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Prescription for Trouble

Midnight Express was enough to scare anybody straight when it comes to bringing illegal drugs into a foreign country. But even over-the-counter medication can cause nightmares. An American carrying Dristan was detained for several days by Japanese officials. In Bermuda, a British doctor on a cruise was arrested for carrying anti-cholesterol medication without a prescription. Tylenol with codeine in Greece, Valium and Ritalin in Singapore-interrogations and confiscations are rare but harrowing.

A few countries are particularly vigilant, if only about certain drugs. Greece and Turkey frown on opiates like codeine, while Japan gets riled up about stimulants. The Japanese embassy warns against carrying such over-the-counter allergy and sinus medication as Sudafed and Vicks inhalers. To get permission to import other allergy medications, narcotics, syringes, or more than one asthma inhaler, travelers must fax the Ministry of Health. Exceptions will not be made at the airport, and Japanese authorities have been known to detain travelers for days while the wheels of justice grind.

"I tend to be more conservative when my patients are going to a strict country," says Dr. Alan Spira, who runs a travel medicine clinic in Beverly Hills. For example, he'll prescribe Vicodin for pain relief instead of Tylenol with codeine because the word codeine may set off alarms with customs agents.

Some travelers take advantage of lower prices to stock up on drugs abroad. Customs regulations allow Americans to bring back a 90-day supply as long as they have a doctor's prescription (or "50 dosage units" without a prescription if they're coming from Canada or Mexico); all drug purchases must be declared upon returning home. But buying drugs outside the United States can be risky: recently U.S. Customs officials seized counterfeit and unsanitary drugs in San Diego that were specifically targeted for sale to American tourists in Mexico.

Usually, drugs in developed countries are of the same quality as their American counterparts and often can be purchased without a prescription. Brand names may differ, so travelers should get generic names from their doctor.

That doesn't mean you should leave your medicine at home and try to get a better deal overseas. In some countries your drugs might not be available. Hydrochlorothiazide, a common blood pressure medication, is not sold in Greece. Acetaminophen, ibuprofen, and the antimalarial drug Lariam are difficult to find in Japan. And while the Ministry of Health approved Viagra in record time, Japanese women have been waiting 38 years for the government to green-light oral contraceptives (travelers are permitted to bring a one-month supply).

Of course, no matter where they're going, women should bring their own birth-control pills, says Dr. Gregory Thompson of the University of Southern California's Drug Information Center. "That's because there's a wide variance of products from country to country," he explains. "If it's off by just a little, a woman can have breakthrough bleeding or not be controlled for pregnancy. Trying to find the same thing in a foreign country is nearly impossible." He also adds that this advice should apply to "any medicines that keep you alive."

Wherever you go, keep in mind that customs officials can apply rules arbitrarily. "When you leave America, you leave behind concrete rules and regulations," says a State Department spokesperson. "Surprises may await."

An ounce of prevention…
• Before you go, try to find out the country's laws. Most people, for example, know that Singapore bans chewing gum, but many don't realize this applies to Nicorette.
•Carry all medication—prescription, over-the-counter, even vitamins—in its original container.
•If you have drugs that are commonly abused, or if you're carrying syringes, ask your doctor for a letter explaining why you need them.
•Make sure medication is labeled with its generic name to reduce the chance of confusion. Travelers with HIV should consider asking for medication to be labeled in a way that does not reveal their HIV status.

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