Pain Medication in Japan

[Roger Van Zant]

Where in Japan are you?
I know a foreign (Dutch) doctor in Fukuoka.
I have been going to him for over fifteen years.
He will be able to give you the best advice.
None of this “gamen “ nonsense.

Would that be Dr. Schlemper? (I did a quick Google search).

I live in Kanto but I would definitely be willing to pay the price of a Shinkansen ticket for a doctor that has knowledge of modern medicine.

Yes, that's him.

[Teflon]

Currently for someone like me who has fallen through this pain treatment gap in Japan, there is no respite other than maybe a stress related heart attack or something similar. That is why I ask the question: Has anybody been able to find a viable solutions to bridging this gap other than moving out of Japan? I’m so desperate that, I’m embarrassed to admit, I even tried acupuncture for a while.

I'm not an expert in this field but I'm sympathetic to your situation. No one should suffer needlessly with breakthrough pain when modern medicine is available to effectively treat it.

Do you qualify for Medicare? If so, then you could get the meds you need in Guam which is about a four hour flight from Tokyo and costs around $600 round trip. You would need to apply for a narcotics import permit two weeks in advance which can be done in Japan. You would also need a medical certificate from the prescribing doctor. With these documents in hand you could legally enter Japan carrying a certain quantity of oxycontin or oxycodone (I think up to one month's supply but not sure). This is a costly and time consuming process but for occasional breakthrough pain it might work if you can get prescribed the max dose for the max number of days possible and see how long you could stretch it out in Japan.

[Gulliver]

Currently for someone like me who has fallen through this pain treatment gap in Japan, there is no respite other than maybe a stress related heart attack or something similar. That is why I ask the question: Has anybody been able to find a viable solutions to bridging this gap other than moving out of Japan? I’m so desperate that, I’m embarrassed to admit, I even tried acupuncture for a while.

I'm not an expert in this field but I'm sympathetic to your situation. No one should suffer needlessly with breakthrough pain when modern medicine is available to effectively treat it.

Do you qualify for Medicare? If so, then you could get the meds you need in Guam which is about a four hour flight from Tokyo and costs around $600 round trip. You would need to apply for a narcotics import permit two weeks in advance which can be done in Japan. You would also need a medical certificate from the prescribing doctor. With these documents in hand you could legally enter Japan carrying a certain quantity of oxycontin or oxycodone (I think up to one month's supply but not sure). This is a costly and time consuming process but for occasional breakthrough pain it might work if you can get prescribed the max dose for the max number of days possible and see how long you could stretch it out in Japan.

I hadn’t thought about that. You’re right- a months supply would probably last me several months because I wouldn’t need it every day. That’s a really great idea. Thank you!

Incidentally, I do still have my US insurance. i’ve used it several times when I’ve gone back on vacation and to offset the high price of hospital stays in Japan. Keeping it has more than paid for itself.

If anyone reading this has ever applied for a narcotics import permit for Japan, I would be interested to know how smooth the process is and if there were any snags.

[Roger Van Zant]

Currently for someone like me who has fallen through this pain treatment gap in Japan, there is no respite other than maybe a stress related heart attack or something similar. That is why I ask the question: Has anybody been able to find a viable solutions to bridging this gap other than moving out of Japan? I’m so desperate that, I’m embarrassed to admit, I even tried acupuncture for a while.

I'm not an expert in this field but I'm sympathetic to your situation. No one should suffer needlessly with breakthrough pain when modern medicine is available to effectively treat it.

Do you qualify for Medicare? If so, then you could get the meds you need in Guam which is about a four hour flight from Tokyo and costs around $600 round trip. You would need to apply for a narcotics import permit two weeks in advance which can be done in Japan. You would also need a medical certificate from the prescribing doctor. With these documents in hand you could legally enter Japan carrying a certain quantity of oxycontin or oxycodone (I think up to one month's supply but not sure). This is a costly and time consuming process but for occasional breakthrough pain it might work if you can get prescribed the max dose for the max number of days possible and see how long you could stretch it out in Japan.

I hadn’t thought about that. You’re right- a months supply would probably last me several months because I wouldn’t need it every day. That’s a really great idea. Thank you!

Incidentally, I do still have my US insurance. i’ve used it several times when I’ve gone back on vacation and to offset the high price of hospital stays in Japan. Keeping it has more than paid for itself.

If anyone reading this has ever applied for a narcotics import permit for Japan, I would be interested to know how smooth the process is and if there were any snags.

Did you go to Dr. Schlemper in the end?

[Gulliver]

Did you go to Dr. Schlemper in the end?

At this point I have not. I recently had a conversation with my family doctor who told me that, “In order to prescribe severe pain medication you need a special permit, and very few doctors are allowed to get it.” So I was thinking your doctor is probably hamstrung by the same restrictions as other Japanese doctors.

Unless you have experience to the contrary?

Appreciate your help though.

[Roger Van Zant]

Did you go to Dr. Schlemper in the end?

At this point I have not. I recently had a conversation with my family doctor who told me that, “In order to prescribe severe pain medication you need a special permit, and very few doctors are allowed to get it.” So I was thinking your doctor is probably hamstrung by the same restrictions as other Japanese doctors.

Unless you have experience to the contrary?

Appreciate your help though.

Not sure, but I always get UK-strength pain meds from him, for a fraction of the over-the-counter price in Japan.

[jcherni]

I thought I had just an unlucky experience, but reading your comments this "gaman" thing seems to be common in Japan?

I had to go through a root canal procedure due to a shattered tooth. Was the first time I ever went to the dentist in Japan, so I didn't really know what to expect, just went to a dentist near my house.

The dentist tried to perform the procedure without giving me any anesthesia whatsoever...
She just gave me a small device to chew, which would give me small electrical shocks which were supposed to make my tooth and surrounding area numb, but didn't do anything. At the end I couldn't bear ("gaman") the pain, so we stopped at the middle.
I went there two more times but it wasn't working, so I just gave up (with half of my teeth hollowed out).

Move forward a few weeks and I got a massive infection (bacteria? entered through the hole in the teeth and lodged between the skin and the jaw bone. You could actually see and feel the bump on the side of my face caused by the pus...).

I was at work fighting through the pain, so I just called a bunch of dentists offices until I found one which was available.
I was lucky that it was a young guy who studied abroad (Harvard, I guess), who quickly diagnosed, gave me meds for the infection, and eventually brought some good anesthesia to finish my teeth. He even mentioned that he had to get a stronger anesthesia for me, because he knew the usual ones wouldn't be enough for my size.
It was such a pleasant procedure that I actually slept a bit during it.

He has an office on Marunouchi, Tokyo, if anyone needs a good dentist.

[Gulliver]

I thought I had just an unlucky experience, but reading your comments this "gaman" thing seems to be common in Japan?

I had to go through a root canal procedure due to a shattered tooth. Was the first time I ever went to the dentist in Japan, so I didn't really know what to expect, just went to a dentist near my house.

The dentist tried to perform the procedure without giving me any anesthesia whatsoever...
She just gave me a small device to chew, which would give me small electrical shocks which were supposed to make my tooth and surrounding area numb, but didn't do anything. At the end I couldn't bear ("gaman") the pain, so we stopped at the middle.
I went there two more times but it wasn't working, so I just gave up (with half of my teeth hollowed out).

Move forward a few weeks and I got a massive infection (bacteria? entered through the hole in the teeth and lodged between the skin and the jaw bone. You could actually see and feel the bump on the side of my face caused by the pus...).

I was at work fighting through the pain, so I just called a bunch of dentists offices until I found one which was available.
I was lucky that it was a young guy who studied abroad (Harvard, I guess), who quickly diagnosed, gave me meds for the infection, and eventually brought some good anesthesia to finish my teeth. He even mentioned that he had to get a stronger anesthesia for me, because he knew the usual ones wouldn't be enough for my size.
It was such a pleasant procedure that I actually slept a bit during it.

He has an office on Marunouchi, Tokyo, if anyone needs a good dentist.

Definitely let us know who he is. Finding quality and honest doctors can be a time consuming process here.

[ghodlin]

For chronic back pain/knee and shoulder injuries I have generally been prescribed NSAIDS as usual here (loxonin being the local favorite) but I found Naproxen worked better for me, with 'mucosta' (Rebamipide) to help protect the stomach. If you aren't being precribed Rebamipide with NASAIDs, that's unusal and you should ask your doctor. For more 'neuropathic' pain, I've been prescribed lyrica (pregabalin) several times (in doses from 60-180 mg). I've found that lyrica and an NSAID in combination can be effective. I've been prescribed acetominopen/codeine for acute pain and that's effective (but codeine gives me headaches so I avoid). I've also been prescribed Tramadol and Tramadol/Acetominopen combo several times and that's effective, but sounds like a no-go for you.

For pain management, i find going to a good 'seikeigeka' for regular massage combined with electric pulse treatment helps a lot. I also use 'shippu' regularly, especially as a way to reduce NSAID damage to stomach. Swimming helped me over the years too. Now I struggle to swim with a dodgy shoulder, but just walking in the pool can help with aerobic and lift your mood. Perfect in this weather and there are the cheap public pools in schools everywhere.

I live in Tokyo where there are a lot of options, including some pain management centers which are a new thing here. As always with medical care in Japan, the key is to shop around until you find a doc who takes you seriously and relates well to your mental and physical situation. It takes time and effort but there are some good doctors out there who will help as best they can, working within the regulatory and cultural constraints.

I've lived with pain for most of my adult life with back hernias from my early 20s, back surgey at 30, and other injuries and issues. I relate to your situation and hope you can get some good care soon.

[hana]

Sorry to hear you're suffering from such intractable pain, especially in Japan. Must be horrendous.

I imagine you've tried everything you can get your hands on here, but FWIW (and I have no experience of) CBDs are available and may have a different mechanism of action than NSAIDs.

https://www.tokyoweekender.com/2021/03/ ... -in-tokyo/

Hope you can find something that helps.