Travel and Substance Use

Some travellers may turn to alcohol or drugs to reduce stress or escape feelings of isolation. For others, being free of social rules governing behaviour back home is a chance to ‘let loose’ or experiment with substances not easily available in their own country. Substance use in a foreign country can have increased risks, as travellers may put their health or the safety of others at risk and may encounter severe or unexpected legal consequences.

What is substance abuse?

Substance abuse is the harmful or hazardous use of psychoactive substances such as alcohol and drugs. It can cause you to need the substance to function properly (psychological dependence) or need more of the substance to get the same effect (physical dependence). This causes a strong desire to use the substance and difficulty controlling its use.

Signs of substance dependence:

Experiencing cravings or strong compulsions to ingest the substance
Difficulty controlling intake
Suffering physical withdrawal when use has been reduced or stopped
Needing to increase the amount over time
Spending an inordinate amount of time and energy to access the substance
Continuing to take the substance despite its harmful effects

Substance abuse and travel

Travel does not cause substance dependence, but it can provide an opportunity to misuse substances or cause a relapse in addiction survivors. Even if you have no prior history of substance dependence or misuse, the excitement of travelling or the challenges associated with it can lead to unsafe use of alcohol or drugs. Certain groups such as young people and persons with existing substance use disorders are more susceptible to misusing drugs or alcohol while travelling.

Know the risks

Using mood altering substances can risk placing you in unwanted or dangerous situations. Increases in risk-taking behaviour from substance use can lead to unsafe choices such as violence or risky sexual practices. Loss of control, disorientation, psychiatric disassociation, psychosis, or the effects of withdrawal (such as anxiety, agitation, hallucinations, delusion, delirium tremens, seizures, and hyperactivity) in an unfamiliar environment increases stress levels and could result in a medical emergency or arrest.

If you are going to seek a prohibited substance abroad, be aware that the purchase and use of some psychoactive drugs is illegal in the majority of countries and can lead to criminal charges, fines, imprisonment, or the death penalty (i.e. Singapore, Iran, Saudi Arabia). In addition, the quality of the product may be different than you may be used to back home. Consuming a drug of an unknown quality may lead to unwanted physical or mental effects or cause you to overdose. Make sure you know the risks of accidental overdose, where to get clean injecting equipment, and always practice safe sex.

Getting treatment in a foreign country

Lack of familiar support networks, language barriers, and cultural perceptions toward substance use can make it difficult to seek appropriate medical attention. How the host culture perceives substance use and persons with substance addiction can also have an impact – negative attitudes can make it more difficult to get proper treatment.

Recognizing the warning signs of substance abuse and/or dependence and how to get help abroad are key to a safe trip. Treatment for substance abuse usually involves hospitalization to stabilize symptoms of intoxication or withdrawal, with possible evacuation. Keep in mind that travel health insurance policies do not cover medical expenses related to the misuse of alcohol or the use of illegal drugs.

If you require medical attention for substance abuse, visit your doctor once you return home to continue treatment, which many include addiction counselling psychotherapy, peer support, and medication.

Helping a family member or friend

If you are travelling with someone who you suspect is experiencing an overdose or withdrawal, seek medical attention immediately. Remove self-harming objects such as knives, toxic chemicals, alcohol, and other psychoactive substances. Contact the person's embassy or consulate for emergency assistance. Note that travellers may require legal assistance if they are found to be in possession of illegal substances.

I have substance dependence

You can travel safely if you are actively controlling and treating your substance addiction. Know how unfamiliar environments, language barriers, and difficulty understanding social mores can increase stress levels and trigger the need to use. Recognizing warning signs that may lead to substance use can help you seek support or medical care in a timely manner.

Keep in mind that countries restrict the use or import of substances that alleviate withdrawal symptoms, such as methadone or buprenorphine. Check the International Narcotics Control Board for country restrictions (note that some country information may be missing or incomplete). You can also check your destination’s embassy, consulate, and ministry of health websites for further information.

Travel and mental health checklist

Before you leave

Consult your healthcare practitioner to discuss if the type of travel you are planning is right for you. Get advice on how to stay healthy and cope with the effects of travel stress and jet lack.
If you are managing an addiction, talk to your counsellor or health professional about coping strategies while you are away. Ask if you can keep in touch during your trip.
Find a reputable mental health professional at your destination who speaks your language. You may want to contact them prior to your trip to ensure continuity of care.
Familiarize yourself with the healthcare system and legal consequences of substance use or possession at your destination country. Know what steps you need to take in case of an emergency.
Book the most direct route possible to your destination; avoid layovers and long hours in transit.
Travel with a trusted friend, family member, or professional travel companion. If you are travelling alone, set up regular check-in times to reach a family member or friend.
Register with your embassy or consulate in case you need their assistance during an emergency abroad.
Make sure to pack enough medication for the duration of your trip. Check whether your medication is regulated or restricted at your destination.

During your trip

Give yourself plenty of time to arrive and go through security checks. Note that airports, train stations, bus depots generally have medical facilities.
Establish a routine that sets the tone for your trip. Familiarize yourself with your surroundings and if you can, integrate some activities that you are used to doing back home or bring you a sense of comfort.
Bring a calming item (a book, a device to play music), memento, or journal that provides comfort during stressful situations.
Know your mental and physical limits and avoid or limit your exposure to triggering situations. Regularly re-assess your original plans and change them to keep your stress levels low.
Stay within suggested daily and weekly limits for alcohol consumption and make sure to have a few non-drinking days within the week. Practice caution at all-inclusive resorts, cruises, or events with unlimited access to alcohol.
Always take precautions with your personal safety. Trust your instincts and make plans to leave if you feel unsafe in a certain situation.
Practice relaxing breathing exercises and integrate physical activity like walking and stretching to relieve stress. Get the appropriate amount of sleep, eat a healthy diet, and stay hydrated.

When you return

Book an extra day or two off after you return to mentally and physically recover from your trip. This will help you adjust from jet lag and help you get back into your daily routine.
Follow up with your healthcare practitioner if you needed emergency care abroad or to address any concerns you may have related to post-travel readjustment.