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Pain Management

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christinelindsey
6/16/2015 12:32 EST

My husband and I are looking to relocate from US to CR this December and have several concerns, one of which pertains to our pain management. We both have back problems and have been on extended relief 60 mg morphine sulfate and 30 mg instant relief morphine sulfate. Can anyone tell me if these medications are available?

Also, I read something that indicated medications couldn't be imported into the country without an import license. Does anyone know how difficult it is to get this?

Thanks for any responses.

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Czechrite
9/2/2015 19:22 EST

Hi.
I can tell you that any form of Morphine is tightly controlled in the United States, however, if you are not a US National you should be able to bring a limited supply with you. There are specific guidelines but border officials do have some discretion and judgement.

I am American but live overseas so if I am traveling back home for a visit with any controlled substance medications that I have a legal prescription for in my host country the best thing to do is have paperwork.

I have a history since before leaving the states and I have a folder that has brief clinic notes from my US Doctor who made the diagnosis and my foreign doctor who confirmed the first doc's diagnosis and also prescribed similar pain medication. Since many overseas pharmacies do not have prescription information on the medicine container itself, I will usually get a photocopy of the actual written prescription AND get a note or statement from the doctor on his/her letterhead OR clinic/hospital letterhead (which has all contact info) that states what I'm being treated for and which medicine I've been prescribed for treatment and the quantity and use of that medicine.

It sounds like A LOT when I type it out like that, but really it's just about 4 or 5 sheets of info really. Just supporting info that WHERE YOU LIVE you are currently in treatment using this medicine and that your doctor states you need to keep taking it. The medical history notes (just clinic notes...something non-medical people can read and understand) should be there to support your treatment.

It must be clear that you are visiting or just arriving from somewhere else where you've been living and that either you will be returning or if staying in the US you need and intend to find a doctor to confirm your diagnosis and continue treatment. If you've only recently left the US and return in a short time, it is not likely that you'd be allowed to keep medicines with have controlled substances in them.

Having said that, Morphine of any kind is a serious medicine and Schedule II controlled substance which is highly addictive and often abused. I would make sure you declare it and offer your paperwork. Otherwise, you could try an alternative medicine that might be just as strong but not so stigmatic. Even Oxycontin or codeine might be less problematic. When they ask you if you have any drugs or controlled substances, you must at least say "I just have some Prescription medications and toiletries" and answer honestly to any questions.

If you're just visiting or 1st time arriving on US soil and have a medical condition serious enough to warrant use of Morphine and you bring supporting paperwork you should be allowed to keep your meds....however make certain you have everything that can support you. Be as open as possible and make it clear you can eaily contact your doctor back where you come from.

It is reasonable to assume if you are legit that you should be able to retain a 30 day supply of your medicine according to how the doctor prescribes it.

I have had to travel with a type of slow release Codeine before into the US but I only had a couple packages at most and I made it 100% clear WHY I was taking it, WHO prescribed it, and HOW much I was to take and HOW often I took it so they practically didn't have to ask me anything else.

If you can substitute anything less stringent and serious than morphine, I would try to do so. Otherwise be certain to have all the supporting paperwork you possibly can hopefully from a pain specialist of some kind who can easily refer them to. If they take the info they will (and should) follow up on it.

It can also depend where you're coming from and what the medical standards are like compared to the US. In Europe, they are even less likely to prescribe narcotic pain medicines than in the US so if you come from...say...Germany and your German doctor from a German Spinal Pain Clinic prescribes your meds and writes a nice letter for you and gives you a copy of clinic notes then I'd say their standards are even HIGHER than US standards and this doctor would be easy to talk to and very available. But if you come from Pakistan (no offence to anyone from there) or another less developed nation with lower medical standards, you would be scrutinized more I'm sure. If you've only been out of the US a week or two and then show up after a visit from Pakastan with notes from a "Doctor" that says you must take tons of morphine each day I think you may have a problem.

OBTAINING MEDICINE IN THE US:

Now a visit with a monthly supply is one thing, but these medicines are definitely NOT really "available" in the USA. Doctors can prescribe them but they must have a verifiable reason to do so.
You should have that 30 day supply with you so you have enough time to have a new doctor confirm your diagnosis and continue your treatment.

I would start by using the Clinic notes you would bring with you to support your claim of your condition and help your new doctor confirm your problem quickly. Only a REGULAR FAMILY DOCTOR or a PAIN SPECIALIST can prescribe such strong medicines in regular quantities, so you must establish your problem and a relationship with such a doctor and of course, you must still be verifiable as sick/injured. Your new doctor may not agree that Morphine medicines are appropriate.

I would also suggest trying to set up an appointment with a regular family doctor in your new area even before you arrive. If you have friends/family in the area they could help. They could get the contact info or even set up your appointment. You could also forward any information and documents (Clinic notes, xrays, CAT scans, etc) to the new doctor even before you arrive.

Even if your "new" doctor thinks you should no longer use morphine, he/she may substitute something else just as strong and also help wean you off the morphine onto something better.....assuming there would be any change.

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Czechrite
9/2/2015 19:33 EST

Whoops! I wrote an essay for you but you're going the other way! Which country is "CR"? Czech Republic? Yes, you can get this here but you must go to a specialist. However they are LOATHE to prescribe such things here....but then I guess it depends on the doc. In the meantime, you should bring a 60 day or so supply with you but be sure it is all properly labeled and have a note from your doctor or clinic if possible. Bringing it in WITH you in properly labelled prescription containers should be ok, but in the meantime you will have to ask friends and other doctors as much as possible who to see and what to do.

DON'T BE DISCOURAGED! Everyone has a different answer for everything! That is a benefit and drawback here. One person says its impossible but another will do it. I've also noticed that if you go to the same pharmacy long enough and they are nice and friendly and they know your doctor writes a prescription for you sometimes you can just go direct to the pharmacy. You can have your American doctor write one or two scrips for you to help things last, but you might have to go to several pharmacies to find one that has what you need. Make sure you mention you are a foreigner and that you PAY CASH for your medicine and you're not registered (yet) with the national health care. This means there are less restrictions and rules because the state insurance sets all the restrictions.

Bring clinic notes, supporting documents. Extra prescriptions (and make copies, those can come in handy) and work hard and finding a good doctor who will help you.

I hope that helps!
One more personal note.....Morphine is dangerous....the longer you take it the less it works and you have to be weaned off of it or you'll get sick. It is only a SHORT TERM solution in my opinion. I can recommend substitutions here that are more available and may be better than MS04. Otherwise you must be so sick that you will have trouble travelling anyway!

I am familiar with Eastern Europe so if that's where you're going I can advise you. I hope my information has helped. Let me know if I can help further. GOOD LUCK and I hope you feel better soon!

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