Pain management, in Mexico? Trust me on this, I have researched this with real passion for decades. Controlled substances are very highly regulated and in practicality, they almost don't exist. Manufacturing is tightly controlled, then distribution to pharmaceutical wholesalers and the entire chain leading to the public is beyond over-regulated. In a conversation with an owner of Famacia Dori years back, "you know Spanish, another word for inspector is extortionist in Mexico"!
Dori is the only pharmacy in Cozumel licensed to carry controlled substances. They are the only drug store that uses multiple wholesale providers and often are the only source for more expensive, exotic, newer to the market brand name drugs. They can and will order directly from the source for medications not widely distributed. It was in the late 1990s that common schedule III narcotics began to be listed in the Mexican version of the Physicians Desk Reference (drug Bible). Light weight compounded versions of assorted hydrocodone and oxycodone did not appear on their wholesale availability to order lists for close to ten years later. They had included them in their orders for years, but have never been able to obtain them. Inspector = Extortionist in Mexico. Again from the point of manufacturing, each and every level of the distribution chain will have to abide by complex, strict inventory and control documentation. No matter how strict, preciseness in inventory and accounting for every single unit, they are left wide open to simple extortion during inspections. Gee, everything appears to be in order, but maybe I need to take your entire inventory, all your documents and give them a more complete and thorough examination. But maybe we could avoid that hassle with a few thousand pesos for this time.
Narcotics available on the island and only at Farmacia Dori would be: Tylenol 3s (Tylex CD 30 mg of codeine with acetaminophen. I have seen too a codeine compound containing 50mg of a codeine salt imported from Argentina. Propoxyphene (Darvon) was sold under the brand name of Percodan Demi which many, many tourists bought over the years thinking it actually contained oxycodone. I don't know if that has been removed from the market following the U.S. FDA action. The only other "significant" pain medication would be buprenorphine sold under the brand name Temgesic both sublingual and for injection.
The "strong" easily available pain medication without prescription would be Tramadol and assorted Ketorolac versions, the most popular, but seldom suggested, Sinergix sublingual 25mg tramadol/10mg of keterolaco.
When I researched actual pain management doctors a few years back, there were THREE in Guadalajara that were properly licensed to prescribe real schedule II medications such as hyromorphone or even Oxycotins, larger dose versions of oxycodone. But the tricky part was that In the entire Guadalajara metropolitan area, there were only TWO pharmacies properly licensed to dispense these medications. Guadalajara is Mexico's second largest metropolitan area with a population over 4.5 million people!
Good news regarding Merida, I have seen some Internet reports that I deem credible that there is a pain management doctor in association with Clinica de Merida who can write and one drug store licensed to dispense hydromorphone.
Dr. Andrés Alejandro Medina Gutiérrez http://www.youtube.c...h?v=0R2eMOlGTEs
All general medications are sold without prescriptions in Mexico despite having the words "requires a physician's prescription: printed on the label. Only written prescriptions are required to buy certain controlled medications like Valium or codeine. No documentation is required to possess these drugs, but I have always kept a copy. Written prescriptions are returned to the client with the exception of controlled medications. Real drugs, anything that would be Schedule II in the States, like Dilaudid or oxycodone REQUIRES another written medical permission to CARRY or possess. Or this is what I have been led to believe.
This in a nut shell is what you're up against. Such extreme regulation that doctors don't want the hassle of expense of obtaining proper licenses to write. My guess the specialized prescription forms to write would cost several dollars alone and then few to none pharmacies able or willing to participate and go through all the hassles involved. The out of control pain medication market in the U.S. of assorted "pill mills" and their associated mayhem have caused U.S. physicians to limit their involvement and from situations of robberies, it is a growing problem for patients to find drug stores willing to inventory their meds. I have seen signs on the outside of drug stores boldly stating they do not carry Oxycotin. A very sad state of affairs. In Mexico, untold thousands, millions of people have had to suffer through chronic conditions and cancer patients are denied quality of life that proper pain medication can provide. Given the deteriorating situation in the States, I have lost any limited hope that the situation might improve in Mexico sooner than the distant horizon.