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Guidelines for sports medicine professionals traveling with prescription medications

This is an excerpt from Clinical Pharmacology in Athletic Training by Michelle A. Cleary,Thomas E. Abdenour & Mike Pavlovich.

Traveling With Prescription Medications
Physicians, ATs, and other HCPs who travel outside of their state of licensure must be careful to ensure that they are properly handling and dispensing medications according to legislation for the state they are visiting. Moreover, physicians should not delegate to ATs the responsibility to dispense controlled substances.12 The sports medicine team (whether they travel or not) should be aware of the following:3,10

  • To dispense or administer a drug, the prescriber (e.g., physician assistant or nurse practitioner) must be licensed or otherwise authorized by the state in which the dispensing or administering occurs.
  • A DEA license is the property and responsibility of the prescriber, not the institution. The prescriber is responsible for the acquisition, storage, dispensing, and disposal of all controlled substances within the athletic training facility.
  • A prescriber can transport controlled substances only between physical locations at which she is registered by the DEA and only within the state that has granted authorization numbers for distributing and administering controlled substances.
  • Orders written for a team rather than an individual patient are not permissible.
  • An AT may be granted very limited responsibility for administering prescription drugs. This varies by state; local law must be considered.
  • Coaches absolutely cannot distribute prescription medications under any circumstance.
  • The HCP does not need to be licensed to deliver OTC medication, but the OTC drugs must be delivered with federally required packaging and labeling (described in chapter 2). Penalties for noncompliance with these regulations include a fine of $10,000 to $25,000 USD per violation (where each pill may count as a violation), possible loss of DEA privileges, and possible medical board sanctions.
  • Students should never administer, distribute, or dispense OTC or prescription medications.

In summary, the AT should never carry controlled substances across state lines and must beware of transporting these drugs, even within the home state.10

In the past, states did not provide legal protection for ATs or sports medicine professionals who were traveling to another state with an athletic team solely to provide care for that team. Fortunately, to address the multiple concerns associated with this lack of protection, in 2017, Congress passed the Sports Medicine Licensure Clarity Act, which allows ATs and sports medicine providers to engage in the treatment of injured athletes across state lines without the fear of incurring great professional loss. This legislation provides the following:10

  • ATs and sports medicine professionals who travel to other states with an athletic team to provide care for that team will receive legal protection.
  • For the purposes of liability, health care services provided by a covered AT or sports medicine professional to an athlete, an athletic team, or a staff member of an athlete or athletic team in a secondary state will be deemed to have occurred in the professional’s primary state of licensure.

Clinical Application

International Travel

When traveling internationally with medications, the AT should consider these recommendations:

  • Prior to starting the trip, the AT should consult with the host organizing committee, host team, or the sport’s nongovernmental organization (NGO) regarding local laws that need to be followed.
  • When possible, the team physician should carry the medication and travel with it in his name.
  • The AT should travel with as little inventory as possible.
  • The AT should be aware of any particular regulations relative to transporting or administering the medication, regardless if it is controlled, noncontrolled, or over the counter.
  • Medications available by prescription in 1 nation may not be available in another.
  • The AT should be certain that any medication prescribed by a local physician is not going to cause a positive drug test.