One of the strangest drug policies in México is the almost total lack of “Opioid” type analgesic pain relievers. A check of Mexico’s pharmaceutical manufacturing lists reveals several Mexican owned and sub-licensed foreign firms do indeed produce narcotic drugs for prescription sales – but not for sale in México. Despite Mexico’s reputation as an easy place to buy pharmaceuticals, opioid pain relievers are as hard to get in México as weapons grade uranium is in the United States. Rumor has it that private (read expensive) hospitals in Mexico’s largest cities dispense narcotic pain relievers1 but only by injection. Hospitals such as IMSS, ISSSTE, and Seguro Popular only allow Trauma Doctors to dispense morphine and it’s said each dose entails a blizzard of paperwork. Opioid pain medications are not administered in public hospitals even after surgery2
How far did I chase this elusive trail? To regional administrative staff of public hospitals, the largest proveedores (wholesale suppliers to farmacias) and even to manufacturers themselves. Almost all manufacturing companies are located within an hour’s drive of México DF. Most refused to even discuss the subject, the few that made declarative statements, asserted their product was destined for export. Military hospitals reportedly stock narcotic analgesics in injectable form but only for active duty military personnel who become injured while on duty.
DARVON AND DERIVATIVES ARE BANNED
Following the US, México has banned all products containing the analgesic drug “Darvon.” The US ban was instituted after numerous complaints linked the drug to dangerous side-effects. The efficacy (potency) of Darvon was highly controversial in the US to begin with, so doctors and patients alike seem to agree that pulling of the drug off the market would not cause many complaints from consumers. This leaves but one single narcotic based oral analgesic available in México for retail sales. It is a “Class II” Sector Salud controlled drug so a prescription from a licensed Mexican medical doctor is necessary to obtain it. Few farmacias stock the remaining narcotic medication.
CODEINE PLUS TYLENOL
Codeine and “paracetamol” which is the terminology used in México for acetaminophen (Tylenol) is available in a low dose strength. A few years ago a newly herniated spinal disc forced me to seek this miserably ineffective medication on my way north by bus to a hospital in the United States. The US hospital prescribed oxycodone 5 milligrams plus acetaminophen. FOUR of the Mexican codeine tablets had less pain-killing effect than one, single, lowest-dose of U.S.A. oxycodone. The sad part is TYLEX, the brand name of the Mexican codeine-Tylenol, cost the equivalent of THREE US DOLLARS PER PILL. Twelve dollars for a single dose of four tablets and the results were pathetic. To add insult to injur,y TYLEX is not the easiest medicine to find. Only one out of twenty or thirty Mexican farmacias carry Tylex.
A MORE EFFECTIVE ALTERNATIVE
Having an unfortunately intimate knowledge of pain-relievers, I can state unequivocally that one 100 milligram dose of over-the-counter (sold without a prescription) TRAMADOL is neck-and-neck equal to a TYLEX pill. Tramadol costs a tiny fraction of the price of the narcotic, and most expatriates rely on Tramadol. But Tramadol itself has severe side effects and is nowhere near as strong a pain reliever as the lowest dose oxycodone (maybe 10% as a guess?).
MEXICAN DOCTORS RECOMMEND AMERICANS
BRING NARCOTIC MEDICATIONS FROM THEIR US PHARMACY
A small emergency supply of narcotic analgesics can tide a person over until they get to a US hospital. When kept inside a pill bottle with medical prescription label addressed to the person possessing it, a narcotic pain reliever is absolutely legal to have in México. But Mexican law is clear and draconian regarding misuse of prescription drugs, so do not drink and take drugs not even if they are “legal.” Talk to your doctor about whether or not having an emergency supply of narcotic medications is appropriate for you. Surfers, hang gliders and rock climbers may benefit doing so.
1Narcotic analgesics are purchased from U.S.A. pharmaceutical distributors and imported into México under license of COFEPRIS Sector Salud’s regulatory arm. Reportedly the price to the patient is something like twice that of a hospital in the USA.
2Having been hospitalized twice for major surgery (one instance – three hours complete anesthesia on the operating table) the strongest analgesic given, offered, or available was a non steroid anti-inflammatory medication – little stronger than common Celebrex (Celecoxib). To top it off, it was administered intravenously as are all hospital medications. If a patient needs an oral medication it must be fetched from a non-hospital farmacia and paid for at time of purchase at the farmacia. Patent medicines at sold at full retail price which can rival private pharmacy drug prices in the USA.