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Travel with medications, medical devices can be daunting

By Kathryn Doyle

NEW YORK (Reuters) - (This story has been corrected to clarify Dr. Bauer's comment in paragraph 14)

For international travelers who need to carry medical devices and medications with them, it’s not easy to find out the travel requirements at their destinations, and embassies in general aren’t much help, according to a new study.

“The problem is known to exist but has not previously been published as we have,” said lead author Moses Mutie of the Faculty of Health at the University of Canberra in Bruce, Australia.

“Most embassies focus on trade and tourism,” Mutie told Reuters Health by email. “Health issues are not often a priority.”

The Australian researchers considered the situation of a traveler from their own country going to one of 25 other countries popular with Australian tourists, including destinations in Africa, the Americas, Europe, Southeast Asia and the Western Pacific.

The researchers explored embassy and consular websites looking for the quantities and different types of medication allowed in the country for personal use, required documentation, customs information and details about traveling with medical equipment.

They also sent a standardized email to each embassy asking those same questions.

Two weeks later, 11 embassies had responded, two of which forwarded the questions to the Pharmacy Board of the home country but did not respond further, the authors report in Travel Medicine and Infectious Disease.

Of the eight countries that did respond, their recommendations varied widely, and tended to be much more strict than the recommendations of the International Narcotics Control Board (INCB), an independent body implementing United Nations Drug Control Conventions.

According to the INCB recommendations for individual travelers, you should carry a copy of the prescription, but there are no other certifications or requirements for less than 20 doses of any medication, or less than a 30-day supply of narcotics or psychotropics, such as Ambien or Haldol.

Many embassies, however, said all drugs required special certification of ownership and personal use, beyond a valid prescription. In some countries, a visitor is required to consult a local clinician to validate ongoing need for the medication.

Some countries warn that if authorities are in doubt, they have the right to deny entry or confiscate the medications, the authors write.

Drugs on Schedule I of the U.S. Controlled Substances Act, including hallucinogens or stimulants with no medical use, like THC or cocaine, can never be brought across national borders.

Neither the embassy and consular websites nor the email responses addressed medical equipment.

The lack of information for travelers offered by local embassies may sometimes indicate a lack of suitable regulations in destination countries, or that no one knows where to find them, said Dr. Irmgard Bauer of the Division of Tropical Health and Medicine at James Cook University in Townsville, Australia, who was not part of the study. She called the situation a “huge mess.”

Patients should turn to their treating doctor and a travel clinic, with both having the obligation to find out what is required, she told Reuters Health by email.

“Travelers on longer trips could also be referred to a colleague in the country of destination to continue treatment and prescribe the medication,” she said. “In some cases, it may mean that travel cannot happen.”

Specific outcomes for a traveler with too much medication or not enough documentation depend on the country, its law, and the person working at customs that day, Bauer said.

“With narcotics, an arrest is not unlikely,” she said. “In some countries, this will not be pleasant.”

The situation can be toughest for last minute travelers, Mutie said, but ideally there will be sufficient time to search for information ahead of time and talk to your doctor, who should be the principal source of the required information.

Dr. Natasha Hochberg, an infectious disease physician at Boston University School of Public Health, suggested “that international travelers with chronic medical conditions seek care at least 4 to 6 weeks in advance of travel at a travel clinic to address issues related to bringing medications overseas but also to address the need for immunizations and prophylactic medication and to discuss health-promoting topics.”

Hochberg, who was not involved in the new study, added, “Travelers bringing medication overseas should bring the medication in their carry-on luggage to prevent possible loss in checked baggage, keep it in the original bottle that the medication came in, take enough to last for their trip as well as some extra in case of changes to the itinerary, and have adequate documentation including the original prescription and possibly a signed letter on travel clinic letterhead.”

For medical devices, Mutie suggests planning ahead and checking with the airline. Airlines, he notes, have published clear medical clearance guidelines in this area.

In future, embassy websites should be designed with the user in mind, since embassies are established to provide a service, he said.

SOURCE: http://bit.ly/1lfNmeb Travel Medicine and Infectious Disease, August 6, 2014.

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