Over-the-Counter Drugs in Japan

Nothing is worse than getting sick in a far-away land and having to drag yourself off to a doctor. Following our recent medical theme, today's feature we will explain the world of Japanese over the counter (OTC) medications (一般用医薬品 ippan-yo iyakuhin).

Drug Classifications
There are three main classifications of OTC drugs

• Type 1 Drugs (第一類医薬品 dai-ichi-rui iyakuhin）-- These drugs are classified as having side effects that could "interfere with daily life" as well as the potential for serious health risks if used improperly. A pharmacist must be on hand to dispense these drugs and give adiquit advice about side effects and necessary precautions. 

• Type 2 Drugs (第二類医薬品 dai-ni-rui iyakuhin)-- These drugs are classified as having potential side effects that can interfere with daily but not with the severity of Type 1 medication. A pharmacist or a "registered seller" (登録販売者 toroku hanbai-sha) must be on staff to sell these drugs and provide consultation if necessary.

• Type 3 Drugs (第三類医薬品 dai-san-rui iyakuhin)-- These drugs are consider to have non serious side effects and, in most cases, won't impair one's functionality in any major way. A pharmacist or a "registered seller"  must be on staff to sell these drugs and provide consultation if necessary.

In addition to the above mentioned category, there is another classification of drugs known as i-yakubu gaihin (医薬部外品) shitei i-yakubu gaihin (指定医薬部外品). In English, these are ofter refered to as "quasi-drugs" or "supplements." This category includes vitamin drinks, nutritional supplements, cough drops, and all those energy tonics. These can be sold in any establishment including convenience stores and super markets.


Buying Drugs
As we have discussed in the previous article covering prescription drugs, pharmacies are plentiful in Japan and there is a solid chance that your local grocery or home center store has a non-prescription drug section, too.

But you may notice that these sections of the grocery store periodically get fenced off. This happens whenever a registered seller is not on staff since it is not legal to sell Type 2 and Type 3 drugs without a registered staffer on hand. Even 24 hour chains will generally close these sections off after 9 or 10 pm or so, so don't bank on getting pills for those late night headaches.

Unlike many North American and European countries, the sales of drugs over the internet are still strictly regulated. Currently, online drug stores can only sell Type 3 drugs and quasi-drugs. The sale of Type 2 drugs are limited to specially designated outlying islands and remote areas. The sale of Type 1 drugs over the internet is strictly forbidden.

Type 1 drugs usually only are available on request. In other words, you're going to have to ask for it at the counter - bring along enough Japanese to do so.

If you are worried about what's in your drugs, or what they may do, check out our article on side-effects and ingredients.


More

• Pharmaceutical sales in Japan have long been a highly regulated affair. Until the recently passed Revised Pharmaceutical Law came into effect, you weren't allowed to sell so much as an aspirin without a pharmacist on hand.
• Price wise, OTC drugs in Japan are generally significantly more expensive than the USA but probably closer to prices found in Europe.
• Japanese OTC drugs are usually weaker than their Western counterparts. So, double check the dosage of something you have taken elsewhere before.

And that is all for drug and health. Keep on checking back regularly for more great information on all kinds of topics and don't forget to peek back at our coverage of Japanese health insurance, doctors, and dentists if you are still lost.

Pharmacies and Prescriptions in Japan

Now that we have covered health insurance, medical specialties, and dentists, it seem only fair that we tell you about the ins and outs of your local Japanese pharmacy establishments.

Types of Pharmacies
There are a few types of pharmacies (yakkyoku 薬局 or kusuriya 薬屋) in Japan. The first are the big commercial chains like Matsuo Kyoshi, similar to US counterparts insofar as they sell a variety of food, beer, cleaning supplies and so on in addition to over the counter drugs. However, not many of these big chains fill prescription drugs (shohoyaku 処方薬). If you are filling a prescription at a chain store, make sure to double check to make sure there is a pharmacist on hand.

Another common sight are small, family-run establishments which are almost always found right across the street from a doctors office. These small pharmacies only fill prescriptions and, for the most part, don't sell extra goodies.


Types of Prescription Drugs
Despite being a major drug market, Japan is legendarily strict when it comes to prescription medication. Legal maximum prescription sizes tend to be significantly smaller than the US, and when you want to renew a prescription you need to see a doctor directly. Furthermore, the dosage strength of Japanese medicine is generally weaker than its Western counterparts. 

Also, keep in mind that drugs have different brand names and possibly even slightly different ingredients compared to your home country. Japan does not strictly recognize US Food and Drug Administration approval or the European equivalent so drug makers must go through an additional cumbersome process in order sell their drugs in Japan. Therefore, your drug of choice may not yet be legal here or only available in a different form/dosage. One popular ADD drug, Adderall has actually been illegalized due to fears of over prescription.  


See our previous post on medication side-effects and ingredients.

Filling a Prescription (shohosen 処方箋)
Since all prescriptions must have doctor's original seal, e-prescriptions are pretty much unheard of since seals cannot be transmitted electronically. However, large hospitals and clinics will sometimes offer to fax a copy of your medication to the pharmacy of your choice so it can be ready for you on arrival.

Using Your Drugs
Don't be surprised if a lot of drugs come in the form of granules in little plastic baggies. Be it a cultural thing or some sort pharmaceutical industry quirk, lots of pain killers come in the form of nomi-gusuri (飲み薬) that must be mixed with water and drunk.

Another odd type of drug that appears a lot is the ugai-gusuri (うがい薬) which are solutions that must be mixed and gargled. Usually these types of medications are for sore throats and cough suppression. Even though they may look like cough syrups, make sure not to drink them.

The pharmacist on duty should explain everything to you when you get your drugs and many shops will print out nice detailed sheets with dosage information and instructions in case you need to get your prescription filled at another facility.

More

• Japan has a drug market worth 93.2 billion USD, only trailing the USA's ludicrous 301.3 billion USD (Financial Times, 2010). Therefore, just about every tiny hamlet has a fairly extensive collection of pharmaceutical establishments.

Got all that? Pop back to AccessJ soon since our next topic will be over the counter medication.

Japan and Marijuana

Among the weird characters, objects, and symbols that Japanese adopt as cultural icons (including, but not limited to, Stitch from Lilo & Stitch, human feces, faux-Russian rabbit-centric series Usavich, the V sign, popularizing NG as a handy opposite to OK in everyday life, the abomination that is Sento-kun, and Sento-kun's girlfriend) is one that still catches me off guard every time I see it:

The seven-pointed cannabis leaf.


Any upright, punk-themed fashion store is bound to have a bunch of bracelets and baseball caps bearing the leaf, and a day on the town is enough to find several 20-something Japanese guys thuggin' around with a cannabis-themed Zippo lighter and at least a dozen schoolkids (boys and girls alike) sporting leaved backpacks, sneakers, flair, and pencil cases.

You can surprise any number of kids by telling them what plant that leaf comes from, but it's not like Japan as a nation has never been in touch with psychotropics: Less than a decade ago magic mushrooms were still being openly sold in nightclubs here.

And other drugs have had a place in traditional Japan. A small town in northern Shikoku today maintains an ancient tradition of piling hemp on a mountaintop and burning it bonfire-style in an annual festival.

These traditions persist in a doublethink paradox alongside Japan's zero-tolerance controlled substances policy which criminalize all varieties of drugs, including cannabis. Even modest drug busts tend to make national NHK news, each time shocking the Japanese public, and criminal suspects face penalties far beyond those of Japan's Western allies. For example:

Any person who commits an offense [of growing marijuana] for the purpose of gain shall be liable to penal servitude not exceeding 7 years or to both penal servitude not exceeding 7 years and a fine not exceeding 2,000,000 yen according to the circumstances.

Any person who unlawfully possesses, receives, or transfers cannabis shall be liable to penal servitude not exceeding 5 years. (source)

Photo courtesy of engrish.com

JapanHemp offers some interesting reads on the subject, including accounts of several people who were detained at Narita airport and imprisoned for possession. Stories tell of the absolute servitude demanded in Japanese prisons, followed by deportations and 20-year bans on readmission to the country. Even Sir Paul McCartney spent a brief stint in a Japanese jail when he brought marijuana into the country for a Wings concert tour.

Those harsh penalties appear to keep usage low among nationals. In one survey, only 1.5% of Japanese people admitted to trying marijuana, compared with 42% of US residents. And this low demand keeps street prices for all illegal substances sky high.

In sum, the cannabis leaf gets plenty of exposure as an object of fashion and youth in Japan, but that doesn't mean that the general public understands what it is or wants to smoke it with you. If you're the kind of person who needs the green to get by, you may find it best to stay home.