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 “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 travelling 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.
Travel health and traveling with medications is a “huge mess” and
“supremely unsatisfactory,” 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.
Patients should turn to their treating doctor and a travel clinic,
with both having the obligation to find out what is required, he
told Reuters Health by email.
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“Travellers on longer trips could also be referred to a colleague in
the county of destination to continue treatment and prescribe the
medication,” he 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,” he 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.
(Removes redundant attribution in 22nd paragraph)
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