[Rose76]

Hydrocodone is a very wonderful drug for moderate pain. It was easily obtainable here in the USA. For short-term control of bad pain, it's the bomb.

Well, things are changing in the USA. Getting hydrocodone (usually mixed with tylenol) is going to be a lot harder. In that regard, apparently, we are just following way behind what has already been done in Europe. To my complete astonishment, I am reading that doctors can't even order hydrocodone in some European countries.

The question burning in me is: "What do you do in Europe?"

I mean, we here, many of us (not all), look toward Europe, as a place where enlightened thought is put into changes in the law. I mean . . . look at how careful members of the European Union are about purity of food, about conditions for farm animals . . . etc. So I'm thinking that these are smart people, who are not going to shoot themselves in the foot. I can't imagine that Western Europeans are being left to suffer miserably with pain that can be easily alleviated.

Please, I will so appreciate any response that illuminates for me how pain gets dealt with in Europe. I mean, if you're not so terribly ill as to need morphine, but you do need more than aspirin . . . then what do you do?

[-jimi-]

In my country (it varies), if you have extreme pain, you can get tylenol with codeine, or tramadol.

I know to someone in USA it sounds lame, but that is how we do it here.

Opiates are only for acute pain, like broken bones and surgeries, or for terminal patients.

[-jimi-]

Oh yea, and when I get pain bad, I take unsafe amounts of Naproxen. So I guess that is what people sometimes do.

[Oxidopamine]

I'm not in Europe, however, there are new medications for pain that use radically different mechanisms of action. They can and will compete with hydrocodone as they are not grouped in the same legal categories of medication.

For example, one of them is based on a predatory sea snail of genus Conus, where different species secrete different fast-acting neurotoxins that block different types of calcium channels. The medication is already available for commercial use under the name Prialt and according to this website, it is advertised as being 1,000 times more potent than morphine, while being non-narcotic and non-addictive.

Another possible medication that still is in research but hasn't yet reached clinical trials is RTX with the highest capsacin concentration (molecule that causes sensation of spice). Interestingly, this compound has shown to be so spicy it's deadly and strongly binds with TRPV1, or Transient Receptor Potential Vanilloid 1 (Vanilloid isn't vanilla). TRPV1 mediates calcium channels, so the odd conclusion is the spiciest molecule on Earth that can burn skin is also being researched as a potential (and somewhat successful) pain killer. If you want more information about TRPV1 and RTX as a hopeful medication, go here.

[Rose76]

That is too bad. Naproxen wasn't helping me, so I was given Vicodin (hydrocodone/acetaminophen.) It was amazingly effective. Suddenly, I was told that to continue getting it is going to involve me having to go through a lot of hassle. This is because of new Federal laws, that I knew nothing about.

I read up on-line about the changes. That's when I found out about Europe banning hydrocodone. I was shocked.

jimrat, thank you for the info. I just couldn't hardly believe what I read. So what I read really is true. Wow. I wouldn't want to be in Europe and get a dental abscess.

So - like - in Copenhagen, you can smoke weed, but you can't get hydrocodone. In England, you can get heroin for pain if you're terminal, or even if you're just an addict, but you can not get hydrocodone. I understand about the abuse potential, but I think it's unfair to pain sufferers, who don't need more heavy-duty opiates that remain available to the terminally ill.

Here in Europe we have Diffeine, which is now banned in most countries. this is an anti inflamatry drug. Or we also do Vicodin and tylenol with codeine. Codeine has now been banned unless you have a presciption because it is so addictive.
Here also buying mild painkillers like paracetemol has been limited to one 12 pack per customer because of suicide prevention which is a pain in the butt if you have a cold and need lemsip and a cough medicine- you can only have one. So I don't know if I would call it advanced or tortorous.

[Rose76]

12 Pack of paracetemol!!! Wow. Over here (USA) we call that Tylenol, and we can buy huge bottles of it - like over 100 tabs. I'm quite sure you can get even bigger amounts than that. I just checked - we can get 250 tablets that are 500mg in strength.

I never before knew there was such a difference between Europe and the U.S. on this stuff. I am amazed.

Originally Posted by Rose76

12 Pack of paracetemol!!! Wow. Over here (USA) we call that Tylenol, and we can buy huge bottles of it - like over 100 tabs. I'm quite sure you can get even bigger amounts than that. I just checked - we can get 250 tablets that are 500mg in strength.

I never before knew there was such a difference between Europe and the U.S. on this stuff. I am amazed.

This is why I love the US- God bless America. When I go on holidays to america, I stock up on all medications oh CVS- I love it They even have fillings- well tempory fillings but you can't get those here. You have to wait in pain and sometimes over a week until a dentist will see you.

[Rose76]

Wow, I have a cousin who comes over from Europe every year or so. She told me that CVS is like "a Mecca" to her. I'm not that close to her and didn't know what she meant. I think I have more of an idea, now. (I had thought she was into buying large quantities of shampoo.)

[-jimi-]

We used to have control of selling ASA, but that was like 30 years ago, 20 years ago you could buy stuff with codeine OTC. Now it can be tricky depending on the doc even getting it prescribed. Getting a small prescription is usually fine.

Diclofenac is a popular choice here also because it is effective for some types of pain, despite its quite bad possible side effects. I'd rather they chose something else to be honest. It even made it OTC to my surprise.

Then of course there are specific meds for like migraines and nerve pain. Also some people are treated with steroids, nerve blocks and similar.

Sometimes it can bug me that we're so restrictive, on the other hand sometimes doctors in USA get carried away. Have a friend there who is not asked making any lifestyle changes, just given more and more meds, several different pain medications, opiates, patches and so on, takes a total of 50 pills a day (from the same doc). Wouldn't happen here.

[Conscienceness]

I've been learning a lot about prescription drug overdose in my first year of a master's degree. So it seems that the CDC has now declared drug overdoses an epidemic. 120 people a day are dying from drug overdoses. Hydrocodone is one of these drugs. It is also a gateway to heroin which is a much easier and cheaper option since the government has cracked down on Physicians prescribing opiates like hydrocodone. So, these concerns and issues must be why it's so hard to get opiates in Europe legally.

[-jimi-]

A lot of opiates in USA end up sold on the streets. Europe does not want that. "We" have enough with street drugs sold there. If people are harmed from street drugs here or UK, they end up costing the system a lot. The system has to prevent costs. We don't have private care like in USA, the government has to pick up the check when it comes to drug abuse. That is also why it is harder to buy alcohol here than in USA.

I work in healthcare in England and you can get hydrocodone here, but on a named patient basis only. Suppliers need a Home Office license and the drug is listed in the BNF which is our manual for all approved UK meds BNF Publications. Hydromorphone (a metabolite) is readily available on prescription. Not everyone pays a charge (currently £8.40, whatever the cost of the drug) so it's free if you're disabled, under 16 or retired. The other common treatment in neurology clinics are lumbar epidural steroid injections. For really detailed info on care pathways, see here https://www.evidence.nhs.uk/Search?q...ain+management

[ShaggyChic_1201]

Originally Posted by -jimi-

there are specific meds for ... nerve pain.

Do you have anything for nerve pain other than capsaisin, gabapentin or Lyrica?

There's nothing worse than nerve pain that isn't being helped by the things mentioned above. Makes one feel desperate.

[dwr3]

In Poland, you can get tramadol mixed with paracetamolum, it's called Doreta. There are many more, too. I had Doreta for back pain and migraine, my father - who has his whole spine damaged - used it too. There's also Tramal, a pure tramadol in high dosage. We don't have Vicodin.

[-jimi-]

Tramadol is used here (sometimes). It is basically the strongest pain med you can get.

Otherwise mostly antidepressants (mostly tricyclics), anti seizure meds and if you have an illness with a bad prognosis you might get morphine.