go again!

[smileplur]

I will preface this post by stating that I have actually searched through the forum. I have read many threads dedicated to this subject. I am aware of the forum rules. I will write accordingly.

The Situation: I completely shattered my right leg a year and a half ago. It was a spiral fracture when my motorbike landed on and subsequently twisted my leg. The circumstances aren't too important. Let's just say it was painful.

What Happened? Well, I knew immediately it was broken. I was sober. Initially, I felt no pain, but I know that I had lost the ability to move my right leg. I was in a very Thai area where NO ENGLISH was spoken. Immediately, I grabbed my phone and called my wife to tell her that I had a little bit of a problem. My Thai was good enough to explain that I had broken my leg, ask for help moving the bike, and request an ambulance be called.

Abulances here really are money chasers, so it is a free for all. Who knows where you will end up! My wife arrived simultaneously with the ambulance. I arrived at Vibharam Hospital (I think). It was then that the pain really hit me.

Arriving in the ER, I immediately asked for morphine. I couldn't coherently answer any of their questions. They told me there were no attending doctors present and they could not give me a narcotic. I told them in no uncertain terms that they would need to go find a doctor before moving me. 10 minutes later, they found a doctor who gave me a dose of morphine. Yeah, there was still pain, but I could sit up and speak to people. X-Rays .... all of it .... I was eventually put into a standard cast and told to go home. The doctor agreed to give me another dose of morphine before leaving for the journey home. He told me that if I was going to walk normally again, the fracture would require surgery.

This isn't the kind of surgery I go to any hospital for. I didn't have a common cold. My leg was in pieces and I shutter when I look at the original x-rays. So, I opted for a consultation at Samitvej (Main Branch). The diagnosis was the same. I required a titanium rod, two titanium plates, and a ton of screws (14). Great! The bill for this would be 300,000 THB. My insurance (AIA) wasn't being cooperative.

I elected to have the surgery. I paid out of pocket. I couldn't walk for several months.

Pain Killers - The hospital wasn't shy about giving me what I wanted. I had as much morphine as I wanted. I was fine. I was just dealing with it. After my discharge, I went to the pharmacy and asked about what they had. I had a few choices: codeine (pure) or buprenorphine (sublingually). I opted for codeine. So, I started taking it. I would buy 30 at a time. In the beginning, I required 60 per week. That went down to less than 30 per week. I had asked my doctor about taking this for pain management. He told me to continue buying it at the pharmacy, as it was cheaper. I showed him the pills, and I asked if he could provide them. He simply told me to continue.

So, here I am. My job requires me to stand most of the day. When I am not standing, I am driving. That requires my right leg. Often, I work 15 hours a day.

The Problem - One day, I went to the pharmacy, and they said that codeine was off the table. I couldn't buy it anymore. They didn't know when I could buy it agian ... maybe a month .... maybe a year. I now had two choices available, Codeine w/ Paracetemol or Buprenorphine. I bought both. For some reason, the Codeine didn't work even though the dosage (60 mg) was the same. So I tried the Buprenorphine. Again, no effect at all. I was shocked because I heard it was a powerful pain killer. I consulted friends, etc. I was led to Tramadol. I tried it. I tried one pill - nothing. Two pills - nothing. Seven pills (50 mg) - not a damn thing.

For the last month or so, I have been in constant pain. There seems to be nothing I can buy to make it go away. When I visited America last October, I was handed a bottle of Vicodin which worked perfectly. Alas, this is not available here.

So, a friend had a few MS Contin pills. He gave them to me. Whoa! I certainly wasn't feeling any pain. However, I was pretty buzzed. It's not the best option for me. My pain now does not warrant morphine. However, this seems to be the only option I have available to me in Thailand at the moment. I will need to go to the hospital and ask for morphine because they are unwilling to sell Vicodin .... sigh ....

What advice do you have? The doctor told me I can take out the titanium after two-three years if there is pain. I haven't reached that point yet. I really don't feel like paying the fees at Samitivej.

[Sheryl]

It is not a matter of being "unwilling", Vicodan is not registered for use in Thailand.

The drugs available for dealing with chronic pain include fentanyl (dermal patches), codeine in various forms, tramadol (which often works better when combined with paracetemol), pentozocine and of course morphine. In addition, neuroleptiocs like gabapentin and/or antitricylcics are often given and help to decrease the amount of narcotic required.

All of the various meds have disadvantages, not least of which is that one tends to build a tolerance to them which has likely already occurred in your case and contributes to your difficulty in getting adequate relief. This makes management of chronic pain especially challenging.

Most of these drugs can only be obtained from a hospital pharmacy. Both for that reason and because it is not a simple matter to obtain adequate relief in a manner that does not lead to excessive tolerance or dependency, and treatment needs to take into account the likely need for long duration, you would do best to consult a specialist in pain management.

Suggest one of the following:

Bangkok Hospital: http://www.bangkokhospital.com/index.php?p=doctor_profile&DrID=2345

Bumrungrad Hospital: http://www.bumrungrad.com/doctors/Chomchai-Vichitrananda

http://www.bumrungrad.com/doctors/Nuj-Tontisirin

Best to bring with you a medical summary from your ortho doc stating the procedure done and meds given for pain to date.

[thaiexpat21]

Codeine or Buprenorphine are both illegal to sell and illegal to buy / be in possession of in Thailand unless properly prescribed and obtained from a hospital pharmacy. (Buprenorphine I believe is not even available in Thailand

You will be unlikely to be given a prescription for morphine.

If you can work, stand and drive for 15 hours/day it would seem your problem is related to other than pain.

[smileplur]

Codeine or Buprenorphine are both illegal to sell and illegal to buy / be in possession of in Thailand unless properly prescribed and obtained from a hospital pharmacy. (Buprenorphine I believe is not even available in Thailand

You will be unlikely to be given a prescription for morphine.

If you can work, stand and drive for 15 hours/day it would seem your problem is related to other than pain.

Please read what I mentioned at the beginning of my post. Both Codeine and Buprenorphine are available. I can assure you that they are both readily available illegally under the counter; however, I am not about to get into a discussion of where those locations might be.

As for being prescribed morphine, I am certain I would be able to secure a prescription for it from my doctors at Samitivej. In fact, I think it is silly that you think it is unlikely. Given the amount of money I have given that hospital, I am treated very well there. As mentioned, they give me whatever I want, but it isn't cheap. I don't like their pricing, and I would prefer not to go there.

The problem with my work is that I cannot stand for that long. That means I must sit when I really should be standing. I often skip lunch so I don't have to walk to go get it. My weight loss will reflect that! Then, I get home to my 6 month old son, and I can't really walk with him.

[thaiexpat21]

Discussion about illegally obtained drugs is forbidden on the forum.

I do not doubt you have a "problem" .

Best you follow the advise already given by Sheryl.

The drugs you seek can only be obtained legally via a valid prescription at a hospital pharmacy.

[FiftyTwo]

You should take Sheryl's advice.

Tramadol is very effective, available over the counter, abound 40bht for 10 tablets, take as few as you can per day as they are addictive.

Side effect, marital relations will become disappointing.

Morphine should be avoided, if you keep taking it you will be sorry.

Edited October 27, 2013 by FiftyTwo

[Sheryl]

Codeine or Buprenorphine are both illegal to sell and illegal to buy / be in possession of in Thailand unless properly prescribed and obtained from a hospital pharmacy. (Buprenorphine I believe is not even available in Thailand

You will be unlikely to be given a prescription for morphine.

If you can work, stand and drive for 15 hours/day it would seem your problem is related to other than pain.

Please read what I mentioned at the beginning of my post. Both Codeine and Buprenorphine are available. I can assure you that they are both readily available illegally under the counter; however, I am not about to get into a discussion of where those locations might be.

As for being prescribed morphine, I am certain I would be able to secure a prescription for it from my doctors at Samitivej. In fact, I think it is silly that you think it is unlikely. Given the amount of money I have given that hospital, I am treated very well there. As mentioned, they give me whatever I want, but it isn't cheap. I don't like their pricing, and I would prefer not to go there.

The problem with my work is that I cannot stand for that long. That means I must sit when I really should be standing. I often skip lunch so I don't have to walk to go get it. My weight loss will reflect that! Then, I get home to my 6 month old son, and I can't really walk with him.

Buprenorphine is no longer legally available here anywhere.

Penalties for buying opiates "illegally under the counter" can be extremely severe.

You're going to have to get whatever you end up on from a hospital and you'll find the fees more or less the same whether it is Samitivej, Bangkok Hosp, Bumrungrad etc.

However the quality of pain management you will get will be much better if you consult a specialist. This is not just a matter of "getting" someone to prescribe. (Or if it is, then you have an altogther other problem). It is a matter of determining the best medical approach to a complex problem, taking onto account the likely duration of the pain, issues of tolerance, other side effects etc.

[smileplur]

It is very odd that you guys are telling me that Buprenorphine is not available here because it seems to be the only thing I can get at the moment. However, it doesn't work. Maybe it is fake. I don't know. There are a lot of fakes floating around out there.

Shryl, thank you very much for the advice. I think you are right. I should go see a pain management professional. I always assumed it would be far too expensive given my insurance covered a mere 20,000 baht of the 300,000 bill at Samitivej. Furthermore, the didn't contribute at all to any of the follow up appointments which lasted about a year.I w

As advised (and mentioned above), I continued with Codeine but cut back when I could. I was told to continue buying them under-the-counter because it would save me money. I trusted my doctor and did just what he said.

I have some experience in my life and family with opiates, and they are nothing to play around with. This is why I have continued to shy away from Bupenorphin. From what I understand Fetynal is way too strong. I still need to operate a motor vehicle which is an obstacle by itself here in Bangkok. Furthermore, I have a child to take care of. Finally, I have to work.

So, here I am. I guess I will try to find a pain management person. I don't know if such a thing exists at Samitvej. Otherwise, I will try the doctors suggested aboce. I don't know what else to do because I cannot last this way.

[thaiexpat21]

Attempting to source drugs illegally , will , eventually, land you in very big trouble.

If you have have a genuine chronic pain problem then follow the advise given above .

Your post is interesting in that you state Buprenorphine " doesn't work" BUT then state "I have continued to shy away from Buprenorphin." and then "it seems to be the only thing I can get at the moment"

All these statements cannot be be true !

Which one is the truth?

Seeking narcotics in Thailand is hazardous to your health , well being and freedom.

I

[Sheryl]

It is very odd that you guys are telling me that Buprenorphine is not available here because it seems to be the only thing I can get at the moment. However, it doesn't work. Maybe it is fake. I don't know. There are a lot of fakes floating around out there.

Shryl, thank you very much for the advice. I think you are right. I should go see a pain management professional. I always assumed it would be far too expensive given my insurance covered a mere 20,000 baht of the 300,000 bill at Samitivej. Furthermore, the didn't contribute at all to any of the follow up appointments which lasted about a year.I w

As advised (and mentioned above), I continued with Codeine but cut back when I could. I was told to continue buying them under-the-counter because it would save me money. I trusted my doctor and did just what he said.

I have some experience in my life and family with opiates, and they are nothing to play around with. This is why I have continued to shy away from Bupenorphin. From what I understand Fetynal is way too strong. I still need to operate a motor vehicle which is an obstacle by itself here in Bangkok. Furthermore, I have a child to take care of. Finally, I have to work.

So, here I am. I guess I will try to find a pain management person. I don't know if such a thing exists at Samitvej. Otherwise, I will try the doctors suggested aboce. I don't know what else to do because I cannot last this way.

The reason I did not suggest Samitivej is that I do not see any pain management specialists listed on their website. Otherwise it would be a logical choice since all your records are there. But you could try asking your ortho doctor.

Outpatient visits are not all that costly, and for pain management you are nto looking at expensive tests and the like.

[PHP87]

IDK about the availability of Bupe in Thailand, but it sucks for pain relief. It is used more to keep opiate addicts from using as Bupe occupies all of the receptors and even large doses of very strong opiates will not break thru.

It is basically an opiate blocker but it also prevents the user from experiencing withdrawals when switching from and opiate habit to Bupe.

However, there are Methadone clinics in Thailand. Methadone is a very inexpensive pain reliever and is a blessing for people with Chronic Pain.

The clinic in the pic is in Chiang Mai, right outside of the Moat. Not sure of the cost, but I've heard it's about 3,000-5,000 Baht per month and you only have to come in 2x a month.

Your cost may also depend on your dosage.

If you speak Thai or know someone that does, give them a call at the number on the sign in the pic and find out the details and post them as I'm a CP patient currently on Methadone and plan to retire to Chiang Mai in a few years when I turn 62.

BTW, I believe the place in the pic is a private clinic. They charge more than Government run clinics from what I've heard.

I have CP and it's hell. Tolerance to most pain meds develops quickly and addiction develops. Fortunately, Methadone is a long-acting pain releiver and does not get people "high" or give them a sense of euphoria that most opiates do which is part of the reason they are so addictive.

Nor does Methadone require higher doses to acheive the same level of pain relief. I've been on the same dosage for 3 years and have no need to go to a higher dose and will probably taper down to a lower dose that gives me the most pain relief without making me lethargic as Methadone tends to do like most opiates.

There is a stigma attached to Methadone as most people think it's for heroin addicts. While it is used to wean/maintain heroin addicts off of street drugs, Methadone is becoming an increasingly popular pain med for those with CP issues.

Here in the US, #210 x 10mg. tablets cost about $30.00. That is what I use in a month and my pain management doctor charges on a sliding scale and I only pay $100 for my monthly visit as I am on SSDI for multiple chronic pain issues.

Make no mistake - Methadone is a very physically addictive med. Go a few days without and it's hell on Earth and the withdrawl symptoms last a very long time (months) due to the long half-life of Methadone.

I've heard that most "Benzo" type meds in Thailand are being strictly regulated as Lady Boys use them to drug falangs and rob them, but if you have a legit reason you might get a script.

Good luck and if you or anyone else can find details regarding cost and other details regarding Methadone treatment in Thailand, please post them.

Thanks and again, best of luck to you.

Edited November 16, 2013 by PHP87

[uptheos]

IDK about the availability of Bupe in Thailand, but it sucks for pain relief. It is used more to keep opiate addicts from using as Bupe occupies all of the receptors and even large doses of very strong opiates will not break thru.

It is basically an opiate blocker but it also prevents the user from experiencing withdrawals when switching from and opiate habit to Bupe.

However, there are Methadone clinics in Thailand. Methadone is a very inexpensive pain reliever and is a blessing for people with Chronic Pain.

The clinic in the pic is in Chiang Mai, right outside of the Moat. Not sure of the cost, but I've heard it's about 3,000-5,000 Baht per month and you only have to come in 2x a month.

Your cost may also depend on your dosage.

If you speak Thai or know someone that does, give them a call at the number on the sign in the pic and find out the details and post them as I'm a CP patient currently on Methadone and plan to retire to Chiang Mai in a few years when I turn 62.

BTW, I believe the place in the pic is a private clinic. They charge more than Government run clinics from what I've heard.

I have CP and it's hell. Tolerance to most pain meds develops quickly and addiction develops. Fortunately, Methadone is a long-acting pain releiver and does not get people "high" or give them a sense of euphoria that most opiates do which is part of the reason they are so addictive.

Nor does Methadone require higher doses to acheive the same level of pain relief. I've been on the same dosage for 3 years and have no need to go to a higher dose and will probably taper down to a lower dose that gives me the most pain relief without making me lethargic as Methadone tends to do like most opiates.

There is a stigma attached to Methadone as most people think it's for heroin addicts. While it is used to wean/maintain heroin addicts off of street drugs, Methadone is becoming an increasingly popular pain med for those with CP issues.

Here in the US, #210 x 10mg. tablets cost about $30.00. That is what I use in a month and my pain management doctor charges on a sliding scale and I only pay $100 for my monthly visit as I am on SSDI for multiple chronic pain issues.

Make no mistake - Methadone is a very physically addictive med. Go a few days without and it's hell on Earth and the withdrawl symptoms last a very long time (months) due to the long half-life of Methadone.

I've heard that most "Benzo" type meds in Thailand are being strictly regulated as Lady Boys use them to drug falangs and rob them, but if you have a legit reason you might get a script.

Good luck and if you or anyone else can find details regarding cost and other details regarding Methadone treatment in Thailand, please post them.

Thanks and again, best of luck to you.

http://classifieds.thaivisa.com/services/health-well-being/methadone-pain-killer-and-sleep-medicine-196465.html

[PHP87]

As for Tramadol, it's a nasty, synthetic, opiate-like med. It is OK for mild to moderate pain relief but it has a propensity to cause seizures due to Seratonin Syndrome, especially if you are taking it with an anti-depressant like Cymbalta. I've had two seizures from Tramadol and they were not pleasant, to say the least.

Google "Seratonin Syndrome Tramadol"

Most US doctors will start you on the least effective pain med and then escalate the type and strength of the drug depending on your pain issues.

My advice is to avoid Tramadol like a Thai cab with a broken meter. It's really nasty stuff, doesn't do much for pain and causes anxiety/panic attacks as well as life-threatening seratonin syndrome.

And as mentioned, I've been on Bupe and even the generic is fairly expensive and is a mediocre pain reliever.

One thing with Bupe: "Less is More" as in a lower dose (2mg.) seems to work better than a higher dose such as 8mg.

And it's even harder to get off of than Methadone as it has an extremely long half-life and the WD's are horrific and Post Acute Withdrawl Symptoms can last for well over a year. Another med to avoid.

At my age and with my chronic pain issues I will likely be a "lifer" on Methadone although one would never know it looking at me.

Facts are, there are people from all socio-economic backgrounds on Methadone. I see them every month in the waiting room at my PM doc's office.

The heroin user at a Methadone clinic usually looks like they've lived a very rough life, while the average chronic pain patient on Methadone looks like your next door neighbor, your co-worker, your employer, etc...In othe words, you would never guess in a million years unless they told you.

As I said, there is a stigma attached to Methadone. There is one pharmacist where I fill my script that basically treats me like a low-life drug-addict despite the fact that I'm clean-cut, dress well, am well-spoken and polite while all the other pharmacists and pharm techs are far more compassionate towards me. I've heard that Methadone doctors in Thailand are extremely compassionate towards people with CP issues as well.

Again, if someone in the LOS can do a little research on this and post their findings, it would be much appreciated as I plan to retire to Chiang Mai in a couple of years, although a lot can change between now and then, I've narrowed my choice down to Thailand and Chiang Mai and will probably move further south once I get over the culture shock and learn the ropes.

[PHP87]

IDK about the availability of Bupe in Thailand, but it sucks for pain relief. It is used more to keep opiate addicts from using as Bupe occupies all of the receptors and even large doses of very strong opiates will not break thru.

It is basically an opiate blocker but it also prevents the user from experiencing withdrawals when switching from and opiate habit to Bupe.

However, there are Methadone clinics in Thailand. Methadone is a very inexpensive pain reliever and is a blessing for people with Chronic Pain.

The clinic in the pic is in Chiang Mai, right outside of the Moat. Not sure of the cost, but I've heard it's about 3,000-5,000 Baht per month and you only have to come in 2x a month.

Your cost may also depend on your dosage.

If you speak Thai or know someone that does, give them a call at the number on the sign in the pic and find out the details and post them as I'm a CP patient currently on Methadone and plan to retire to Chiang Mai in a few years when I turn 62.

BTW, I believe the place in the pic is a private clinic. They charge more than Government run clinics from what I've heard.

I have CP and it's hell. Tolerance to most pain meds develops quickly and addiction develops. Fortunately, Methadone is a long-acting pain releiver and does not get people "high" or give them a sense of euphoria that most opiates do which is part of the reason they are so addictive.

Nor does Methadone require higher doses to acheive the same level of pain relief. I've been on the same dosage for 3 years and have no need to go to a higher dose and will probably taper down to a lower dose that gives me the most pain relief without making me lethargic as Methadone tends to do like most opiates.

There is a stigma attached to Methadone as most people think it's for heroin addicts. While it is used to wean/maintain heroin addicts off of street drugs, Methadone is becoming an increasingly popular pain med for those with CP issues.

Here in the US, #210 x 10mg. tablets cost about $30.00. That is what I use in a month and my pain management doctor charges on a sliding scale and I only pay $100 for my monthly visit as I am on SSDI for multiple chronic pain issues.

Make no mistake - Methadone is a very physically addictive med. Go a few days without and it's hell on Earth and the withdrawl symptoms last a very long time (months) due to the long half-life of Methadone.

I've heard that most "Benzo" type meds in Thailand are being strictly regulated as Lady Boys use them to drug falangs and rob them, but if you have a legit reason you might get a script.

Good luck and if you or anyone else can find details regarding cost and other details regarding Methadone treatment in Thailand, please post them.

Thanks and again, best of luck to you.

http://classifieds.thaivisa.com/services/health-well-being/methadone-pain-killer-and-sleep-medicine-196465.html

Thanks for the link. I have no idea what the 400 baht covers or for how much meds. I can't imagine 400 baht per "dose" per day as that wouldn't be cost-effective and would be far more costly than most pain management doctors in the US and mine is in Marin County, California which is just north of San Francisco and is one of the most expensive places to live in the State.

12,000 BHT per month would be $400 USD per month for a med that is very inexpensive. As mentioned, I pay $30.00 a month for my prescription and $100 for my doctor visit, so my total cost is $130 USSD per month, plus about $8.00 for #60 x 10mg. Valium, so I'm wondering what the 400BHT covers? Is that for a daily dose? Weekly? Monthly? My hope it is something reasonable like 400BHT per week.

Again if someone can find out the specifics, it would be very helpful and appreciated.

And for the OP, I believe you are near BKK, so you shouldn't have any problem finding a private or government clinic in Bangkok.

Edited November 16, 2013 by PHP87

[Sheryl]

....My advice is to avoid Tramadol like a Thai cab with a broken meter. It's really nasty stuff, doesn't do much for pain and causes anxiety/panic attacks as well as life-threatening seratonin syndrome....

That has not been my experience at all, neither for myself nor for patients I've worked with. For acute pain, tramadol works quite well. a small number of people have adverse effects, most tolerate it well.

I was able to discontinbue IV morphine in favor of oral tramadol + paracetemol less than 24 hours after surgery, with no reduction in efficacy (but a big reduction in sedation), and more recently it got me through a nasty bout of dengue or something dengue-like.

But again, this is as regards acute pain. Chronic pain is a complex matter and since by definition whatever it used will be used for many, many doses over a long time, there is more scope for problems.

Local nerve blocks/ablation are an option for some cases of chronic pain that is underutilized in my experience.

[uptheos]

IDK about the availability of Bupe in Thailand, but it sucks for pain relief. It is used more to keep opiate addicts from using as Bupe occupies all of the receptors and even large doses of very strong opiates will not break thru.

It is basically an opiate blocker but it also prevents the user from experiencing withdrawals when switching from and opiate habit to Bupe.

However, there are Methadone clinics in Thailand. Methadone is a very inexpensive pain reliever and is a blessing for people with Chronic Pain.

The clinic in the pic is in Chiang Mai, right outside of the Moat. Not sure of the cost, but I've heard it's about 3,000-5,000 Baht per month and you only have to come in 2x a month.

Your cost may also depend on your dosage.

If you speak Thai or know someone that does, give them a call at the number on the sign in the pic and find out the details and post them as I'm a CP patient currently on Methadone and plan to retire to Chiang Mai in a few years when I turn 62.

BTW, I believe the place in the pic is a private clinic. They charge more than Government run clinics from what I've heard.

I have CP and it's hell. Tolerance to most pain meds develops quickly and addiction develops. Fortunately, Methadone is a long-acting pain releiver and does not get people "high" or give them a sense of euphoria that most opiates do which is part of the reason they are so addictive.

Nor does Methadone require higher doses to acheive the same level of pain relief. I've been on the same dosage for 3 years and have no need to go to a higher dose and will probably taper down to a lower dose that gives me the most pain relief without making me lethargic as Methadone tends to do like most opiates.

There is a stigma attached to Methadone as most people think it's for heroin addicts. While it is used to wean/maintain heroin addicts off of street drugs, Methadone is becoming an increasingly popular pain med for those with CP issues.

Here in the US, #210 x 10mg. tablets cost about $30.00. That is what I use in a month and my pain management doctor charges on a sliding scale and I only pay $100 for my monthly visit as I am on SSDI for multiple chronic pain issues.

Make no mistake - Methadone is a very physically addictive med. Go a few days without and it's hell on Earth and the withdrawl symptoms last a very long time (months) due to the long half-life of Methadone.

I've heard that most "Benzo" type meds in Thailand are being strictly regulated as Lady Boys use them to drug falangs and rob them, but if you have a legit reason you might get a script.

Good luck and if you or anyone else can find details regarding cost and other details regarding Methadone treatment in Thailand, please post them.

Thanks and again, best of luck to you.

http://classifieds.thaivisa.com/services/health-well-being/methadone-pain-killer-and-sleep-medicine-196465.html

Thanks for the link. I have no idea what the 400 baht covers or for how much meds. I can't imagine 400 baht per "dose" per day as that wouldn't be cost-effective and would be far more costly than most pain management doctors in the US and mine is in Marin County, California which is just north of San Francisco and is one of the most expensive places to live in the State.

12,000 BHT per month would be $400 USD per month for a med that is very inexpensive. As mentioned, I pay $30.00 a month for my prescription and $100 for my doctor visit, so my total cost is $130 USSD per month, plus about $8.00 for #60 x 10mg. Valium, so I'm wondering what the 400BHT covers? Is that for a daily dose? Weekly? Monthly? My hope it is something reasonable like 400BHT per week.

Again if someone can find out the specifics, it would be very helpful and appreciated.

And for the OP, I believe you are near BKK, so you shouldn't have any problem finding a private or government clinic in Bangkok.

I could imagine 400 Baht per dose, it might be an inexpensive drug, but try to get it!

I might be able to find out for you, but not for a few weeks. If I do, I'll certainly let you know.

Chronic pain is the pits.

As Sheryl said nerve blocks are an option at times and can be very effective.

[PHP87]

Thanks, much appreciated. I've had Cortisone shots in my back and they don't last very long, have side-effects and become less effective each time and it's not good to have more than a few a year, not to mention all the other CP issues I have that do not respond to nerve blocks.

I can't imagine $400 USD a month for a drug that costs $1USD a day in the US...

But let me know if you can.

Thanks.

[PHP87]

I emailed the clinic in Chiang Mai about 10 days ago, but never heard back.

Language barrier? The web site is in English, so...?

Can anyone in Thailand, especially Chiang Mai look into this for me?

Thanks.

[Sheryl]

A nerve block and cortisone shot are not the same thing. It doesn't sound like you have ever had a nerve block. Fort hat, need an anesthesiologist specializing in pain management.

I think you will find that enrolling in a Thai methadone clinic is not so easy.

[PHP87]

Hmmm. I talked to a friend that went to the clinic in Chiang Mai and he said it was very easy and they would give you two weeks worth of meds to take with you.

You can even have it delivered anywhere in the country for about 180 BHT

I no longer have contact info for this friend, but I have emailed the clinic in the pics above and no response.

Was hoping someone in the LOS could contact them to find out the basics.

Yeah, I've had nerve blocks along with cortisone shots as well, and I also have other chronic pain issues that are non-nerve related.

My body is breaking down after 33 years of hard, physical work and I am in constant pain from head to toe.

This is why my Pain doc put me on Methadone as I have multiple impairments.

SSDI approved my case in record time due to my pain issues. 1st time applicants are denied 67% of the time. I was approved almost immediately.

If someone speaks Thai and could give them a call and find out the basics, I would be very appreciative as I plan on retiring to Thailand soon, but need to know if pain management will be an issue.

If there are Methadone clinics, I don't see why it would be problematic. I have all of my med records in .PDF form on a CD, but would likely need to have them translated which might be costly, or hopefully the doc at the Methadone clinic will be able to read English.

Thanks again.

[Sceptict11]

If addicted to "pain" medication or Methadone Thailand would be a very poor choice for retirement

[PHP87]

If addicted to "pain" medication or Methadone Thailand would be a very poor choice for retirement

There's a difference between "addicted" and dependent.

Is a diabetic "addicted" to insulin? No, but they are dependent on insulin. Too many people misunderstand chronic pain and treatment. Even many doctors.

Multiple pain impairments are no fun. I would rather not be taking this medicine, but without it I would be in agonizing pain and would have probably taken my own life long ago.

Thailand obviously has Methadone clinics as seen in the photographic evidence I posted and I have heard first-hand from a person that spent 20 months there and went to that same clinic.

He said pricing was dose-dependent, but also said the government run clinics are less expensive.

If Thailand has Methadone clinics, why would Thailand by a bad choice for someone who takes Methadone for pain management? Especially if you only have to visit the clinic (supposedly) 2x a month? This is why I'm trying to find out specifics as I'm in the process of selecting my retirement destination and would like to spend my final years in the LOS

If someone is fluent in Thai and could call the clinic, it would be very helpful to a future Expat looking to retire in the LOS and would hopefully help others as well.

Thanks again.

[Sceptict11]

Sorry

Your chances of securing long term out-patient narcotic "treatment" in Thailand are less than zero.

Would suggest another plan

[PHP87]

Sorry

Your chances of securing long term out-patient narcotic "treatment" in Thailand are less than zero.

Would suggest another plan

Based on what? At least back your statement with some facts.

How did my acquaintance manage 20 month treatment at the Chiang Mai clinic then?

BTW, here's a post from another forum although it is from the year 2008:

'I've been on Methadone in 3 countries (Slovenia, Thailand, Cambodia). In Slovenia I got it for free, 1 week waiting, mandatory daily visits for 2-3 months, then weekly dosages and travelling dosages (up to 6 weeks' supply).

In Thailand and Cambodia there was no waiting period, I paid about $6 for the visit and meds and in both cases immediately got 2 week's supply in a cute bottle with lines for easy daily dosage."

IDK if it's OK to post to other forums, but this is what was posted.

And if the chances are less than zero, how do you explain this:

Edited November 22, 2013 by PHP87

[Sceptict11]

The clinic mentioned has a web presence and claims to provide psychiatric care/treatment to addicts.

It does not appear to offer care or treatment to those with chronic pain management needs.

[PHP87]

The clinic mentioned has a web presence and claims to provide psychiatric care/treatment to addicts.

It does not appear to offer care or treatment to those with chronic pain management needs.

So basically, you are speculating.

And this?:

'I've been on Methadone in 3 countries (Slovenia, Thailand, Cambodia). In Slovenia I got it for free, 1 week waiting, mandatory daily visits for 2-3 months, then weekly dosages and travelling dosages (up to 6 weeks' supply).

In Thailand and Cambodia there was no waiting period, I paid about $6 for the visit and meds and in both cases immediately got 2 week's supply in a cute bottle with lines for easy daily dosage."

Or the person I mentioned claiming 20 months treatment at the clinic mentioned above before returning to the US?

Lastly, I would disagree that the clinic mentioned above has a "web presence" - the pics were found on google and were taken by a tourist and the clinic has a sparse web site and they don't respond to emails. Hardly what I would call a "web presence"

If someone that has any factual info regarding treatment for chronic pain in the LOS, including Methadone for pain, please respond.

Thanks again.

[Sceptict11]

Why would I speculate ?

The clinic does have a website and the doctor is a Psychiatrist with a special interest in addiction......................FACT !

Detail of the doctor here !

http://www.geocities.ws/panu303/doctor.html

Edited November 22, 2013 by Sceptict11

[PHP87]

Why would I speculate ?

The clinic does have a website and the doctor is a Psychiatrist with a special interest in addiction......................FACT !

Detail of the doctor here !

http://www.geocities.ws/panu303/doctor.html

Explain why someone that has well-documented, multiple impairments would have a less than zero chance of being prescribed pain medication like Methadone in Thailand when anecdotal evidence says otherwise?

Simply posting a link is not a factual argument to your "less than zero" claim.

Thanks.

[Sceptict11]

If you are determined to come to Thailand then I suggest you just do it !

Narcotic medication however is very difficult to obtain and that is a FACT.

You can believe that or not.

Continuing to post here will change nothing.

[PHP87]

Continuing to post the same thing over and over and over without any factual evidence is detrimental to those in pain that wish to retire in Thailand.

You haven't posted a shred of evidence to back your "less than zero chance" claim despite the fact that I have posted evidence of Methadone Pain Clinics, have anecdotal evidence of people legally obtaining Methadone in Thailand, etc...

If someone who actually has knowledge regarding how much it costs and what the requirements are to see the Dr. at the Chiang Mai clinic, or at another clinic for example, please weigh in.

Naysayers, if you have nothing factual to contribute to those with chronic, intractable pain issues other than opinion, please keep them to yourself as you're not helping.

Thanks.