Do's & Don'ts Of Traveling With Medication Rather then writing about a specific illness, injury or disease process this month, we will look at the medications that we take with us on our adventures that take us away from out homes. Specifically, we will concentrate on how to transport these medications legally and safely across and within the U.S. as well as outside of this country. Now, we all know how complex our legal system is and that you have to be or have an attorney just to decipher it. Compound that already existing problem with all the rules and regulations of all the other countries and the numerous airlines worldwide and you now have a dizzying array of mind boggling laws to contend with. In all other countries, as in this one, ignorance of their laws, let alone ours, in not an excuse so relating a lack of knowledge to a customs officer generally just irritates him more. As usual, we have first hand knowledge of the problems one can encounter and because of our experience; we did a little bit of research on how to avoid future issues with custom agents. We, as physicians, thought that it would be easy for us to transport medications anywhere we wanted simply because we are U.S. trained and licensed M.D.s which the whole world recognizes at least in theory. We always carry an emergency medical kit with us that contain some surgical equipment but mostly a different variety of over the counter and prescription medications. These vary from simple Tylenol to antibiotics to medications for GI distress, muscle spasms and every other minor ailment one can get while away from home. Most of these medications are samples from drug company representatives that leave them in our offices for us to try. As most of you have been to a doctor here in the U.S. and have been given samples at some point in time, then you know that drug manufacturing companies will put one or two pills in a very large and cumbersome box. So in order to transport all these varieties of pills, we take them out of their bulky packages and usually place them in labeled 35mm film containers. Before we go any further, I will tell you we had no narcotic medications with us at all but it did not matter. Upon arriving into a foreign country, we fell into one of their random search lines and were ushered behind the dreaded wall to have our bags searched. Low and behold they found our medical kits and proceeded to go through them for the next three hours. Bottle by bottle, pill by pill they exhaustively examined everything over and over again despite everything being labeled. We were informed our medical license cards were not honored in that country, that none of the pills were in their original sample boxes, we did not have prescriptions for any of the medications nor was there expiration dates on any of it. Then we were asked why we were carrying this much medicine for just the two of us. We explained that we always end up hunting with others and inevitably someone else gets sick and needs some help. Well, that was a stupid response on our part because we were quickly told that was illegal because we did not have a license to practice medicine in that country. But because they needed more doctors desperately there, it would be easy for us to get one if we just would apply. “Fat chance of that happening”, we thought to ourselves after all this hassle. So there we stood as they put each pill, one pill by agonizingly slow the next pill, into some type of machine that we were told detects illegal substances, illicit drugs we presumed. Finally, after threatening us with multiple felony charges the officers decided that the two middle-aged physicians from rural S.C. that had no criminal history probably posed little threat to their country so they decided to let us pass through those holy gates after a stern warning. As mentioned before, we did as much research as two non-attorney persons can do. We looked into travel rules here and abroad and found a huge difference in the laws as one could expect. But there was a common thread to all of them that can keep you safe just about anywhere you want to go. What custom agents are looking for is illicit drugs or prescriptions medications that have a high abuse potential pure and simple. The responsibility is yours to prove what you have is legal and safe. One of the major problems is that most medications look very similar and only have numbers or letters stamped on them instead of their names so there is no way for the custom agents to identify what that particular pill is so they immediately assume it is an illegal substance till proven otherwise. Now, we have traveled many places numerous times with few occurrences like the one described above despite carrying the very same emergency medical kit. But as always prevention is the key so if you want to avoid this potentially very bad experience pay heed to the following suggestions. First, only carry YOUR prescription medications and in their original bottles, no one else’s. Make sure they are not expired and that you only have enough or a little bit more then needed to last you the duration of your trip. Second, if you are carrying over the counter medications make sure it also is in its original packaging and not outdated. Do not carry more then you would be expected to use within the time frame that are planning to be gone. Third, if your doctor gave you samples of a medication for the trip, make sure to keep it in its original packaging and get a prescription for it since it is not in a prescription bottle. Fourth, if you bring an emergency medical kit with you, leave everything in its original packaging or prescription bottle no matter how bulky it is and again make sure it is not outdated. Do not bring in medications or instruments that you are not licensed to have. If you have taken emergency courses that give you a certificate of completion then bring it with you. It will go a long way to helping you in your defense. Do not bring more medications or supplies needed to treat one or two people because it is illegal to treat others since that is deemed practicing medicine without a license. Now, we know that sounds ludicrous but frankly custom’s agents do not care and can make your entry into their country very delayed to say the least. Fifth, even if you have an up to date, legally filled prescription bottle with narcotics (pain medications) in it, we would advise you strongly to limit the quantity that you take with you since that will be scrutinized closely. We all need to realize that the chance of this type of scrutiny occurring in this grand of a scale isn’t high but it happens daily at all airports around the world to a lot of people. If you happen to be the unlucky one picked for a random search and get an officer that lets say, has had less then a pleasant day your trip is going to take a turn for the worse right there. Follow the easy rules above and you should be bullet proof and make the officer’s job easier and quicker for the both of you. As usual, we hope this helps you. As always enjoy the outdoors and be safe.