Prescription medications

[Rob_P]

How do you handle this when you cruise to a different country?

Some countries won't allow you to bring certain medications in (Japan won't allow opiods for instance) so what do you do to deal with it?

[GoneDiving]

Pre Covid my wife and I travelled alot. We soon learnt it's best to declare EVERYTHING and let the inspectors decide. Many times being open and upfront has led to questionable items passing through where as them finding an undeclared item has led to ALL out gear being searched and trivial items being confiscated.

Formal doctors' letters identifying medical need, prescriptions or being ready with reasons help. With food items we have a printed out list detailing all the items and just hand the list over. This saves everyone angst.

[JPA Cate]

You can bring a lot with you when you leave. And, of course if you make trips back to the US, you can re-up the Rxes then.

Make arrangements for re-upping your Rxes with your Stateside doctor. At some point, you will discover that not all medications you use are available overseas, but the other countries do have medications for what ails you. You will find yourself going to a doc to get prescriptions valid in their country.

It does help to have a list from your Stateside doc stating what conditions you have and what treatments he or she has prescribed for you, along with the medications, for when you are asked.

Often, they just accept "Ship's medical kit". I had one officer they wanted me to store some vicodin in a different location on the boat, but that is the only interference we've had. ....Although, it did require some "handling" to import one of my Rx's into New Caledonia, one time. But I was able to do it eventually.

So, I'd say, plan ahead to make it as convenient as possible for them and you.

Ann

[svRaison d Etre]

Originally Posted by JPA Cate

You can bring a lot with you when you leave. And, of course if you make trips back to the US, you can re-up the Rxes then.

Why would you buy medication in the country were they are the most expensive? The same equivalent could be 10 time cheaper elsewhere and just as effective.

[PirateFoxy]

Originally Posted by svRaison d Etre

Why would you buy medication in the country were they are the most expensive? The same equivalent could be 10 time cheaper elsewhere and just as effective.

Because a prescription from a US dr may not be valid elsewhere and finding a local dr who will prescribe the same thing is not necessarily straightforward? Especially if the treatment you use is not what is commonly used in the other country.

[Rob_P]

Originally Posted by PirateFoxy

Because a prescription from a US dr may not be valid elsewhere and finding a local dr who will prescribe the same thing is not necessarily straightforward? Especially if the treatment you use is not what is commonly used in the other country.

It's also that some of the medications you need may not be available in that country.

To get specific for me; I have to take Testosterone daily. Much of the Testosterone I get is manufactured in other countries, often Israel but not exclusively, so availability is probably good almost everywhere. But it's a drug that is easily abused and has a high black market desirability. Importing quantities of black market drugs is pretty much a no-no. Each "dispenser" (a pump container like hand soap or lotion) has 30 days in it. 30 days is passage time so you'd need 2 "dispensers" at least.

I also have to have both Soma (powerful muscle relaxant) and opioid-based pain medications because of my spine issues. A single prescription for either/both will last me a year, but it's still a lot of "restricted" drugs to have on hand and these may not be quickly available in foreign lands.

On another subject: For women, how do you handle prescriptions for birth control pills when on years-long cruises? How does that affect where you can and can't go with those meds on board?

And yet another question: Do all of these meds have to be "locked up" in the the boat's medical cabinet at all times?

[zeehag]

as all pains are from an inflammation of whatever, why are mds continuing to prescribe opioids for inflammation..all opioids do is numb the brain. convert to a decent antiinflammatory product..there are several that donot mess with guts.

and if you are finding yourself asking for opioids, why. are you that addicted you canot function without numbbrain--remember itis illegal to operate a boat under influence of opioids and or booze.

[Jammer]

Originally Posted by Rob_P

Testosterone ... Soma ... opioid-based pain medications

I think that you will find that those will raise eyebrows anywhere.



Soma, in particular, has been withdrawn from the market in Europe and several other countries. You would have to be prepared for the possibility of your medications being confiscated by customs. You might consider talking to your prescriber about switching to a medication that is more widely accepted internationally.


With the testosterone and opiates you could still have trouble. You would want to carry a copy of your chart with you showing lab results and your provider's medical rationale for treatment and then you would probably have reasonably good chances of getting a local physician to prescribe those for you. Prescribing attitudes vary and you may still have trouble especially if the indications are not clearly met in a way that can be documented.

On another subject: For women, how do you handle prescriptions for birth control pills when on years-long cruises?

Medications that have low abuse potential are more readily available in almost any place in the world than they are in the USA. While practices vary, in many cases they are available over the counter, or after a brief consultation with a pharmacist, or upon presentation of a prescription from a doctor from another country, or upon presentation of an empty vial or box.

[Rob_P]

Originally Posted by zeehag

as all pains are from an inflammation of whatever, why are mds continuing to prescribe opioids for inflammation..all opioids do is numb the brain. convert to a decent antiinflammatory product..there are several that donot mess with guts.

and if you are finding yourself asking for opioids, why. are you that addicted you canot function without numbbrain--remember itis illegal to operate a boat under influence of opioids and or booze.

1. My spine isn't "inflamed". My vertebrae have insufficient internal size clearance for my spinal column and nerve junctions. In layman's lingo, the vertical channel in my spine is too small for my spinal column to fit without touching the inside of the channel. Like trying to wear shoes that are too small, that touching can occasionally cause excruciating pain. In my case I cannot take off the too tight shoes when it hurts.

There is no medical procedure which can fix this issue.


2. Thanks to the rest of you for the advice given. It appears I will have to consult with my doctor when the time comes, if it comes, for me to travel internationally.

[Rob_P]

Originally Posted by Jammer

I think that you will find that those will raise eyebrows anywhere.



Soma, in particular, has been withdrawn from the market in Europe and several other countries. You would have to be prepared for the possibility of your medications being confiscated by customs. You might consider talking to your prescriber about switching to a medication that is more widely accepted internationally.


With the testosterone and opiates you could still have trouble. You would want to carry a copy of your chart with you showing lab results and your provider's medical rationale for treatment and then you would probably have reasonably good chances of getting a local physician to prescribe those for you. Prescribing attitudes vary and you may still have trouble especially if the indications are not clearly met in a way that can be documented.









Medications that have low abuse potential are more readily available in almost any place in the world than they are in the USA. While practices vary, in many cases they are available over the counter, or after a brief consultation with a pharmacist, or upon presentation of a prescription from a doctor from another country, or upon presentation of an empty vial or box.

This is good information and I will make a note to discuss this with my doctor when the time comes.

Query: Are originals of my records required instead of copies?

[PirateFoxy]

Originally Posted by zeehag

as all pains are from an inflammation of whatever, why are mds continuing to prescribe opioids for inflammation..all opioids do is numb the brain. convert to a decent antiinflammatory product..there are several that donot mess with guts.

and if you are finding yourself asking for opioids, why. are you that addicted you canot function without numbbrain--remember itis illegal to operate a boat under influence of opioids and or booze.

There does not exist adequate treatment for my autoimmune arthritis. I currently use an immune-system-modifying injection, an anti-inflammatory, acetaminophen, and occasionally a painkiller like an opioid to stay functional. Steroids and high dose NSAIDS have their own issues that make them unsuitable for some people. As far as I have been able to determine, an appropriate dose of painkiller does not significantly interfere with my ability to do things, though I’ve never done a reaction time test in a lab. (I’ve done them elsewhere but in a lab setting would be the gold standard as it would control distractions, etc.)

That said, I do try to avoid being in charge of anything after I’ve taken pain meds and do not combine pain meds with alcohol or even extreme tiredness. But the pain med in and of itself doesn’t make me sleepy or anything - people who know me can’t tell if I’ve taken it.

[Jammer]

Originally Posted by Rob_P

Query: Are originals of my records required instead of copies?

Who knows, it's a big world out there with widely varying levels of paranoia and bureaucracy. In practice nobody's going to care much about whether your records are original though they may use that as an excuse.


Instead, prescribers are going to try to assess whether your problem is genuine and your treatment is, in their view, reasonable. That will depend just as much on how long your hair is and what kind of clothes you wear as it will on the perceived originality of the documents. Stamps and signatures are going to help but aren't going to be seen as the the sine qua non of authenticity.


And sometimes it will be easier to just find another doc. Some are reluctant to prescribe anything that could create a problem for them. Some of them are reluctant to change their mind once they've decided you're a recreational user.


By way of example, once I had a prescription from my USA doc that I couldn't get filled in Mexico because they didn't recognize the USA name of the medication he had written. I called my doc and wrote down all the synonyms he could think of for it, on a post-it, and gave that to the pharmacist and they filled it right away.


The thing is that the therapies you're using are controversial. There are docs in the USA that won't write scrip for those, and there are pharmacists that won't fill an out of state scrip for them. It varies. Internationally, it varies even more, and it's hard to anticipate.

[Jammer]

Originally Posted by zeehag

as all pains are from an inflammation of whatever, why are mds continuing to prescribe opioids for inflammation..all opioids do is numb the brain. convert to a decent antiinflammatory product..there are several that donot mess with guts.

and if you are finding yourself asking for opioids, why. are you that addicted you canot function without numbbrain--remember itis illegal to operate a boat under influence of opioids and or booze.

I am thankful that I don't have a problem with chronic pain.


I am not a doc, but I have watched people around me who have struggled with chronic pain. There are some -- many -- for whom long term opioid therapy is the best possible treatment. People work with their doc and make their choices. I don't know their full history. I haven't seen imaging studies and lab results. I don't have to live with the choices and haven't devoted my life to that sort of thing. So I don't second guess.



Maybe, zeehag, you know more about medicine than I do.

[PirateFoxy]

Originally Posted by Jammer

The thing is that the therapies you're using are controversial. There are docs in the USA that won't write scrip for those, and there are pharmacists that won't fill an out of state scrip for them. It varies. Internationally, it varies even more, and it's hard to anticipate.

This can happen even with ‘normal’ meds - my SO and I have both had doctors who, when we moved, wanted to switch us from perfectly acceptable common medications to different ones that treat the same condition simply because that was the one that doctor was most familiar with.

We found different doctors both times because when you’re on a medication that is working, switching on the basis of a doctor’s comfort level when there are other doctors available seems silly - you never know what side effects you’ll have or how effective a drug will be for you until you try it, you know? So if I’m on something effective with minimal side effects I want to stick with it until it stops working or something legitimately BETTER comes along. I certainly don’t want to swap to something basically the same.

But we fully expect to potentially have that issue when dealing with a new doctor in the future, especially when in a different country where one drug may be cheaper than the other or more readily available, or was approved first and thus is what people got used to using, etc.

[Singularity]

-Not sure of OP's insurance/financial/travel plans, but subcutaneous testosterone pellets (inserted by the doc) can last 4-6 months. A year's supply of injectable T as an alternative is ~$120 plus a few bucks for syringes.

-Regarding obtaining T outside (or inside) the US, having a copy of original doc's records, particulary the first low testosterone labs, would be a good start if having to convince anyone to consider refills. If the next doc exercises any discretion at all in continuing treatment, the worst thing to show is simply an empty or near empty prescription bottle.

-Low T can have effect to lower pain threshold such that replacement often helps those genuinely T deficient and with a chronic pain issue (in males)

-Regarding opioids, they muck with all manner of brain/body signaling, lowering pain threshold, altering what effectively is mood/motivation chemicals, etc, etc. Most of the world (and the US until recent times) doesn't/hasn't routinely treated chronic pain conditions with opioids, with equal treatment effect. Clearly a loaded topic, use of opioids tends to beget more opioids independent of traditional "addiction" mechanisms, soma similar in this last regard.

-Female birth control tablets are approved available over the counter in many/?most countries nowadays.