I am currently on an oxycodone m/r script, and find that it certainly does not last for the claimed twelve hours per tablet. No matter what, my doctor refuses to prescribe anything for this 'breakthrough' pain, not even a 20mg OxyNorm to carry me over. I have heard, however that a DIFFERENT analgesic is best in this situation. Since most drug information sites and forums are American, the drug which keeps cropping up and is most highly recommended to me is hydrocodone. This is NOT available in the UK, and despite many attempts, I can find no place to access it. The only other country which uses hydrocodone, in a much better pure form, is Germany, where it is available under the brand DICODID by Knoll, 10mg per tablet. Unfortunately I have had just as little success in tracing a source for this as for the US version, which is ALWAYS adulterated with paracetamol, usually 325mg/tab.
Does anyone have any idea where I could obtain a supply for these dreadful times when the OxyContin doesn't work? Dicodod would obviously be the preference but I HAVE tried the US hydro a few times and found that by far the best I have tried is Mallinckrodt's 'M367' 10mg/325mg tablet, in a dosage of 30-40mg.
This is a matter of access though, so if anybody can suggest any way that I can manage to get a stock of this most useful drug, then please post. There is a gap between dihydrocodeine and morphine in the UK which has nothing of in-between strength to fill it. In he US you have hydro and meperidine and hydromorphone in 4mg and 8mg strengths, instant release. All I want is relief from those bad times. Under-prescribing and refusal to prescribe for such occasions is becoming almost an obsession with me, and I really need something of this order to help.
Hey you in the UK. . . .Sounds like you are butting up against a brick wall Try a mind shift (a different approach) to try to get to the source of the pain rather than a topical pain pill. Give me (us) more details as to what has happened with your health breakdown. For example, in the US we have a catch-all health problem that has been labeled FIBROMYALGIA. There are many different drug classes with medications that are more acceptable and easier to obtain. What about nerve pain from a previous surgery or injury? Let me stop here; my information may be irrelevant. Go to the source and also please advise. Love to the UK. Myra
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Yes, the reason BEHIND the pain. Been through this with a pain specialist God knows how many times; have used and not used a waliking-stick; have tried meditative techniques; name it. It is spondylo-arthritis. I was told just the other week that my L knee is showing signs of the increase in OSTEOarthritis as well. Not pleasant and extremely painful indeed. Both my doctor and myslf have agreed that the treatment of symptoms with drugs is the best way forward. I use OxyContin as my primary analgesic and also diclofenac and mist.... what the hell is it called again?... anyway, it's a stomach protector for those who use diclofenac regularly. It is a dreadful drug for the stomach, and with that 'm' drug is known by the brand name 'ARTHROTEC'. Sometimes I use the muscle-relaxant CARISOMA (carisoprodol) which is often of great help because for some reason this spondyloarthritis can give me cramps in the leg muscles - carisoprodol is a great drug for preventing this when one knows it's coming, as one often does through knowing the early signs of these events. Anyway, that's the REASON for the pain. We are agreed that it's a case of 'keep taking the medicine'. I wouldn't mind an increase in OxyContin dosage but my doc is totally against this; I wish I didn't have to take diclofenac at all, since it is a much more dangerous drug than normally portrayed, but I am glad of the 'Arthrotec' combo which prevents me fcuking up my stomach. So it's back to the original question - what to take to cope with 'breakthrough' and 'tail-ending' of my primary PK. Hydrocodone I mentioned specifically because it is two to three times stronger than dihydrocodeine and the kind of strength which would help immensely. As would hydromorphone and Diconal (dipipanone, a most efficacious painkiller which for some reason, my doctor is not very keen to prescribe, even though it's about the same strength as an instant release oxycodone.) I return to my original plea; if anybody can point me in the direction of where I can be prescribed (EU) DICODID 10mg, I'd be very grateful indeed. Similarly, should I fail, then the adulterated US version, with at least 325mg paracetamol per tablet, would do. There don't appear to be many clinics or Pharmacies on the web that will ship hydrocodone products over here though. I am stuck there unless anyone has any bright ideas. Love Michael
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I have been on chronic pain treatment, I myself have a condition that cannot be fixed, so what I can tell you comes from tons of experience.
First off, Oxycodone is the strongest drug on the market that you can get by prescription, it is natural for your doctor to want you to stay on the same dose for as long as possible. If you jump to a higher dose too soon, then your tolerance will develop much too quickly and you will eventually run out of options for any type of pain treatment.
Secondly, there are some narcotics, such as Morphine, that are actually bad for someone with spinal problems, they actually make it worse, rather than better. I found this out the hardway, so there are some drugs that you have to stay away from, because they cause inflammation and joint pain and would not help you.
Now, if you are using the generic version of your medication, then that could be causing your problem right there.
Generics are allowed to differ from the name brand medications, in the US they can differ by as much as plus or minus 20% of the ACTIVE INGREDIENT, so you may NOT be getting the full dose necessary to help your pain.
In addition, your doctor has to protect himself, by being careful what he prescribes and he has to worry about creating an addicted patient.
No offense intended, but the more you carry on about wanting more drugs, then the less he is apt to prescribe something else, because you are making him think you are only there for the drugs.
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First, oxycodone is not the strongest at all. There are Diconaland Fentanyl which are both stronger. Hydromorphone is also stronger. Secondly, there is no such thing as a generic OxyContin, as the patent does not expire until 2016. Thirdly, of course I want drugs. The whole point is that I require something for breakthrough and tail-ending. Finally, it is the law that generic medicines MUST contain exactly the correct amount of the active ingredient; the only difference betwee the original and a generic should be the fillers and binders. 2mg alprazolam is 2mg alprazolam whoever makes it. The reasn that some people find certain generics feel weaker or stronger is that the additional ingredients may affect the body chemistry. But they MUST contain that 2mg alprazolam. Morphine sulphate is a relatively weak opiate and makes me sick; I also know that it is no good for my condition which involves inflammation, hence the diclofenac combo, Arthrotec. Finally, dependence matters not one jot when one must take a drug of that type for the rest of one's life. So doc's woory does not come into the matter at all. It is their job to relieve the pain as best they can, and that is precisely what they are NOT doing in this case. Hope that's straightforward enough for you.
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I have been where you are, I suffer a severe spinal problem that cannot be fixed, so my information comes from both experience and my work.
I did not mean Oxycodone was the strongest of all. However, for spinal issues, it is not safe to use medications from the Morphine class, they cause swelling and joint pain and can actually make spinal conditions worse. I discovered this the hard way, my doctor was not aware.
Fentanyl is, indeed, much stronger, but should only be used when all other options have been exhausted.
I also did not say that the information I gave on generic drugs being allowed to differ applied in all countries, I said it applied in the US and I can point people to the applicable law that allows such differences.
As to the Oxycontin generic, there was one available in the US until very recently, when due to abuse, they took it off the market and now will only let Perdue Pharma manufacture the name brand, which is why they have an extended patent. Pharmacies here may sell whatever generic stock they have left and then they are done and will have to sell only the name brand. (This information is available in various US news stories!)
As to dependence, I understand that as well, I was on tremendous doses of both Morphine and Oxycodone for over 5 years and when I stopped taking them, I was miserable for about a week.
I am not familiar with your countries drug laws, but I would ask you to please make sure you are and won't be getting yourself into any trouble if you obtain drugs from another country. In the US, if there is a legal equivilent drug available, then it is illegal to bring something in from another country.
Now, that said, the only other suggestion I can give you is, if this doctor isn't helping, then can you try seeing someone else?
From my own experience, I do know that not only should someone who needs long term pain management be on a time released me, but they should also have something that works faster that they can take for breakthrough pain.
Doctor's responsibilities are often dampened and controlled by the laws of the area they are practicing in and if they say that he has to watch what he prescribes, so he doesn't lose his livelihood and up in jail, then that is what he must do.
Their obligations generally only go so far, they can try to help you and prescribe something to help you be more comfortable, but they do not have to provide you with complete pain relief and, in most cases, they can tell you that they can't help you and tell you to find someone else, and there is nothing you can do about it. (I also did not say doctors worried about dependence, but addiction, which is quite a different matter!)
You do have the right to find a different doctor to help you, you are obviously having problems here and your pain is not being managed properly.
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myra brackins Says:
Michael, it's so hard to live with so much pain. Your cries for help are heard, maybe someone will send you the medicine; exactly what you're asking for? My comments seem so insignificant because you've tried everything. Certainly you've tried ALL of the NERVE BLOCKS (INJECTIONS) ie HYALGAN, SYNVISC; EPIIDURALs, CORTISONE, FACET BLOCKS ETC. What about PREDNISONE a steroid? SKELAXIN (800mg 4 times a day) is a good muscle relaxer with fewer side effects. LYRICA, a newer drug, has also been a good drug for me recently to help treat the nerve pain and migraines. Is your pain correctly diagnosed? I suffered with a burning pain for almost 6 years and thought it was just my nervous energy, until recently, a Nurse Practitioner, partnered with my Rheumatologist, diagnosed my cries, of some of the pain, as Nerve Damage. She was able to substantiate my need for appropriate pain medicine. . . and surely you've tried PHYSICAL THERAPY and ACUPUNCTURE. iT WOULD HELP IF YOU HAD SOMEONE TO HELP KEEP YOU CALM. I just saw an advertisement for Canadian, online drugs? God Bless Michael. Some of us are chronic pain sufferers; not drug abusers. We are penalized in the US for trying to get cheaper cigarettes online. Why In the UK you can't get what you need? DOESN'T TRUST WORK THERE EITHER. A DOCTOR WHO ISN'T AFRAID OF LOSING THEIR LICENSE. Moral support during this time of crisis is important and I pray we have been a good ear. This is a wonderful forum. Love.
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robyn in delaware Says:
First of all, there is a generic version of oxycotin. I know this for a fact! I feel that a break through pain agent as you wish for should be giving if the patient does have a serious need for such. I often wonder if the Doctor themselves are choosing who should and should not need these medicine's out of personal feelings about the patient (looks like he/she might be a drug addict, past matters, or for what ever). This is wrong if it i so. I can tell you if you were to chew the tablet (half at a time) it would release faster and give you a fast relief, although it is very dangerous this way. I am not a doctor so what do I know?
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Chewing Oxycontin is NOT a good idea, it is very dangerous and you could end up getting to much of the medication at once and killing yourself.
As to the generic, as I said, it is no longer allowed to be manufactured in the US, so if you are taking it, you will eventually have to take the name brand, or if your insurance doesn't cover it, you will have to switch to something else.
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wat is oxynorm 40mg yoused for
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Cherie, Oxynorm is a UK brand name for a short acting version of Oxycodone. It is used to treat severe pain in people who are already tolerant to other narcotic pain medications.
Some of the most common side effects include: drowsiness, nausea, constipation and dry mouth.
A lo to reply to and explain more of here. Myra; pregabalin, which has a US brand LYRICA, is unsuitable. This from the doc's mouth. It is of greatest use in peripheral neuropathy, and that is what our BNF (your PDR) indicates it for. The lumbar problem is not really significant; more of a bloody awful discomfor, a distraction I could do without and which is taken care of by the OxyContin. The problem which MATTERS is the spondylo- and osteo- arthritis in the knees. As you are aware, spondyloarthritis involves the calcification of bone and is one of the most painful things; hence my pleas for a raise in dosage. I have even discussed a method used sometimes whereby for one month out of each four, i am given an alternative which would reduce tolerance to OC. Oxycodone is made from thebaine, not morphine or codeine. An analgesic such as hydroorphone, NOT based on thebaine would do that job. But it still does not address the breakthrough and tail-ending problm. You are now aware that we here have a dreadful analgesic 'gap' which means there is nothing between dihydrocodeine and morphine in strength; this is where hydrocodone coes in. It is licenced only as an antitussive in Europe and is almost impossible to find. Hence my plea for a way of accessing the US version, which is unfortunately not pure hydrocodone. As to the law, I am allowed to import a 90-day supply of medicine for personal use. Yes, I've tried the alternative therapies as well, except hypno, which is beyond somebody living purely on disability benefits. Robyn - perhaps in the USA that is true. OxyContin was introduced in 1996, therefore the patent runs out in 2016. Basic pharmaceutical patent law, 20 years. The US have shorter patents. Yes, chewing or halving OxyContin is an option i use on bad days; and at the low dosage of 40mg is not dangerous in the least to an opiate-tolerant individual. OxyNorm is instant-release oxycodone; there is a US brand called ROXICODONE. The highest dosage capsule though is 20mg, not 40mg. If I have missed anything out then I'll rectify later. In the meanwhile, the issue remains - how do I access the 'in-between', relatively weak narcotic analgesichydrocodone now that I have lost my source for Dicodid? The only alternative is that combination with 10mg of hydrocodone mixed with paracetamol you have in the US, but not available here. As I said, there is NO website which will ship to the UK, and must therefore find somebody who is able to access the cheap ($56/120) Mallinckrodt M367 10mg/325mg tablet. Mallinckrodt produce the highest quality hydrocodone in the US, a fact confirmed by the American Pharmaceutical Association, and in my limited experience of US combos, is definitely true, it is so much better than the versions made by Watson and Vintage/Qualitest, the others I have tried. The crux of the matter is that it is THE CORRECT STRENGTH for the purpose intended. Further discussion required perhaps, but there is no getting away from my need forthat strength of analgesic for the breakthrough and tail-end pain. Hoping this makes things slightly clearer. Love to all from Scotland, Michael x
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If I may update on my situation regarding my pain issues; it is now well into the season of 'mists and mellow fruitfulness' which to us arthritics means the season of increased pain and misery. I STILL have not found a source to replace my 'lost' source of Dicodid. I admit to being wrong about the analgesic gap - there is tramadol in between. Unfortunately that particular drug does not agree with me, as they once tried it with me and I suffered terrible side effects. Which brings us back to hydrocodone. Why I have to seek a prescription from another country is easily answered. Money. The British NHS has, since the time of that bloody woman Thatcher, turned from its original point and philosophy into something quite different and the range of medicines available has been decimated. Wrong word. That means divided by ten. It's a lot worse than that. Take benzodiazepines, another class of drug I require. There are 42 of them and now only around ten are available for prescription here. When you consider that each has a specific action which is useful for different types of condition, then look through our BNF, you'll see that many of the most useful have been deleted. Indeed, in 2002 I was on a bromazepam (Lexilium) script when it was taken off the market. The official explanation was that the BZDs that remained should cover any eventuality. WRONG. Lexilium (or Lexotan, Lexaurin, whatever, there is not much difference) is the fastest-acting and produces the most wonderful calm and serenity for those of us who suffer thanatophobic panic attacks. NOTHING left for prescription here now comes close to the usefulness of bromazepam in those situations. I can, however, get Lexotan and an excellent generic from Belgium. They even make a 12mg tablet there, twice the strength of what was the highest (6mg) available in the UK. As I mentioned, we are allowed to import up to 90 days' supply of medicines for personal use. My hypnotic (or one of them, since I used to rotate, and still do, to avoid the build-up of tolerance), flunitrazepam (Rohypnol, Rohydorm, Hypnodorm) was deleted about 3 years ago. That was particularly useful since unusually for an hypnotic, it has a half-life of 200 hours. After a Rohypnol night, i NEVER needed a morning anxiolytic, managing to get right through to the afternoon, often late afternoon, before requiring a Xanax, which is the brand of anxiolytic I have been prescribed now for several years, though my dosage is down from 6mg/day to 2.25mg. There is only one generic alprazolam here, and no pharmacy I know stocks it, so I am always dispensed the brand. The onlt thing I find wrong with it is that it requires frequent dosing because of its short half-life, so I take four 500mcg and one 250mcg tablet daily, usually leaving the smallest dose to take with a 500mcg in the evening. So a trip to Belgium for Rohypnol, Lysanxia and Lexotan is on the cards every three months, and the medicines are extremely cheap there. It's less than £20 ($42) for 180 x 1mg Roche Rohypnol, and the 2mg generic is only £15 for 90 tablets. And because i hold a European health Insurance Card, I end up being remunerated for 80% of even that low cost. If I have a Xanax script dispensed iin Belgium, 50 x 2mg tablets (long white bars marked Upjohn 94) cost less than a US$ each so I end up paying the equivalent of around 40 cents per bar. I do NOT pay for my OxyContin, which is a boon because a box (containing a month's supply, 56 tablets) costs almost £100. Thank the Lord it's available on the NHS at no cost. Pregabalin is another extremely expensive drug, but, as I said, is not suitable for me. 'Fibromyalgia' is a diagnosis which i have never heard in the UK. I have read up on it though, and many of the symptoms described in the Wikipedia article of that name actually DO apply for me, though I do not suffer peripheral neuropathy. I haven't got around to discussing that particular thing with my doctor yet, but it's uncanny that many of what I considered to be relatively minor symptoms of the disease I suffer could in fact be indicators of some form of this Fibromyalgia. Thanks for mentioning that word! So legally, so long as a drug is for personal use and covered by a doctor, I am able to import 90 days' worth of it. I may have to find somebody in th USA who can access those Mallinckrodt M367s after all, since Dicodid is only available in Germany. A pharmacist may order it but the cost for the importation would be prohibitive to me, so I have to find my own source of supply. Ah, the joys of being ridden with illness and disease, what? If I have missed out on any point that anybody has made which required a reply from me, I'm sorry - let me know and I'll answer. The final shot is that US Law will not allow a website to send hydrocodone products to the UK, and I have tried a few. Only private individuals have helped. And may God bless them that understand and have gone out of their way to help me in the past. This is a good point to mention that Nick Day, a musician from California who helped me out on many occasions, sadly died of cancer in June. If you get the chance, listen to his final work, 'The Journey' which is excellent. Actually I am not sure that he lived to release it... his name on the boards was 'daybreak' and his own record label was 'Daybreak Records'. So sad that he has left us so soon, so young. And so talented and so sympathetic and generous. 'Requiescat in Pace'. R.I.P. Nick.
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Michael, perhaps your problems have been solved, as your post was a year old, but if not then take the following suggestions to your doctor.
As for mid level pain killers in the UK, doctors are *supposed* to use the lower strength Oramorph [morphine sulphate] solution. It is NOT a controlled drug, as its concentration is below the limit set by the law, precisely so that it CAN be used for pain relief when good analgesia is needed, but a doctor doesn't feel a controlled drug is needed.
Alternatively you could look at changing the main painkiller you are getting. Oxycontin is notorious for not lasting the claimed 12 hours. Many people have said this. A good alternative to Oxy is either the Durogesic [fentanyl] patches, or Physeptone, [methadone].
Methadone is not just for detoxing heroin addicts. It is a very good painkiller, with a very long half-life, so its analgesic effect lasts for a good while.
Other choices are to try and access an pain clinic in your area, and get specialist help with your pain needs. Many GP's are opiophobic. They have been so conditioned with the rhetoric of opiates = addict, that they are loathe to prescribe, and when they do they do so in a mean and stingy way, which if you think about it is totally illogical, since once they have realised that you are in need of an opiate for pain relief they should give you the amount that YOU need. Since opiates are more effective on some than others, there is no standard dose for controlling chronic pain. One person may get relief from 30mgs, while another needs 100mgs to control the same symptoms. If you keep on gently explaining that you are getting no relief you will eventually get the dose you need I think. Try keeping a diary of your pain, noting down the times you use various drugs, how long they take to work, and how effective they are. This will help show the doctor that [a] you aren't just blagging for a dose increase, and [b] that you are using you medicine responsibly.
A final alternative if you can afford it is to go to a private doctor, where, considering that you are paying for the service, you will get a far better treatment.
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I am on oxynorm 10mg for spinal problems , im here in the uk, My spine is in bad shape and i refuse to have more surgery as its will only get worse again over time, my doctor in the uk prescribes my medicine for me every month no problem, i dont abuse the system whatsoever, but my oxynorm i get every month. Im planning on moving to the usa in a few months, i will get my medical history and my thyroid medicine and estrogen info to take with me. Will a docter in usa precscribe the same medicine every month like im used to? estrogen, synthroid, oxynorm?
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First, are you a readhead (or ginger)? If so, the problem with pain relief can be in your genes. Look at http://www.cnn.com/2009/HEALTH/07/30/redhead.pain.dentist/ . Show this to your doctor. CNN isn't exactly a witchdoctor. He should listen to you if it's not working. My friend, a redhead, has suffered from chronic neck and back pain since an attack. She also has arthritis. When she feels it coming on she starts with 4 - 200mg ibuprophen and a 350mg carisoprodol. If it is bad she adds 2 tramadol -apap (which is synthetic codeine and tylenol) 37.5-325. Then she is out of commission, sitting in a high backed chair. If she doesn't do this, she winds up with reflexive vomiting from muscle spasms. She also goes to a chiropractor when this gets really painful and he has office hours. ---> side note from the redhead here:both the tramadol and the carisoprodol are supposed to be taken no more than 3x day, but I've had to take them every 6 hrs when it's bad. This is along with 4 of the 200 mg otc ibuprophen. Also, 1 drink doesn't hurt if you're chairbound. When you're not in the middle of pain, see if you can go to a beginners yoga class. it will help to balance and stretch. Good luck to you. if all else fails try googling hydrocodone. people are so whatever about chronic pain, including some doctors, until they experience it themselves.
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Thx 2 U Says:
Designer: I moved from the UK to the US 4 years ago, at that point with no health problems. If you are moving here, you need GOOD medical insurance or the medications will cost you tremendously. Unlike the UK prescription of £6 odd, the price without prescription would be far more. With it, I end up paying between $4 and $20 depending on the medication. I have seen some people without insurance at the chemists / pharmacies and having bills over $300 for certain drugs- that's a month's supply.
When I moved here, I did think the US was a much cheaper place to live. I was wrong. They are very similar when all is totaled at the end of the year.
Good luck though!
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I too have a bad back which cannot be repaired. I use Endocet 10/650 which is a generic for Percocet 10/650 (oxycondon/APAP 10-650 is also a generic).
I take one about 7:00 pm and if necessary, another around 11:00 pm. Because I have no wish to become addicted, I do not take the 4 a day which is prescribed. My 120 tablet prescription lasts 2 to 2 1/2 months, as I take them when the (pain) tears start!!!!
I have 3 different areas which are extremely painful. I get an epidural twice a year for the 2 worst areas. Otherwise, I just use the Endocet.
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know this is an old post but most of those painkillers are avalible in the uk us mepridine is just pethidine which is stronger than dihydrocodeine but weaker than morphine, i doubt your gp would issue pethidine 50mg tablets long term because pethidine use can cause fits with some people hydromorphone is available here. Im not supprised about your gp not likeing to issue diconal tablets due to their very high abuse potential and black market value you would have every addict in your town hassleing you to sell them some. Do not go on methadone though after around 3-6 months your body will adapt to the methadone and you will get no analgesia from it dueto the way it accumulates in your system. taking into account its very long half life and a whopping 92% bio oralavalibilty it is around 3times more potent than oral morphineMETHADONE=TROUBLE !!!
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So back to the question. Does anyone (mike) know of a contact in the US, or elsewhere that will ship dihydrocodeine or similar into the UK? I have similar problems with back pain and my fathers medication works best, however, my doc is reluctant to prescribe it :-(
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Anton Says: Report Abuse Friday, 5/21/2010 7:59:08 PM
So back to the question. Does anyone (mike) know of a contact in the US, or elsewhere that will ship dihydrocodeine or similar into the UK? I have similar problems with back pain and my fathers medication works best, however, my doc is reluctant to prescribe it :-( You can buy a slightlyweaker form of co-dydramol otc in the uk called paramol it contains 7.46mg per tablet and 500 paracetamol hope that helps ;-)