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post #1 of 27 Old 09-26-2016 Thread Starter
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Prescription medications in your kit

I could use help sorting fact from urban legend.

It has been my understanding that a USCG Documented boat can get prescriptions written "for the boat" for things like antibiotics and pain medication. My searches using Google seem to lead toward "find an understanding physician."

Does anyone have an official citation that points toward the more general case of prescribing for the boat?

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post #2 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

Never had such an experience. The US Dr.s I've met need to be talked into giving scripts for quantities of antibiotics, pain killers or whatever. Personal, specific meds needed for one's specific ailments are not usually a problem in quantities of 6 months to a year.

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post #3 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

To my knowledge, unless you have a clinic on a commercial vessell, a physician cannot prescribe drugs to the vessel - only the individual patient that is symptomatic.

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post #4 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

Do you want the law or the practice?

Practically you need to speak with a doctor and they will write you a prescription for drugs to be stored on board for use as needed. The upside to this is that it is mostly regulatory free and fits into the normal scheme of drug prescriptions. The downside is it can be difficult to find a doctor to go along with it.

Legally the master of a vessel can walk into a pharmacy (assuming they are a participating one) and ask for pretty much anything the master wants for the 'ships medicine cabinate.' But this is fraught with regulatory issues. The master then becomes obligated to file paperwork with the DEA every year about what was requested, what was used, who it was used by, and then follow proper disposal requirements (and reporting). Technically this is legal, practicaly I don't know anyone who has ever done it other than commercial vessels.

If you want the background see https://www.deadiversion.usdoj.gov/2...01/1301_25.htm

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Re: Prescription medications in your kit

Possibly more legend, but I'm lead to believe it's easier to do in Canada, than the US. I wonder if a US citizen can go to Canada, get the script, fill it and bring them back. For a good med kit, it would be worth the trip.


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post #6 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

On this website it looks like it can be prescribed to the boat - OceanMedix - Cruiser Prescription Kit - OceanMedix

It also says there Use Record that Stumble was talking about as well.


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post #7 of 27 Old 09-26-2016 Thread Starter
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Re: Prescription medications in your kit

Quote:
Originally Posted by Stumble View Post
Do you want the law or the practice?
Yep.

Quote:
Originally Posted by Stumble View Post
Practically you need to speak with a doctor and they will write you a prescription for drugs to be stored on board for use as needed. The upside to this is that it is mostly regulatory free and fits into the normal scheme of drug prescriptions. The downside is it can be difficult to find a doctor to go along with it.
That goes to the "cooperative physician" so broadly recommended.

Quote:
Originally Posted by Stumble View Post
Legally the master of a vessel can walk into a pharmacy (assuming they are a participating one) and ask for pretty much anything the master wants for the 'ships medicine cabinate.' But this is fraught with regulatory issues. The master then becomes obligated to file paperwork with the DEA every year about what was requested, what was used, who it was used by, and then follow proper disposal requirements (and reporting). Technically this is legal, practicaly I don't know anyone who has ever done it other than commercial vessels.

If you want the background see https://www.deadiversion.usdoj.gov/2...01/1301_25.htm
I really like citations of the CFR. *grin* As I read CFR Title 21 §1301.25 the vessel must be "in trade" which would seem to exclude private craft. I'll work on a reading from the DEA.

Quote:
Originally Posted by dwedeking View Post
On this website it looks like it can be prescribed to the boat - OceanMedix - Cruiser Prescription Kit - OceanMedix

It also says there Use Record that Stumble was talking about as well.
I have already sent an email to Denny Emory, one of the founders of OceanMedix. Apparently he's out tramping in the wilds of Wyoming.

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post #8 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

Yep, the CFR is fairly clear on this issue, but just to be sure, I called my pharmacist friend at Rite Aid and he said "Anyone that comes in with a prescription for a legal drug will be supplied that drug. If you don't have a prescription, well, it just ain't gonna happen." I asked about a ships captain or medical officer, he said that he has never encountered that situation in his 50 years of being a pharmacist and doesn't anticipate ever doing so.

I took a careful look at the kit, and there was only a single drug that would fit into the narcotic category, and it was nothing more than aspirin and codine. There were a few lightweight antibiotics in the kit as well, but nothing earth shaking.

In the essence of finding the actual facts, I have placed a call to Paul McElroy, who holds an unlimited master's license and recently retired from training individuals to obtain their captain's licenses. He is also listed as an expert witness nationally in these issues. I am awaiting his call to determine what legal ramifications there are.

I looked carefully at the kit, which is fairly comprehensive, but IMO, overpriced to a huge extent. The quantities are small to modest, and treatment beyond two weeks would be pushing it for the most part.

The danger of any of this is that for the average lay person, it would be nearly impossible to provide a definitive diagnosis for the vast majority of onboard illnesses. This is where significant and ongoing medical training is a must, which is rarely the case with a private vessel captain. Yes, I know, there is a few MD's out there sailing, but most are not sailing on any vessel other than their own, and those that I know personally, which is only 3, have an emergency first aid kit onboard - not a $1,760 kit containing a lot of over the counter drugs and a few prescription drugs. Their kits usually contain suture kits, gauze bandages, bandaids, iodine, alcohol, aspirin, etc..., items that would be readily used for minor cuts and injuries.

When Paul calls back, I will update you on his findings and post it immediately.

Take a close look at:

PART 1301 — REGISTRATION OF MANUFACTURERS, DISTRIBUTORS, AND
DISPENSERS OF CONTROLLED SUBSTANCES
EXCEPTIONS TO REGISTRATION AND FEES
§1301.25 Registration regarding ocean vessels, aircraft, and other entities.

(a) If acquired by and dispensed under the general supervision of a medical officer described in paragraph (b) of this section, or the master or first officer of the vessel under the circumstances described in paragraph (d) of this section, controlled substances may be held for stocking, be maintained in, and dispensed from medicine chests, first aid packets, or dispensaries:

(1) On board any vessel engaged in international trade or in trade between ports of the United States and any merchant vessel belonging to the U.S. Government;

(2) On board any aircraft operated by an air carrier under a certificate of permit issued pursuant to the Federal Aviation Act of 1958 (49 U.S.C. 1301); and

(3) In any other entity of fixed or transient location approved by the Administrator as appropriate for application of this section (e.g., emergency kits at field sites of an industrial firm).

(b) A medical officer shall be:

(1) Licensed in a state as a physician;

(2) Employed by the owner or operator of the vessel, aircraft or other entity; and

(3) Registered under the Act at either of the following locations:

(i) The principal office of the owner or operator of the vessel, aircraft or other entity or

(ii) At any other location provided that the name, address, registration number and expiration date as they appear on his/her Certificate of Registration (DEA Form 223) for this location are maintained for inspection at said principal office in a readily retrievable manner.


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Re: Prescription medications in your kit

Quote:
Originally Posted by travlin-easy View Post
The danger of any of this is that for the average lay person, it would be nearly impossible to provide a definitive diagnosis for the vast majority of onboard illnesses. This is where significant and ongoing medical training is a must, which is rarely the case with a private vessel captain.
It is relatively straightforward to get professional medical advice, even mid-ocean, using HF/SSB or a satellite phone. You can only use what you have however.

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post #10 of 27 Old 09-26-2016
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Re: Prescription medications in your kit

Auspicious,

It is a little confused since the regulations are really written for commercial operation, but I don't read anything there that requires the vessel to be in trade, perhaps documented... But again I am pretty sure that whatever system is in place for a commercial vessel are going to be nearly impossible to take advantage of as a recreational craft. Even assuming the law allows for it, no pharmacist is going to risk their license on it.

Maybe if you find a serious pill mill, or someone who regularly does this... But I doubt it. It's just to easy to get a doctor who will write a script and to risky for the pharmacist without one.

Greg

Last edited by Stumble; 09-27-2016 at 12:04 AM.
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