This should be an interesting question for sociologists of medicine to
answer, and I hope it will be a stimulating topic for a researcher to
look into.
I am looking for information on how US consumers gain access to pain
medication through quasi-legal means for *legitimate* use in pain
control, and I am interested in learning the *legal* (in country)
availability of the pain medication percodan and/or oxycontin. Because
brand names vary (and mixtures), let me specify that I'm interested in
any drug that contains significant (10 mg and up) levels of oxycodone.
To fill out the picture: many of the people who would avail themselves
of these drugs suffer from pain that has no obivous direct medical
cause. The only evidence of their suffering is what they themselves
report; doctors have no independent means to verify that a particular
person is indeed suffering as heavily as they assert, and may thus
be unwilling or too cautious to prescribe such strong drugs as
oxycodone. Thus consumers find themselves in an adversarial
relationship to their doctor, disagreeing about the kind and level of
medication they should
receive.
(As a sidenote: this is a fascinating topic in itself, since people
whose conditions are very similar from the POV of current medical
technology may be in vastly different "amounts" of pain, raising
philosophical and sociological questions about the nature of pain
representation itself; this forms the bulk of my research, which is
more literary-theoretic than medical -- I am quite an amateur.)
The area of interest is Latin/South America, and in particular the two
countries Brazil and Mexico. (If it helps further, I am interested in
the Mexcian border towns, and Rio.)
The particular questions I would like to have answers to fall into two
categories:
A. The official status of these drugs
1. What is the legal status of oxycodone in these countries? Do you
need a prescription to purchase oxycodone-containing drugs? Some, or
all?
2. What are the brand names of these drugs? What are their oxycodone
levels? Are they simply different names for the same compounds, or can
people find themselves in medical difficulty when taking them as
replacements for US brands? If possible, I would be interested in a
price comparison of these drugs with their US counterparts, but that's
extra.
3. Are there problems with fraud (consumers being sold fake, damaged,
or underpotent drugs)? With price gouging, or substitutions (for
example, I understand that a drug in Mexcio is called "neo-percodan",
but is entirely different chemically from percodan itself.)
B. Access to these drugs by US consumers
1. If there are legal restrictions (e.g., prescriptions) to oxycodone
access South of the border, how do US consumers go about satisfying
them? Is it the case, for example, that pharmacies in Mexico and
Brazil accomodate these overseas consumers by, e.g., providing doctors
to write prescriptions on site, or even by simply ignoring the laws?
(Documentation about this -- including how these pharmacies market
themselves to the US -- of great interest.)
2. Do such pharmacies do business by mail order, or do consumers need
to physically enter the country to receive these drugs?
3. What kind of consumer activism is present in the US to help
distribute information about these methods of gaining access to
oxycodone?
4. What kind of legal or diplomatic action has the US taken to
restrict this kind of access? Does the US turn a blind eye to this
kind of business, including towards people who buy their medicines in
bulk to take home (either to avoid legal restrictions in the US, or
simply to save money?) Government information is of particular
interest here.
5. Since oxycontin has had popularity in the US as a "street drug",
are there crossovers between the quasi-legal and completely-illegal
channels? (This is a less pressing question, more of interest for
filling out the picture of what a US consumer would encounter in her
transaction -- e.g., are these pharmacies directly involved with the
black market.)
I have had a great deal of trouble finding this kind of information on
the web, and the subject is too young to have much print literature.
In addition, I'm particularly interested in non-profit groups who
might provide information, but web research seems to turn up lots of
commerical companies. I am explicitly not interested in the viagra or
prozac trade, although the ritalin trade seems to have some similar
issues (through ritalin is easier to get from a doctor.)
A wonderful thing from my point of view would be some sort of personal
narrative or "pro bono" piece written by someone who has had recourse
to this channel, or who sympathises with those who believe they need
to. Is there any kind of "activism" (either "information for people in
need" or more general FDA pressure groups that seek to change US laws
or policies) around this issue? Are there commercial companies that
will "smooth out" the difficulties a non-Spanish/Portugeuse speaker
unfamiliar with the culture might find?
For a detailed, sourced answer, especially one that required some
legwork away from the computer screen, or includes first-hand
knowledge, I will tip generously (and may even cite you in my article,
if rules permit.) |
