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Old 11-02-2010, 12:12 PM   #1
TVic OP
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Carrying Narcotics

No, not those kind.

My wife and I are planning a trip through South America and incorporating some medical volunteering in some remote regions (she is a Critical Care Nurse Practitioner). We're planning on coordinating mailing in supplies with the local relief organizations we expect to be working with, but since we're riding, my wife really wants to bring a fairly extensive kit with her in case (1) we fall down, or (2) there are issues with the supplies being mailed in and she wants to have some with her.

A basic first aid kit I wouldn't be too concerned with at border crossings, but what we're probably looking at would involve airway management tools, minor surgical instruments, (probably won't be a problem) and various narcotics and other drugs (I imagine this would be where the problem would be).

In the US she has prescribing authority and a DEA number, but obviously that would probably mean little outside the US. I've been searching but haven't seen any posts dealing with it, and figured there is so much expertise here someone will probably have some experience to share.

Anyways, does anyone have any thoughts about whether this is likely to be a big problem in any countries in South or Central America, or heck, Mexico even. Any suggestions for where to go for information on this sort of thing? My wife has declared it my responsibility to "make it work" and I don't know where to begin here.
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Old 11-02-2010, 01:56 PM   #2
bananaman
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You can bring your pro first aid kit, an airway kit, and minor trauma tools. You can bring meds for yourself. You can not bring more. If you come to an accident, you'll be able to package and prep for transport. Your wife isn't going to be doing roadside surgery.

Anything you would use at a volunteer clinic- especially meds- you'll have to coordinate with the clinic.

Do some research about licensing and stuff.

I always carry personal meds- antibiotics and pain killers. You have to keep them in a package with the pharmacy label and your name on it.

In Giatemala I encountered one bad accident. I could have helped, but a cop told me to leave the victim alone, and there were bad guys with guns. I did the smart thing: I told Barb to get on her bike as fast as possible and we got the hell out of there! No matter what your motives and training, you're tourists. Guests.

A buddy of mine is going to the DR on Friday for a week of surgery. There are doctors like him in every hospital. When you talk to them, ask precise questions and get details. But none of them will know anything about crossing a dozen borders with a stash of meds.
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Old 11-02-2010, 04:41 PM   #3
TVic OP
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Thanks, I knew someone here would have the info. She definitely doesn't plan on any roadside surgeries--I think she mainly wants them for her clinic work. That said, some heavy duty painkillers would be nice in case of a really, really bad day on the bike. I suppose we could just get scrips for them in our name then, and be ok right (assuming reasonable quantities)?
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Old 11-03-2010, 06:28 AM   #4
bananaman
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Quote:
Originally Posted by TVic
Thanks, I knew someone here would have the info. She definitely doesn't plan on any roadside surgeries--I think she mainly wants them for her clinic work. That said, some heavy duty painkillers would be nice in case of a really, really bad day on the bike. I suppose we could just get scrips for them in our name then, and be ok right (assuming reasonable quantities)?
"Reasonable quantities" is key. Can you have 10 vicoden? Yes. Can you have 1000 vicoden? Um, no.

Read up on all kinds of scary deadly illnesses at the CDC's website. My HMO has a Travel Nurse who keeps up to date on all the different shots and stuff that you'll need. Things like Hep, Dip, Polio, Yellow Fever, Rabies. (For Rabies you have to plan ahead. It takes three shots spread over 28 days.) I carry zithro, doxy, cipro, vicoden, and oxycodone, plus a small pharmacy of non-prescription drugs, like real sudafed, benadryl, advil, tylenol, sting-ease, iodine, immodium, etc.
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Old 11-03-2010, 06:40 PM   #5
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Bananaman summed it up quite well. No ifs, ands, or buts, or eben maybes.
Quantities beyond what is considered normal for personal use make you a "dealer". You don't want that risk.
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Old 11-04-2010, 08:18 AM   #6
autolycos
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Doing what you are proposing is done regularly by aid groups. Call the US State Department and the consulates of the countries you are planning on touring through and ask them.

Worst case scenario is you have to cut back your expected kit to minimum amounts of narcotics. Keep in mind that you are will likely be doing Emergency/Wilderness medicine, not continuing care in many cases. So, stuff for procedures, but not long-term prescribing. Not sure if that changes how you want to pack.

P.M. me if you want some other info. I've taken some wilderness medicine courses, and have some contacts in that world. Also, a newly minted M.D. waiting to go to residency.
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Old 11-04-2010, 08:19 AM   #7
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Hell, if you're in Rapid and not doing too much, swing down on 71. Got some adv'ers swinging through on a hack on Friday and will be lighting the turkey.
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Old 11-04-2010, 05:41 PM   #8
bananaman
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Quote:
Originally Posted by autolycos
Doing what you are proposing is done regularly by aid groups. Call the US State Department and the consulates of the countries you are planning on touring through and ask them.

Worst case scenario is you have to cut back your expected kit to minimum amounts of narcotics. Keep in mind that you are will likely be doing Emergency/Wilderness medicine, not continuing care in many cases. So, stuff for procedures, but not long-term prescribing. Not sure if that changes how you want to pack.

P.M. me if you want some other info. I've taken some wilderness medicine courses, and have some contacts in that world. Also, a newly minted M.D. waiting to go to residency.
November is a strange month for a newly minted MD to be waiting for a residency...

Emergency/Wilderness medicine? Not likely. Central America has tons of clinics and hospitals. South America is a lot bigger, but the big empty places don't have people. This is what makes them "empty." Of course there's always plenty for a medical pro to do. Just make sure to take an open mind and then ask tons of questions before jumping to any conclusions.

So I called my buddy- the guy going to the DR tomorrow. He's taking bags and bags of stuff, including his special anesthesia stuff, but he's NOT taking narcotics. "Oo. Narcotics? You can't take narcotics. ESPECIALLY not to Ecuador or Peru. Not even your own personal scrip." (He carries a few vicoden anyway, in a scrip in his name.) He's done the volunteer surgery thing in Ecuador and Peru. He said he wanted to take narcotics, but it's not allowed. The good news is, there are plenty there. Local in-country pharmacies have plenty of all the narcotics you'll need. As for your own personal needs, his opinion, based on his own experience and the experiences shared with him: be extremely careful about taking narcotics through an airport, even just 10 oxycodone with your name on them. Best case, according to him: they'll take them away. Worst case.... you don't want to think about the worst case.

I reminded him that he was one of the guys who'd advised me to take my own percaset, vicoden, oxycodone, oxycontin, lorazapam, etc. (Do any of you guys know the difference between all these? I feel like some of them are the same thing.)

As for his anesthesia stuff, he has a special letter for DR customs. I think you need to clear it all with the consul of the country you're going to. When he went to Ecuador and Peru, he shipped a lot of the stuff he needed.

A few years ago my dad coordinated a container of dentist stuff for Panama. He got it all in, but it was a pretty big hastle.
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Old 11-05-2010, 06:59 AM   #9
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Quote:
Originally Posted by bananaman
...Just make sure to take an open mind and then ask tons of questions before jumping to any conclusions.

...Local in-country pharmacies have plenty of all the narcotics you'll need.
Best advice was about not taking more than you personally really absolutely need, keeping an open mind, and asking questions.

This stuff has changed a lot over the last 20 years. Most of the pharmacies are not the wide open counters that they used to be. Or that legend still likes to describe. First, know the proper names for what you want, not the trade name. This one simple thing has screwed me up more than once, especially since this is not the simple conversational language stuff that you normally get by with. Out will come what I call "The Big Pill Book" that seems to be needed for every med sold south of San Diego.

Second is that while my wife the RN is amazed by what still is considered to be over the counter down there, a lot of the actual narcotics (your original question) are now controlled, even in the boonies. The upside to this one is that the docs are usually right there with the pharmacy and can write for you on the spot.

Third is that you're going to be in somebody else's small neighborhood and you don't want to carry. If you do, word will get around and it'll make your bags a target.

Don't overplan or worry, it's amazing how things always work out in the boonies. Do plan to have extra time for all of the warm people you come across.
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Old 11-05-2010, 07:42 AM   #10
TVic OP
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Thanks everyone again. We're planning on 9-12 months for the ride/stops. We're still trying to nail down which organizations and countries we end up spending time at, as we've learned that many of them seem to be nothing more than scam travel agencies. Once we have them narrowed down we'll just try and coordinate the meds issue with them...sounds like it's definitely not worth the headaches.

And thanks for the invite autolycos--I would jump on that except I'm heading out to the Black Hills for some hiking and camping this weekend while the weather stays warm. Hopefully warm anyways.
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