Tramadol Crackdown or blatant lie?

[Thighlander]

I went into a pharmacy last night to buy 10 Tramadol, as I seemed to have strained my back. Girl behind the counter says "now 70, government tell us to stop selling." It's been 30-40 all over the country.......I didn't bite. Went to another pharmacy about 100 m from the main Rd....the guy pulls out a box of 10 strips....35 thb, how many you want? I hate to start rumors, but since this is a popular, legal pain reliever I wanted to compare notes....if true, it might be a good idea to get some now. OTOH, the lady with the story spoke very good non-native English, which of course hurts her credibility. I live near CMU, and there aren't many farang up here. There is some occasional gouging, but there is plenty of great 30-35 thb meals, too. Any clues?

[KhunBENQ]

No clue, but a couple more threads on TV about it.

There IS something going on.

http://www.thaivisa.com/forum/topic/718890-my-latest-attempt-to-purchase-tramadol/#entry7689032

http://www.thaivisa.com/forum/topic/664488-oncb-is-pushing-for-stricter-controls-on-over-the-counter-sales-of-tramadol/#entry6770072

Edited June 27, 2014 by KhunBENQ

[bazmlb]

They may not have wanted to comply with the new rule where they can only supply max 2 strips and must record it with a copy of your passport, easier to say no we dont have or cant sell.

[AnotherOneAmerican]

Not supposed to sell without pharmacist on premises.

But it's been that way two years.

[bazmlb]

Don't get hooked on these tablets they are very addictive and are worse than trying to get off heroine and Prozac at once, as they are an Opiod and SSRI in one tablet.

[bazmlb]

Not supposed to sell without pharmacist on premises.

But it's been that way two years.

Yes, that was the other part i forgot in my post above

[Thighlander]

They may not have wanted to comply with the new rule where they can only supply max 2 strips and must record it with a copy of your passport, easier to say no we dont have or cant sell.

She was perfectly willing to sell them to me without ID, just at double the price.....I'll read the other threads, though. BTW, I only wanted one strip.

[northernjohn]

I think Thailand is tightening down on what is allowed to be sold here. Not sure what it is I take at night for my RLM but the doctor said that Thailand was going to ban it. This is the second time I have had to change the pill.

Also Thailand could be tightening down on every thing coming in. Not sure how much Thailand is producing here in Thailand it' self.

She could not get me the Niacin pills for two months.

Maybe there is a limit to how much can be imported for Thailand. I know she was getting the niacin from Bangkok.

[mesquite]

RLM?

[uptheos]

RLM?

Rapid Leg Movement during sleep?

Just a guess

Whatever NJ takes for it he doesn't know what it is, which is strange.

[uptheos]

Don't get hooked on these tablets they are very addictive and are worse than trying to get off heroine and Prozac at once, as they are an Opiod and SSRI in one tablet.

Really?

Personal experience of that combination?

[Ulysses G.]

I think Thailand is tightening down on what is allowed to be sold here.

I tried to buy Valium from a well known shop that has sold it to me for years- I can't stand flying without it. The woman said no, that is is "illegal" and was quite adamant about it. Thailand is changing.

[WinnieTheKhwai]

^ From your neck of the woods, walk down Soi 5 Thapae to Phanu Clinic.

And I suggest Xanax over Valium, but they'll readily sell you either.

https://www.google.co.th/maps/@18.787325,98.99513,3a,75y,54.36h,84.28t/data=!3m4!1e1!3m2!1sFvy4gFVE_5zOC7mxOzeJgg!2e0

Open in the evenings I think. Alternatively, and perhaps more cheaply: Suan Prung Hospital. As that's a psychiatric hospital it helps to state your ailment as fear of flying or anything else with the word 'anxiety' in it. (As opposed to Phanu clinic, where the only question to answer is how many strips you want.)

Edited June 27, 2014 by WinnieTheKhwai

[Oscar2]

I think Thailand is tightening down on what is allowed to be sold here.

I tried to buy Valium from a well known shop that has sold it to me for years- I can't stand flying without it. The woman said no, that is is "illegal" and was quite adamant about it. Thailand is changing.

there are crackdowns going on everywhere in the country on everything. yes Thailand is changing. i hope the guy in the traffic ticket thread who hates rules/laws doesn't get wind of this thread!

[Oscar2]

^ From your neck of the woods, walk down Soi 5 Thapae to Phanu Clinic.

And I suggest Xanax over Valium, but they'll readily sell you either.

https://www.google.co.th/maps/@18.787325,98.99513,3a,75y,54.36h,84.28t/data=!3m4!1e1!3m2!1sFvy4gFVE_5zOC7mxOzeJgg!2e0

Open in the evenings I think. Alternatively, and perhaps more cheaply: Suan Prung Hospital. As that's a psychiatric hospital it helps to state your ailment as fear of flying or anything else with the word 'anxiety' in it. (As opposed to Phanu clinic, where the only question to answer is how many strips you want.)

a friend just told me the other day that they have been closed for some time but may be re-opening or will be re-opening but that some medicines will no longer be available.

[Farma]

I spoke to very close pharmacist friend and they confirmed restrictions have been placed on the sale of Tramadol. They told me they can no longer hold it in their pharmacy. They can still sell products with Tramadol as a partial ingredient.

They suggested the pharmacy who sold the Tramadol was ignoring the new restrictions.

Edited June 27, 2014 by Farma

[uptheos]

It's fast becoming a country where terminal cancer pain will be limited to Paracetamol one day!

Sadly, I've been visiting a friend whilst in the UK, who is terminally ill.

Diamorphine is given as well as a self administered Morphine pump.

I wonder what the Thai's have against letting people be pain free?

[DogNo1]

I wasn't aware that either tramadol or darvon were especially addictive. I've taken both from time-to-time but felt that they were not particularly addictive. I now take Voltaren for pain - either gel or tablets depending on where the pain is located. If it's muscles or joints, I use the gel. When the pain is over, I don't miss taking it so I guess it's not addictive.

[smileplur]

There will always be "rogue" pharmacies that are willing to sell you anything they can. Many of these pharmacies are simple small businesses, and a lot of them are just getting by. With the relatively 'lax' law enforcement in place in Thailand which only consists of periodic raids, there seems to be very little risk to the pharmacy by selling these medications. There is a thriving grey market out there for all kinds of medications.It certainly seems that law enforcement and legislators select their battles one medication at a time. It's almost a knee-jerk reaction to some piece of news surfaces and action is taken. It's similar to a retrospective face-saving attempt. That's exactly what appears to have happened with Tramadol. If memory serves me correctly, it was discovered that some school-aged children discovered that Tramadol's opiate-related content can provide an intoxicating effect. I believe a child was hospitalized in Samut Prakarn after mixing a couple of strips of Tramadol with a bottle of Coke. Of course, nobody is intended to take 20 pills of any kind at one time as far as I know of. It then surfaced that more students were using this combination of Tramadol and Coke. Initially, the sale of Tramadol became restricted in areas where schools were located within a certain distance. I don't ever recall them being banned at all. Rather, I believe that limitations were put into place regarding the quantity of the pills permitted to be sold and the age of customers for this particular pharmaceutical was to be checked to ensure it was only being sold to adults.

From there, the story kind of dropped off. I no longer read anything about it in the newspaper. That was the last official line I heard about which isn't to say that further actions and restrictions were not put into place. It is very possible that I simply missed it. While I read, or skim at the very least, the nee news in Thailand on a daily basis, the Tramadol usage among Thailand's student population became an old story.

I have a few friends with chronic back pain. Both of them take Tramadol for it simply because it is one of the strongest painkillers available here for such pain. It's worth keeping in mind that this drug is sold OTC in many countries around the world, and is considered a relatively mild / weak painkiller. These friends reported that they had experienced some difficulty obtaining Tramadol suddenly about a year ago. This is Thailand, so Tramadol just disappeared from the stock of "some" pharmacies; however, walking into the pharmacy next door would reveal that they were fully stocked. Inquiring about the legal status of the drug, the pharmacies that stopped selling them maintained the line that it had become more difficult for them to obtain and restrictions were in place to limit the sale of it which has already been pointed out in this thread. Interestingly, but not surprisingly, those pharmacies who continued to sell it said that there were no issues at all with availability or legality and it was merely rumours perpetuated by the media, etc. due to a few cases like the one I mentioned above. I'm not entirely sure what the legal status of Tramadol is, but it would be nice to know. Personally, I also suffer from ongoing pain issues that are a result of a motorbike accident 2 years ago which resulted in hardware installation (titanium) to ensure I proper healing and that I would be able to walk normally again!

Unfortunately (or fortunately depending on how you look at it), I am unable to take Tramadol. I am not sure what the biochemical reason is, but Tramadol has one of two effects on me. 90% of the time I take Tramadol, nothing happens. There is absolutely no reduction in pain whatsoever. I feel nothing. It is as if I am taking a placebo. I have tried various dosages and even exceeded the maximum recommended amount on a few isolated occasions when I did not have my regular pain medication at my disposal. The other 10% of the time, Tramadol makes me violently ill. One or two tablets can make me vomit, very very forcefully, for several hours. When this reaction first happened, I thought it was the particular batch or strip that caused it. However, I have had both effects, no effect and vomiting, at separate times several days apart from the same strip of the medication. There are some people out there, my two friends included, who claim it is a miracle drug that enables them to carry out their normal day-to-day tasks by eliminating their back pain without any negative side-effects whatsoever. In fact, they didn't believe that it didn't have any effect on me whatsoever until they witnessed it themselves. That is, they saw me take the pills and report that absolutely nothing had happened to alleviate any of the pain I was feeling. It is some sort of anomaly. Either that, or there is something wrong with my opiate receptors that prohibit this medication from having an effect on me.

This leaves me in a sticky situation which I have posted about here on ThaiVisa for advice. I suffer from chronic pain that no OTC medication can provide relief for. Obviously, there are some days which are worse than others when the pain is borderline severe. Other days, I can manage just fine without taking any pain medication and only experience a small amount of discomfort. My job has me on my feet all day, so it really does exacerbate the pain when I am having one of those days when the pain is severe. Unfortunately, this isn't the good old USA or a western country where I can simply get a prescription for Vicodin which solves all of my problems when I do need to take pain medication. As such, I always make it a point to visit my doctor in the states when I do make the trip back home. Given that I only go home once every two years, I have a problem when my trusty Vicodin supply does run out!

This means I need to take the next best thing I can get in Thailand which is Codeine. Without any doubt at all, this is a bona fide restricted substance that carries serious penalties if I were to be caught with it in my possession without approval from a licensed physician! Doctors fees are expensive, and I simply cannot afford to return to the hospital I use, Samitivej Sukhumvit, every 2-3 weeks to get more Codeine. The doctors fees, the overpriced medication, and the other charges associated with a trip to the hospital can add up pretty quickly. My insurance is pretty bad, so I can only claim 500 baht back from each outpatient visit. Either of the aforementioned fees charged by Samitivej are higher than the amount I can claim back from AIA. Therein lies my problem!! I prefer not to take paracetamol (Tylenol) on a daily basis, so I take Codeine Phosphate without any additional medications mixed in. I've discussed this issue with my doctor who said there isn't much he can do to help me. He did offer me time-released morphine tablets. I felt that was a bit excessive for the pain I have, and it would probably leave me unable to drive which is something I need to do for my job.

The only solution we could come up with was for me to purchase the medication under-the-counter at a pharmacy who is willing to sell Codeine Phosphate and actually has some in stock. This is another grey area of the law with regards to pharmaceuticals in Thailand. Opiates here are a serious business that many doctors don't particularly like to give out. Those doctors who were trained and even practiced medicine in the west have no problems giving me the medication I need. My doctor lived in America for quite some time. So, he writes me a prescription and a note stating the reason for taking the medication. I always carry this prescription and note with me. Let's not forget that street-side drug testing does occur here from time to time. I would certainly test positive for opiates if I were to be tested. I'm not really sure what they test for when they carry out this mini-raids and piss test everyone, either on the side of the road or in a club. I have a feeling that they are mainly looking for the use of methamphetamine and maybe cocaine. I have no idea if they even test for opiates, but it isn't a gamble I am going to take. Therefore, the doctor's note along with his contact information are always with me just in case.

I have no idea about the legality of what I am doing regarding my pain management; however, it seems legitimate given that I have all of the paperwork in order for the medication I take. I don't discuss the pharmacies that sell Codeine because of the legal ramifications associated with it, so please don't ask me where to buy it. My suggestion is to do what I did if you should find that you have pain management issues and need to take medication to alleviate moderate to severe pain. Ask your doctor for alternatives and/or suggestions because hospital fees can add up very quickly.

My point is that it is entirely possible that Tramadol could eventually go the route of Codeine. Alternatively, the entire issue could be forgotten and swept under the rug as if the incidents regarding young people abusing the medication never took place. Time will tell. At this point in time, does anyone have a definitive answer regarding the legality of Tramadol, buying it, carrying it on your person, and using it in Thailand?

Lastly, do you any of you have any insight into the legality of what I currently do to ovtain the medication I need and its legality??? I would really love to have an absolute answer regarding this as well!

I'm sorry for the lengthy post. I didn't intend to get into my personal story, but it seemed to fit. There are many threads about pain management and medications on this forum. The legal statuses of OTC drugs changes from time-to-time, but I haven't read about any changes regarding Codeine in a very long time. Thanks a lot for any insight you can provide.

[onthedarkside]

Troll post removed

[northernjohn]

RLM?

Rapid Leg Movement during sleep?

Just a guess

Whatever NJ takes for it he doesn't know what it is, which is strange.

Yes it is Rapid Leg Movement.

Nothing strange about not knowing the name. I trust my doctor and when she said she would have to change it to some thing else I just said OK.

I have a list of the medications I take and when traveling I take them with me.

That is why I got a good doctor instead of shopping around from doctor to doctor for various issues. If I need to see a heart specialist she will tell me Or any other kind of specialist. She has a record of all my medications plus I even tell her when I buy supplements like Saw Palmetto, MSM chondroitin sulphate, Beta Carotene and Omega 3.

I take my health seriously and trust my doctor. She even said I could try acupuncture for my Neuropathy.

[Tywais]

This was posted by Sheryl in the Health forum regarding Tramadol.

As best as I can determine, tramadol is still legal for OTC sale but the FDA is strictly enforcing requirement that all sales be recorded and reported monthly and a first class pharmacist be on duty at all times. And they seem to be scrutinizing sales records and questioning unusually large sales.

Actually these rules have always been in place and pertain to a large number of drugs, including antibiotics, but in practice are not strictly enforced as a rule. Due to some recent highly publicized events they are now being strictly enforced for tramadol.

Many pharmacies have simply decided it is not worth the trouble.

When they say "not allowed to order" they may mean, not allowed by their boss...not that it is not allowed by law or the FDA.

There are some pharmacies still ordering, receiving and selling it but they will ask for ID, record the sale and likely limit the quantity sold at any one time.

[anchan]

Hi there,

can anybody please tell me where I can buy 100 mg Tramadol (not many, only 10-20 pills) in a pharmacy in Chiang Mai WITHOUT going to a clinic and having to pay for a doctor too before? I had a bike accident 4 years ago when I lived in Thailand and still have screws and metal plates in my wrist, and in Germany, I have a prescription. I just stayed 6 weeks on Koh Phangan and there, you can buy it in every pharmacy (like aspirin really), but tonight I was told in 2 pharmacies in Changklan Road that I have to go to see a doctor first and pay for that too...I didn´t know, otherwise I´d have brought some with me...I´m a bit short of cash, so I´d appreciate a cheaper solution....

THANK YOU VERY MUCH!!!!!

Anja

[RxDan]

Being a clinical pharmacist for over 30 years in the US, we used to compound formulations for different areas of the body for pain relief. You could try using lidocaine patch which you apply externally. You might be able to get at Pharmachoice

Or ask them to order it if lists in their formulary guide they use.

[Dante99]

Hi there,

can anybody please tell me where I can buy 100 mg Tramadol (not many, only 10-20 pills) in a pharmacy in Chiang Mai WITHOUT going to a clinic and having to pay for a doctor too before? I had a bike accident 4 years ago when I lived in Thailand and still have screws and metal plates in my wrist, and in Germany, I have a prescription. I just stayed 6 weeks on Koh Phangan and there, you can buy it in every pharmacy (like aspirin really), but tonight I was told in 2 pharmacies in Changklan Road that I have to go to see a doctor first and pay for that too...I didn´t know, otherwise I´d have brought some with me...I´m a bit short of cash, so I´d appreciate a cheaper solution....

THANK YOU VERY MUCH!!!!!

A doctor visit will cost 2-300 Baht and that is too much? If so, you are a lot more than a bit short of cash. Time to move on.

[naboo]

Personally I find Iboprofen to work better than Tramadol. And the OP may enjoy that its cheaper.

[anchan]

Have tried ibuprofen and paracetamol already, ibuprofen doesn´t help and paracetamol doesn´t either, it just affects my stomach.....my doctor at home is also a medicine professor who teaches it at a big university and HE prescibed me Tramadol, so I trust him.

Edited February 22, 2015 by anchan

[uptheos]

Anchan If Tramadol works for you then that's what you need.

You can trawl the myriad of pharmacies to try and get it, but wouldn't it be easier to bite the bullet and see a doctor if you're in pain?

Edited February 22, 2015 by uptheos

[nzexpat]

Tramadol is thus classified by the Thai FDA :-

"D = Dangerous Drug (ยาอันตราย)

A first grade pharmacist shall be on duty at the premises selling modern drugs, at all times, while the premises are open for operation. Daily purchase and sale record required.

ผู้รับอนุญาตขายยาแผนปัจจุบันทำบัญชียาอันตรายแต่ละอย่างทุกครั้ง โดยแสดงเลขที่หรืออักษรของครั้งที่ผลิต ชื่อและปริมาณยา ตลอดจนวันเดือนปีที่ขาย

เภสัชกรชั้นหนึ่งให้คำแนะนำตามสมควรเกี่ยวกับการใช้ยาอันตรายให้ปลอดภัยตามหลักวิชา และตามมารยาทแห่งวิชาชีพ". *

Whilst still legal to sell/purchase Tramadol many "Pharmacies" cannot or do not wish to abide by the requirements listed above. Any stock freely available for purchase is likely "old" stock which will not be replaced unless the Pharmacist is able to produce the necessary records.

It can be expected that the availability of Tramadol will diminish over time.

*Ref

MIMS (THIALAND)

All pharmacies should have a copy of the current issue of this reference book.

Edited February 22, 2015 by nzexpat

[Mapguy]

Have bought a brand (Ultracet) that is part tramadol and the rest paracetamol simply by signing the pharmacy book in some but not all pharmacies visited. I believe that heavy-duty tramadol must be prescribed and might only be legally available in a hospital. Not all pharmacies pay attention to this regulation, but many if not most of them do. Anything opiate-based, in my experience, is available only through a hospital and by prescription.

Self-prescription of painkillers can lead to serious problems. See a doc.

Edited February 22, 2015 by Mapguy