A Pharmacist’s Thoughts on Drum Corps Tour Medication Access
You got your acceptance, you've confirmed your spot…now comes the part nobody talks about at audition camp: how do you manage your medications across months on the road, moving through dozens of states, far from your home pharmacy and your regular doctor? For drum corps performers with maintenance medications, chronic conditions, or prescriptions that require special handling, tour can get complicated fast. Dr. Megan Elizabeth Conklin, PharmD, MPH, is a pharmacist who wants to share what she wishes more corps members and staff knew before move-in day.
Touring with a drum corps is one of the most challenging, and potentially rewarding, undertakings imaginable for a performer or educator such as yourself. Let’s start with a summary of plans in recommended order, then follow up with a series of exceptions and more detailed options:
Plan A:
Have enough of your meds with you before tour starts to last the duration of your time on the road.
Plan B:
If you can’t get a 60-90 day supply of your meds prior to leaving, get your tour schedule and plan ahead with your doctor to fill a script at a specific brick and mortar store along your tour route.
Plan C:
Arrange a delivery on tour through a licensed mail order pharmacy. I will mention this multiple times in the following text; unless you are specifically licensed, it isn’t legal to ship drugs by, say, hiding medication in a shipment of otherwise innocuous care package items. You may be punished if caught.
Plan D:
You run out of meds on tour and need to call your doctor or go to an ER/hospital and ask them to send a prescription to somewhere near by. For obvious reasons, do what you can to avoid this.
Hopefully the following text provides some food for thought, and helps you this summer. Refilling maintenance medications while on the road is possible and can be quite easy, but requires some pre-planning.
Before You Leave For Tour
Figure out how many days you will be gone, and try to get enough (a 90 day supply should get you by) of your maintenance medications on hand. You can ask your pharmacy if insurance allows them to make vacation overrides for early refills. Many insurance companies allow for one of these overrides per medication per calendar year.
Medicaid is state-by-state, so those covered by state insurance can only fill medications in that state. If they need medications while traveling, they may need to pay out of pocket for medications or may benefit from having someone at home mail them their medications if needed.
For legal purposes, we have to mention again: unless you are specifically licensed to do so, you can’t legally mail certain substances. It’s worth looking into whether or not online pharmacies will ship to certain places along your tour. Costplusdrugs.com doesn’t have every med. on the market, but might have what you need. They’ll probably ship it to you anywhere your tour takes you. (This is not a sponsored ad.)
Transferring Prescriptions
Transferring prescriptions within the same pharmacy system is usually very easy. There may be state-specific laws related to controlled substances, but for other medications, for instance, a CVS pharmacy in Texas should be able to pull a medication file from a CVS in California. The same goes for Walgreens, Walmart, etc. Just call ahead to ensure there are no issues. Tour schedules are planned well in advance, so finding a pharmacy along the way should be very doable. Ask your staff if there is a plan for prescription refill days or how that has worked in the past.
We wouldn’t recommend using mail order pharmacies for the simple fact that your stops on tour are not places a typical mail order pharmacy is set up to deliver to.
Assuming your corps has access to a traveling cooler or fridge for food, work with your corps to make sure you have a spot in there for your meds. But if something goes wrong and there’s an “oh no! I left my meds at the last stop or my insulin got too warm on the bus!” moment, don’t fret, many insurances allow for lost medication overrides.
This, again, may mean calling a pharmacy, preferably in the chain you normally use for this med, in advance to see if they can pull the prescription from your home pharmacy, and the pharmacy staff may need to call the insurance company, but an early fill may be covered in these situations. If not, you may need to pay out of pocket. Again, this can be avoided by corps making it someone’s job to ensure meds are tracked and stored properly.
Filling controlled substances (ADHD stimulant medications, some sleep medications, etc) outside of your home state can be a red flag at any pharmacy. However, if a member is due for a refill of these medications while out of state, the best course of action is to have their prescriber (primary care physician, doctor psychiatrist, etc.) send the medication directly to a pharmacy near where they will be when the refill is due (even if it is out of state). There may be a need to explain to the pharmacist why this fill is being done out of state, but they should be reasonable about filling the script.
I would recommend that the members picking up controlled substances go with an admin member to the pharmacy for pickup, make sure to bring an ID (the one you use to pick up your meds normally). Having the patient present makes it much less of a red flag/liability for the pharmacy. As a reminder, it is technically illegal to ship controlled substances through the mail, so it is not recommend to try filling these medications at home and shipping to where the corps is.
Some medications are required to be electronically prescribed (e-scribed). If you show up to certain pharmacies with paper scripts for certain meds (controlled substances in particular), we can’t legally fill them without an e-scribe. Again, get your tour schedule and talk to your prescribing physician ahead of time so they can coordinate with the pharmacy on all of the backend work necessary for a smooth pickup while you’re on the road.
For acute illnesses (UTI, cough/cold), utilize telehealth services if available - many insurance companies partner with providers like Teladoc to provide these services and send prescriptions to a local pharmacy. If you don’t have insurance, going to a CVS Minute Clinic, Kroger Little Clinic, or something of the like is a decent (possibly lower cost) option, as the clinic and pharmacy will be at the same location, minimizing stops needed to receive care.
For illnesses like flu, covid, or something that may require testing or an in-person visit, definitely check out one of the clinics mentioned above. Hospital visits are pricey. We recommend corps stock up on common OTC illness tests before leaving. Also, ensure corps/members either have budgeted to cover the cost of the visit or their insurance cards (and know how to look up what clinics may be in-network) to avoid surprise bills later.
State-By-State Laws and Restrictions
Unfortunately “safe” pharmacies may or may not exist in certain areas, as individual pharmacists may deny a prescription for personal reasons (esp. related to birth control, abortion pills, gender-affirming care, life-saving meds, etc). If this is a concern, it’s recommended to call the pharmacy ahead of time and ensure the pharmacist who will be working at the time of scheduled pickup will fill the scripts. If they are denying the medication, they are required to provide information on an alternative time/place to fill, whether that be another local pharmacy or when another pharmacist will be on duty who may dispense the prescription. Again, planning ahead will keep this smooth.
Some other currently unconventional, though very helpful additions to a first aid kit
To avoid not having access to these in certain areas, have some on hand beforehand:
Narcan (nasal spray that reverses opioid overdose)
Narcan (generic: Naloxone) is newly available over the counter, so is available at most drugstores, but it can be a little pricey. Fortunately, harm reduction organizations and health departments across the country work to distribute free naloxone to those in need.
For information about where to get free Narcan, visit nextdistro.org or contact your local health department. Generic plan b is available very cheap on Amazon (https://a.co/d/4gFRoCc) or at Costco (no need to have a membership, just tell the person at the door you’re going to the pharmacy; however, this may limit the number of doses a single person can purchase).
Plan B
As for emergency contraception, we know that Plan B may not be as effective for people with higher BMIs, but there is another emergency contraceptive called Ella that can be used in these situations, though it is prescription only, and would require a telehealth appt or emergency room/urgent care visit to receive a prescription.
Some states allow pharmacists to write prescriptions for things like birth control, CPAP supplies, blood sugar testing, nicotine cessation, wound care, etc. but please don’t plan on that. This varies state-to-state, and treatments can still be very expensive even if prescribed, so it’s highly recommended to stick to your original prescribing physician at home or have an NP on corps staff, if need be and resources allow.
When in doubt, reach out! Pharmacists are an amazing resource. They’re the medication experts and the most accessible healthcare providers. Unfortunately, the big corporations that run many pharmacies create an environment where pharmacy staff are often overworked, understaffed, and under appreciated. Please be kind to, and patient with, pharmacists and pharmacy technicians. The vast majority of us truly do want to help!
Dr. Megan Elizabeth Conklin, PharmD, MPH
Pharmacist-In-Charge
Alchemy Health / Raphael Health Center
2nd Chair Clarinet - Kohler High School Symphony Band
Edited by Robert Clark Stevens
MAASIN Research Member
The information in this article is for general informational purposes only and does not constitute medical, pharmaceutical, or legal advice. The views expressed are those of the author in her personal capacity and do not represent the official position of MAASIN. Always consult your physician or pharmacist regarding your specific medications and health needs. MAASIN assumes no liability for any actions taken based on the contents of this article.