Would say the same for many parts of Europe,. Even in Switzerland where it's maybe as easy as nowhere else to get into opioid maintenance program, the docs don't prescribe the more powerful meds from themselves, and if you are in need of, possibility is you have to check a few doctors or go straight illegal.. I felt so useless with doctors, emergency or not, quite a few times. Usually only thing they do what I couldn't by myself (cause of lacking infrastructure) are things like X-ray, stethoscope (ok, that one'd be easy to get) and similar and end off "prescribing" you non-Rx ibuprofen... and receiving like 160 CHF (+/- equivalent to € or $) fot this visit (excluding X-ray), in ER it can reach 4 digit numbers very fast and usually you wait for 2h+..
For this, I really would like to be my own doctor, having access to all that's required and as long as one wants and is able to do so, take care of his/her own health instead of having to blindlingly trust strangers that just happen to have some diploma.
Well about that, a friend from Eastern Europe [but could work worldwide, at least in EU] is technically Dr. med. just that some assistence years under supervision would be required for full qualification. Just that this person paid for some exams and really doesn't know that much about medicine, and that I can tell without being a Dr.
Have been to Mexiko recently. They have an interesting system of a doctor in every of the bigger pharmacies, where you can get basic consultion for free or cheap and most of the meds are sold without prescription. You don't need to talk with doctor to get meds, it's separated and usually they don't ask questions .. Don't know about painkillers but they had a tramadol TV spot running so I guess at least that one will be readily available too. No health insurance like the exorbitant sums we pay in Europe, just little tax for hospital or hospital insurence. At least the dentist was very professional, dental cleaning (Swiss insurance, depsite being horrendously expensive, does not cover dentists by tradition. People with bad teeth are "themselves to blame") was like 1/6th the cost and there wasn't even waiting time... although they also hand out antibiotics (too w/o prescription) like candy, had a bad stomach from some food -> antibiotics(even though I didn't take them, have only ever taken antibiotics once in my life yet and they give you a combined antibiotic with severe digestive symptoms, psychosis and depression listed as side effects for bad stomach. Yippeh!)+ibu+buscopan. My friend having sore throat -> antibiotics. They sell them in metro stations next to Wick Formula 55 and cremes..
(correct me please if I'm wrong on somewhat here, as always..
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Or, in the mental health department, any one out of the antipsychotics, depending on the individual habits of the doc and your condition, it might be a "weaker" atypical like quetiapine for everything from feeling nervous, having insomnia, nightmares, shift working, anxieties, to real illusions where you'll get a higher dose and/or a more potent one like risperidone, olanzapine etc..
And they go as far as threatening to stop other prescriptions you need if you refuse the antipsychotic. Insurance pays me a box of aripiprazole every month that I collect for now but could also throw them right into some bin. I had a brief psychotic episode, drug and stress induced, and knew it's a -bad- idea to tell doctors about anything psychotic. Still wanted something I could use if, and only if, the symptoms should reappear. So I told them only when the majority of it was already over.. he played understanding and acted very differently, they don't give me zyprexa as an emergency med but either I should take that daily as sort of "preventive measure" which I "should feel nothing of (yea- I will for sure not feel all the blocked dopamine, and maybe I would develop diabetes or whatever)" or another potent one of choice. So I opted for aripiprazol because it's not a full antagonist, just for the case I should get into a situation where I would need to take as prescribed, and there are no fuckin depot injections of it. They wanted to shoot me invega! Straight out invega, of which we have a ton of people suffering long term side effects from. Horrible, when I have been overly sensitive to other antidopaminergics before.
Good luck finding a doc willing to try more specific treatments, or even off-label (in Swiss they generally reject because of "health insurance won't pay" which partially is correct but the doc could, if the med works and there are papers about using that certain med on this certain condition, convince the insurance otherwise and make kind of a primary case which would help others too. They just don't want. Was the same with psychostimulants in the years before adult ADHD grew into a big topic.) like for Ketamine treatment of depression, or even MDMA/psilocybin etc. for PTSD - apparently in the Netherlands that's possible, as somebody told me recently.