Handling Prescription Drugs on Board

9 December 2020 By Kate Lardy

Kate got her start in the yachting industry working as crew. She spent five years cruising the Bahamas, Caribbean, New England, and Central America, then segued that experience into a career in marine journalism, including stints as editor of Dockwalk and ShowBoats International.

The Below Deck fan base was shocked when Chief Stewardess Hannah Ferrier, who has appeared on all five seasons of the reality TV show Below Deck Mediterranean, was fired abruptly mid-season for possession of Valium and a weed pen. Ferrier’s cabinmate, Bosun Malia White, had taken a photo of the substances and sent it to the captain, Sandy Yawn. When confronted by the captain, the chief stewardess was not able to produce a prescription for the Valium. She said it was prescribed medication that she always carried with her if needed for a panic attack, and that she hadn’t taken any since she had been on board. With regards to the pen, Ferrier claimed that it was a CBD pen, and since it did not contain THC, it was legal in Spain where the yacht was chartering. It was never made clear whether in fact the pen did contain THC, and the on-screen controversy seemed to center around the Valium and the legalities of prescription medication in general — which left some working yacht crew wondering if that odd medication they may carry with them, and may even have forgotten they had, could get them into as much trouble.

During the episode, which aired on August 17 in the U.S., Capt. Yawn explained that it was a safety issue: “If you’re on an airplane, and the plane is in an emergency landing, your flight attendants are responsible for the guests. If something catastrophic happened, the chief stew has a responsibility to gather all the guests, keep them calm. If I didn’t address this and something, God forbid, happened, I would be taken to jail, the boat would be incarcerated, and I would lose my license.”

Whether or not a crewmember has a safety-critical task like the one Yawn described is an important consideration when addressing medication at sea, says the MCA in its Marine Guidance Note 296 (M). “Prescription and over-the-counter drugs may enable users to continue working during periods of acute or chronic illness. However, there is an increased risk that impairing side effects of such medication, e.g. fatigue or disorientation, could jeopardize personal safety and in some cases, the safety of others. At sea, this can be a particular problem, and recent accidents have highlighted impairing medication as a contributory factor.

“Different types of seafarers will pose different patterns of risk,” the guidance note continues. “For example, impairment in a navigating officer can directly put a vessel at risk, whereas similar impairment in customer service personnel may be less significant.”

The MCA suggests various risk-management options that range from high — where those with safety-critical functions need to declare any medication and get a clearance certificate from a health professional prior to departure — to none, for employees with no safety-critical duties.

Medication may also be addressed in the seafarer employment agreement (SEA), requiring crew to disclose it. 

Another question was raised when Bosun White posted about the incident on Instagram: “No crewmember is allowed to self-administer drugs, prescription or not, while on a vessel at sea.” The Cayman Registry, the world’s largest yacht registry, says that when it comes to their vessels, this is not the case. “We don’t have specific requirements,” says Peter Southgate, the Cayman Registry’s regional director, Americas. “If it is prescribed by a doctor, then that’s fine. [The crewmember] needs to follow the guidance of their medical practitioner, but [the meds] don’t necessarily need to be administered by the Medical Person in Charge, they don’t have to be taken away from the individual, and they don’t have to be under lock and key by the captain.”

Then there is the question of whether crew are required to disclose medication. Dr. Coralie Trim-Cauchois, an MCA-approved doctor in Beausoleil, France, says that if a crewmember is issued an unrestricted ENG1 medical certificate while taking medication with no side effects, then whether or not they inform their employer of the medication is up to the seafarer. “In the case the medication might be with side effects, the seafarer will have an ENG3 form (because of the restriction) to show to the Master or to the employer. On the ENG3 will be written only the reason/disease explaining the restriction, so that the Master/employer understands the restriction. But the type of medication taken is not shown on the ENG3, only the disease. So it’s up to the seafarer to tell the Master or employer which medication he takes or not.”

With this particular incident concerning Valium, Dr. Trim-Cauchois says she would not issue an unrestricted medical certificate to anyone with a prescription for Valium, even a low-dose. “It would [lead to] a temporarily unfit for work ENG1, until off Valium medication,” she says.

Medication may also be addressed in the seafarer employment agreement (SEA), requiring crew to disclose it. During the social media backlash that followed Ferrier’s dismissal, an excerpt from what was reportedly the SEA in question was posted, which included: “You undertake, prior to commencement of your employment, to inform the Company and Master of any pre-existing medical condition and of all medication you are taking… If you develop any medical condition or begin to take medication, you must immediately inform the Company and the Master.” And this is where Ferrier admits she made a mistake.

Finally, there is also the port state to consider. Southgate explains, “When [a vessel enters] a port, any prescription drugs have to be declared. If the medication is not legal in their territory, they may deny entry; they may say that they have to be kept under lock and key.”

This column is taken from the December 2020 issue of Dockwalk.


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