Tramadol Crackdown or blatant lie?

[uptheos]

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.

Ultracet is only 37.5mg Tramadol, Anchan would need three minus the paracetamol so no good for him.

I honestly can't understand putting up with pain, instead of paying the 300 baht doctor fee. Maybe as he's from Phuket he thinks the doctors fee would more likely be 1,300 baht?

Of course he could see a Dr. and the Dr. says 'No'

[anchan]

Thanks a lot everybody!!!!

I will go to a pharmacist I know from when I used to live here later today and talk with him, it´s not a chain pharmacy and he´s either a licensed pharmacist or even a doctor, I´m not sure. I hope he will know what the best solution is, and if he can´t sell it, I´ll go to a clinic.

I have the business card and even the mobile no. of the German doctor who prescribes it at home, but the problem is, today´s Sunday....and I really don´t want to disturb him, but he does speak perfect English and can confirm the diagnosis etc. in case of emergency.

And by the way, I´m a she, not a he :-) and I have no idea what the doctors´ fees are in CM, somebody wrote 2-3000 after I first posted the question...

I thought about Ultracet too, but there´s a lot of paracetamol in it and my stomach really doesn´t like that...

Edited February 22, 2015 by anchan

[Dante99]

Thanks a lot everybody!!!!

I will go to a pharmacist I know from when I used to live here later today and talk with him, it´s not a chain pharmacy and he´s either a licensed pharmacist or even a doctor, I´m not sure. I hope he will know what the best solution is, and if he can´t sell it, I´ll go to a clinic.

I have the business card and even the mobile no. of the German doctor who prescribes it at home, but the problem is, today´s Sunday....and I really don´t want to disturb him, but he does speak perfect English and can confirm the diagnosis etc. in case of emergency.

And by the way, I´m a she, not a he :-) and I have no idea what the doctors´ fees are in CM, somebody wrote 2-3000 after I first posted the question...

I thought about Ultracet too, but there´s a lot of paracetamol in it and my stomach really doesn´t like that...

2-300 NOT 2-3,000 !!!!

[bangmai]

I paid 30 thb for 10 "Tramomet" the other day. Expires in 2017. 50 mg Tramodol Hydrochloride........didn't sign anything. I've heard it's 170 thb for 10 on Nimman.

[colinneil]

Tramadol available? Yes some pharmacies will sell some will not, some 30 baht some 70 baht.

My wife gets them for me, same pharmacy different person yes we have/ no have not.

I get most of mine from Khonkaen hospital, 10 strips at a time, go Banphai hospital, they will only prescribe 2 strips at a time.

Confusing, yes very confusing all the pharmacies say it is the law, ok but all say different ,so what is the law????

[BKKdreaming]

where do the pharmacies that do not write in the book get the pills ?

and are they real or ????

one other thing I worry about is medicine that says store at 10c-30c sitting behind a counter when it is 40C outside

what does that do to the medicine ?

[roo860]

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.

Me battery ran out before the end of the post!!!!!

[bangmai]

where do the pharmacies that do not write in the book get the pills ?

and are they real or ????

one other thing I worry about is medicine that says store at 10c-30c sitting behind a counter when it is 40C outside

what does that do to the medicine ?

It actually hurts the beer more.

[Dante99]

I would really love to have an absolute answer regarding this as well!

This is not a place of absolute answers, try Germany or Singapore.

[uptheos]

Anchan did you get any or are you still suffering?

[Mapguy]

Why do people come to TV Chiang Mai for some sort of conclusive opinion on health care? See a doc.

[stament]

What's the difference between tramadol and paracetamol?

[JDGRUEN]

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.

Chronic pain for a number of reasons requires a strong pain reliever .... withdraw from Tramadol 50's taken a couple of times a day ... causes withdraw symptoms -- called Pain in my lower back and legs and knees... caused by an old back injury...

Some of you old men in nagging women's clothes need to find something else to worry about.

People in their late 60's and mid 70's have a drug dependency with Tramadol and it will cause them problems -- such as removal of the drug could cause them to use a wheel chair for transport... GET A LIFE ...worry worts...

[bangmai]

What's the difference between tramadol and paracetamol?

Tramadol is an opioid.

[anchan]

Thanks for asking Uptheos, I got 10 Ultracet tablets at Boots that were enough for yesterday and today, and some herbal stuff to drink ftom a Thai triend to stop the side effects the paracetamol has on my stomach.

I also got the address of a pharmacy from a helpful person where I will try tomorrow, and if that fails, I´ll go and get a prescription.

Actually, it´s silly, I have so many friends on Koh Phangan that if I stay here in CM for a few months, I will just send them money by Paypal to go to any pharmacy there, buy a few packs and post them to me....they are available in every pharmacy on the island, that will be cheaper than paying the docotor´s bill AND the medicine for every single pack....and that was also the reason I´d never heard of any restriction in other places....I used to live in Chiang Mai AFTER I had a back operation and a bike accident a few years later, and the last time I was here on holiday was March 2013, and then it was still the same here, only that some pharmacies would only have 50 mg tablets...

[DaamNaam]

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.

Couldn't agree more. Get on a juice detox for a week or more and throw away all that garbage.

[JDGRUEN]

The 'scare' of selling Tramadol is mainly in the greater Bkk area... Crackdown? by whom ... seems the pharmacy owners are doing it to themselves in response to - most likely - the abuse of selling Tramadol by some ... and the incidents of several years ago of young teens buying Tramadol and mixing it with coke and other things... There was some action at the time to urge caution. I also suspect that some pharmacists my rightly believe that quantities of Tramadol are being bought and resold or abused in some fashion.

However during extensive internally in Thailand to the North and South to as many as 16 sizable towns and cities that Tramadol is widely available ... I recently bought some in Bang Phli and routinely buy Tramadol here in Ao Nang... and Krabi... The so called Crackdown is mostly a scare pushed on by past bad experiences with teens and by rumors.

Also in my opinion - some pharmacists believe the just not selling it is the way to avoid any problem that might arise.

[Tokay]

Tramadol can be found all over. Try hitting the pharmacies that look older, open air, more Thai style. They always have the good stuff.

[Ulysses G.]

You could shoot morphine or heroin 5 times a day for a week and not get physically addicted. It takes a lot longer than that for any opiate.

[uptheos]

You could shoot morphine or heroin 5 times a day for a week and not get physically addicted. It takes a lot longer than that for any opiate.

It's my understanding that when opiates are used for genuine pain as opposed to recreational use, addiction is unlikely.

[Ulysses G.]

It depends on how often and how long one takes them. Anyone that takes them regularly for a long period of time will eventually get addicted.

[JDGRUEN]

It depends on how often and how long one takes them. Anyone that takes them regularly for a long period of time will eventually get addicted.

I agree. And often a sign of addiction is the need to increase the dose -- going from 50 mg to 100 mg Tramadol ... then taking it more times during the day and evening.

But this could be a sign of increase levels of chronic pain or other type of pain.

Some people have a natural resistance to addiction ... their brain's physical and chemical structure is just made that way. And these people can 'get off' whatever they are taking or drinking or even smoking (cigarettes) and have few to no withdraw symptoms. They are certainly the lucky ones.

[circusman]

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?

Just perhaps they know people are abusing it !

[BKKSnowBird]

Same thing with zanax a few years ago. Doubled the price.

[anchan]

My doctor in Munich, who, as I wrote before, also teaches medicine at the university there, has told me the trick not to get addicted to Tramadol is to take it ONLY AFTER the pain has already started in the morning (if you have chronic pain and have to take it every day), and not automatically take it when you get up in the morning cos you know the pain will come anyway. I did it like that from then on and he was right.

Still, another doctor (a GP) said that when all my operations are completed and I can stop taking it, it is maybe better to go from e.g. 2x100mg to 1x100mg and then 1x50mg, each changed dosage for a few days, then I should have no withdrawal symptoms....

[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?

Just perhaps they know people are abusing it !

Ever been in serious pain circusman?

Pray it never happens here!

Edited February 26, 2015 by uptheos

[uptheos]

My doctor in Munich, who, as I wrote before, also teaches medicine at the university there, has told me the trick not to get addicted to Tramadol is to take it ONLY AFTER the pain has already started in the morning (if you have chronic pain and have to take it every day), and not automatically take it when you get up in the morning cos you know the pain will come anyway. I did it like that from then on and he was right.

Still, another doctor (a GP) said that when all my operations are completed and I can stop taking it, it is maybe better to go from e.g. 2x100mg to 1x100mg and then 1x50mg, each changed dosage for a few days, then I should have no withdrawal symptoms....

I did say something similar in another thread, if it's taken for serious pain as opposed to a prophylactic or recreational use, a person is unlikely to get addicted.

[anchan]

It is also a fact (according to the same medicine professor) that if you take it when you feel pain, it will connect to a different receptor in your brain than if you take it just for fun, so the people who take it against pain don´t get high on it anyway, just some get a little tired....

[anchan]

But thankfully, my problem is solved now as I´ve been to a doctor and don´t need to take those pills with the paracetamol in them anymore. My stomach feels better already :-)