SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

Post-its from Practice:
Going on holiday (Oct 2010)

As I make my arrangements to go on holidays, I think how easy it is for me compared to people who are on continual prescriptions. All I need to worry about is whether my passport is in date and if I have enough suntan lotion.

In general the Home Office guidance for travel abroad has dramatically improved (Ref 1). There is now an open general licence that covers all prescriptions lasting up to three months. Patients who are travelling for this duration or more, and who therefore need to carry more than three months' supply are required to apply for a personal licence. A personal licence enables individuals to take prescribed controlled medicines out of the UK and bring them back in on their return. It has no legal standing in other countries. Patients need to apply for a personal licence at least ten working days before the date they are due to travel. The patient's GP will need to provide a letter supporting his or her application.

This only applies to export from the UK and travellers are strongly advised to check with the relevant embassy as to the regulations regarding the import of controlled drugs into the country they intend to visit. Patients should also be aware of new regulations governing the carriage of liquids in hand luggage e.g. methadone tablets may be needed for long-haul flights, unless the methadone mixture is proved to be "essential medication". It is always recommended that anyone taking medication out of the country should get a letter from their prescriber outlining what they will be carrying.

However, a phone call I received a few weeks ago made me realise that this is an area that we as the prescribers can abuse or use wisely our enormous power. I was asked by Release to intervene in a "holiday problem". A distraught father who had paid for his son Jack to go on holiday with his parents to Thailand for three weeks phoned them. He had checked and received confirmation from the Home Office and the Thai Embassy that Jack was allowed to export and import his methadone (50mls mixture daily hence carrying a total of 1000mls). With a month to go, Jack had also spoken to his key worker who thought he was stable enough to go but the worker said he had to get permission of the nurse prescriber, who signs the scripts. During this attempt to get permission, the prescriber refused because Jack had tested positive for heroin in his last urine test. In fact the prescriber said he wouldn't even allow Jack a week in Cornwall!

Fortunately for Jack a few words to the medical lead of the service soon resolved the issue, and was completed with an apology to the family who are now enjoying a family holiday in Thailand. The beautiful postcard from them has pride of place on my desk. With such power we need to remember how to use it to help people on their journey not to create unnecessary hurdles. Now I'm off to Mexico!

- Dr Chris Ford
GP Lonsdale and Clinical Lead for SMMGP