I worked on the island of Maui for two years and, in addition to tourists coming from all over the world, many of its residents traveled all over the world. This made for a brisk vaccine business on the island, especially considering Hawaii allows pharmacists to administer nearly every vaccine on the market (including even the Yellow Fever vaccine). It also brought up a lot of questions about taking personal medications overseas.
Believe it or not you can get in trouble for bringing personal prescription medications into a country, even if they have been prescribed. Take, for example, this Toyota executive that went to jail after mailing herself her personal supplies of oxycodone to Japan.
So what should patients do and how can we help them prepare? Here are some tips:
Check the local laws
That can sometimes be easier said than done, but a good place to start is the country information found on the US Department of State website.
For example, if you were to search for "Laos," you would find the following sentence under the Health sub-header:
"If traveling with prescription medication, check with the Lao Ministry of Foreign Affairs to ensure the medication is legal in Laos. Always carry your prescription medication in original packaging, along with your doctor’s prescription."
It is critical that patients fully understand local laws and obey them; many countries have penalties far stiffer for drug offenses that the US. Combine that with corrupt legal and political systems and poor relationships with the US (sometimes resulting in a lack of a US Embassy in that country) and a dream trip can quickly turn into a nightmare for a traveler.
As an example, the page for Laos also states this:
"Arrest Notification: Laos does not routinely inform the United States Embassy of the arrest of U.S. citizens in a timely fashion and does not always allow consular access to arrested individuals as required by international law. If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy immediately. See our webpage for further information
Police and legal system bribes and informal procedures: It is common for police to target foreigners to pay bribes for alleged traffic offenses. The Embassy is not usually able to provide assistance in these cases. Foreigners arrested for unruly conduct or damaging private property will often be held in police custody without formal charges being brought against them until they pay an indemnity to the injured party. This process usually takes a minimum of two to three weeks."
"Possession of, trafficking in, and manufacture of drugs are serious offenses in Laos and result in lengthy prison sentences or even the death penalty. Some restaurants offer “happy” or “special” menu items--particularly “pizzas” or “shakes”--that may contain opiates or unknown substances. Consuming these items is illegal."
Properly label and declare all medications
This doesn't mean just to US Customs but to the destination immigration agency as well (and this is of course after confirming they can be legal brought into the country). All medications should be stored in their original packaging, labeled, and with a copy of the original prescription. That way there is no doubt as to the contents of the vial being brought in their country.
Be aware of carry-on exceptions for medications
The Transportation Security Administration (TSA) has an excellent article on traveling with medication here. Below are some highlights:
Liquid medications are exempted from the 3.4 oz. limit for carry-on baggage. It is important to let the TSA officer know, however, that there are liquid medications in the bag.
Medications in solid dosage forms are permitted.
Nitroglycerin is permitted (be sure patients have this with them before getting on the plane!)
Overall, it is best to put all medications in the carry-on bag. I worked on Maui for two years and can't count the number of people coming in my pharmacy because they put their medication in their checked bag and then the airline lost their luggage. By the time they got to me, it was too soon to refill the medication and I was stuck trying to call a pharmacy with up to a six-hour time difference (if coming from the East Coast).
Don't forget vaccinations and prophylactic medications
Travel clinics are great revenue builders in the pharmacy and also provide an excellent service to patients. Consider partnering with a physician to provide patients an opportunity to be screened based on their destination, age, and medical conditions and have recommended vaccinations, prophylactic medications, and all prescriptions to be sent directly to the pharmacy.