'Travelling with Medications' by Larry Goodyer
One of the most frequent questions asked by travellers relate to carrying medicines for their own personal use across international borders. This is often prompted when stories hit the headlines describing individuals who have been imprisoned and prosecuted for being found in possession of medicines that are freely available in their country of origin. What are the laws regulating carrying medications abroad and what are the risks to travellers?
Which medications can be a problem?
Two classes of medicines – narcotics and psychotropics – are under the purview of international law. This covers any medicine that can have an effect on the Central Nervous System (CNS) and the potential to be abused. The narcotic class mostly relates to analgesic opioids and their derivatives (e.g. morphine and codeine) which tend to be highly regulated. Psychotropics are all those medications likely to be used to treat mental disorders such as anxiety, depression, and psychotic conditions.
n practice, some countries will include a range of medications used to treat neurological conditions such as epilepsy and Parkinson's disease to their regulated list. Others would even include sedating antihistamines as a banned substance. The message is therefore to be wary of carrying any medicine with the potential to affect the Central Nervous System. However, a few countries such as the United Arab Emirates also include a range of non-CNS items such as contraceptive hormones.
What does international law say?
To view the international agreements governing the transportation of medications across borders check the International Narcotics Control Board (INCB) website. An independent and quasi-judicial organization, the INCB is responsible for international drug control. Their site contains statements and broad principles relating to travellers intending to travel with narcotics and psychotropics, mainly:
> That travellers should be allowed to carry quantities of such substances for personal use, usually for use of up to one month.
> That travellers have a letter or prescription from their doctor if travelling with a narcotic substance (but not necessarily for pyschotropics).
The INCB also requires countries to submit their own individual regulations which can be viewed here. The problem is that not all of them have submitted entries; many are quite vague, and most deviate in some way even from the two INCB principles described above.
Know your risk
Searching out the true regulations of your destination country can be extremely difficult. Country websites that might deal with questions relating to medicine regulations abroad are also quite hard to interpret. The often quoted suggestion of contacting embassies and consulates directly can equally be very frustrating in attempting to identify the correct official and obtaining consistent advice.
So what are the most practical suggestions to minimise the risks? There do appear to be some countries where regulations are quite strictly applied; the United Arab Emirates and Japan are the two best known examples. Otherwise take note of the tip points below. Despite this seeming confusion there do appear to be very few cases of travellers encountering serious problems, given that a large number of travellers must carry medicines for personal use across international borders every day.
Travelling with medicines checklist:
- Check the International Narcotics Control Board website if travelling with medications that are narcotics or psychotropics.
- Be aware of medications with potential for abuse (e.g. anabolic steroids).
- Be aware that many countries permit taking only a 30-day supply of certain medicines and require carrying a prescription or an import license certificate.
- Keep the tablets together with the original packaging and information leaflet. Carry a copy of your prescription, particularly for prescribed medicines that act on the Central Nervous System.
Before You Leave
- Find out which travel health vaccinations you may need for you trip and that they do not interfere with your current medication. Seek alternative medication regimen and protection mechanisms.
- Ask your doctor how to adapt your medication regimen across different time zones.
- Bring enough medication to last the whole trip; ask your doctor for an additional dose in case of an emergency. Be aware of false or mislabelled medication being sold in pharmacies around the world.
- Pack your medication in your carry-on bag. If you are travelling with someone else split the medication to minimize loss or theft. Don't pack medication in checked luggage or send it by post to your destination since it may get lost.
- Learn how to safely store medication and check if it requires refrigeration. Use insulated wallets or containers during transit (ask your pharmacist for recommendations) and make arrangements at your destination for safe storage. Keep in mind that extreme heat also impacts the medicine's effectiveness.
- Bring a copy of your original prescription and, if possible, keep the medication in its original packaging. Ensure that it is clearly labelled with your full passport name, doctor's name, generic and brand name, and exact dosage.
- Carry a letter from your doctor (preferably translated in the language understood at your destination) or an IAMAT Traveller Clinical Record describing your condition and the treatment plan. This will facilitate border crossing and help the attending physician abroad.
- If you need syringes, get a note from your doctor explaining their use. Find out from your airline or other transportation company about the use of syringes during transit.
During Your Trip
- Take your medication routinely and consistently. Do not reduce or stop taking your medication.
- If you require an emergency refill, show the attending physician the copy of your original prescription and letter from your doctor to facilitate the consultation. Be aware that some medications will not be available in your host country or that they may not come in exactly the same dosage that you require.
When You Return
- Follow-up with your doctor if you needed a prescription refill abroad to ensure continuity of care back home.
Larry Goodyer is Professor of Pharmacy Practice and Head of the School of Pharmacy at De Montfort University UK. His principal interest is within the field of travel medicine and his related research interests include methods for bite avoidance and medical supplies for overseas travel. He is Deputy Chair of the British Travel Health Association, co-chair of the Pharmacist Professional Group of the International Society of Travel Medicine and a Fellow of the Faculty of Travel Medicine at the RCPSG.
This article was initially published on the IAMAT website and has been reproduced here with the kind permission of both the author and IAMAT.