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Doctors say a Louisiana law that reclassified abortion-inducing drugs as controlled substances has made it more difficult for doctors to treat a wide range of gynecological conditions.
A similar proposal is currently being filed in Texas.
Texas Congressman Pat Curry, a freshman Republican from Waco, said of the intention: House Bill 1339 It is to make it difficult for people, especially teenagers, to order mifepristone and misoprostol online to get an abortion. Louisiana doctors say the measure does little to strengthen the state’s near-total abortion ban, but it increases fear and confusion among doctors, pharmacists and patients.
“There’s no point in that,” says Dr. Nicole Freehill, an obstetrician-gynecologist in New Orleans. “Despite how often we kept trying to tell them; [these medications] It didn’t matter how safe they were for other uses. It’s just a backdoor way to further restrict abortion. ”
These drugs are often used to empty the uterus after a patient miscarries and are usually prescribed before inserting an intrauterine device. Misoprostol is also often the best treatment for obstetric hemorrhage, a potentially life-threatening condition in which a woman can bleed to death within minutes. Since Louisiana’s law went into effect, hospitals have taken medications from maternity carts and stored them in locked, password-protected central storage.
One hospital, training to get medicines to patients on time, reported an average delay of two minutes compared to before the law took effect. The Louisiana Illuminator reported.
“In obstetrics and gynecology, minutes, even seconds, can mean the difference between life and death,” said Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists. stated in a statement After the Louisiana law was passed. “Forcing clinicians to jump through administrative hurdles to obtain safe and effective medicines is medically unjustified and simply dangerous.”
Curry said these restrictions won’t prevent doctors from prescribing these drugs if needed, but they will prevent “widespread misuse” of the drugs to circumvent the state’s near-total abortion ban. He said he would.
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Curry said he consulted with the authors of the Louisiana law and an obstetrician-gynecologist in Texas when drafting the bill. He said doctors who have criticized the bill are raising these concerns as a “smokescreen” because they don’t want further restrictions.
“I get that. We don’t need or want any kind of regulation,” he said. “Regulation shouldn’t be high on our list, especially as Republicans, but in this case, it’s a necessary evil given the circumstances.”
Texas’ roots lie in Louisiana law
In March 2022, Houston lawyer Mason Herring forced his wife to have an abortion by adding misoprostol to her water. Katherine Herring was pregnant with the couple’s third child, and their daughter was born 10 weeks early. She survived, but she has severe developmental disabilities. Associated Press.
Mason Herring was charged with grievous assault inducing an abortion and pleaded guilty to injury to a child and assault on a pregnant person. He was sentenced to 180 days in prison and 10 years of probation.
Katherine Herring’s experience prompted her brother, Louisiana Congressman Thomas Pressley, to file charges. invoice It would then be a crime to force someone to have an abortion.
But at the last minute, the bill was amended to also reclassify abortion-inducing drugs as controlled substances. According to Louisiana Illuminatorhospitals and doctors are scrambling to comply with new restrictions. state health department advised Store medications in a locked area of the crash cart. the hospital said It’s not possible.
“We had to rethink how we use misoprostol across our hospital system,” Freehill said. “Labor, delivery, pharmacy, nursing staff, you name it, they were all involved in finding a way to use these medications that we need access to while staying within the law. .”
It is unusual for states to make their own decisions to classify drugs as controlled substances. Most commonly, the federal government determines which drugs should be “scheduled” based on their medical utility and potential for abuse. Schedule I drugs like heroin have no medical use and are often used recreationally. Schedules IV and V are medications that are useful but have the potential for abuse, such as Xanax and Valium.
Penalties for possessing controlled substances without a prescription have been increased, and restrictions on how doctors can dispense drugs have also been tightened. Pharmacists must report prescriptions for controlled substances to state prescription monitoring programs, and physicians must check the database before prescribing certain controlled substances. Law enforcement agencies can also access that database.
Prescription monitoring has been key to combating the opioid epidemic by identifying overprescribing physicians and patients receiving prescriptions from multiple health care providers. But mifepristone and misoprostol have received so much political attention as abortion-inducing drugs that doctors fear scrutiny for frequently prescribing these common drugs.
“We needed to solve a problem that wasn’t broken,” Freehill says. “There’s no reason for it to be Schedule IV. It’s not something people would abuse. It’s not something people would get addicted to. It’s extremely safe.”
A group of Louisiana health care providers recently filed a lawsuit They say the law discriminates against people who need mifepristone and misoprostol for other conditions and challenge whether last-minute amendments to the bill were appropriate. Louisiana Attorney General Liz Murrill said The new restrictions are clear and will not delay treatment. Those who have “sought to sow confusion and suspicion” are “profiting from misinformation,” she said in a statement.
When the law first took effect, Anna Ruglied Dopp, senior director of government relations for the American Society of Health-System Pharmacists, said: told CNN The group said it expects other states to consider similar measures.
“Members expressed concern that if this is being done in one state, it could quickly become a template for other states to use,” Dopp said.
drug restrictions
Mr. Curry recently won a special election to fill the seat long held by Republican Rep. Doc Anderson, and Mr. Pressley and Mr. Herring will come to testify in support of his bill this Congress. He said he offered. He hopes the bill will receive broad support from his fellow senators.
Since the Roe v. Wade reversal, conservative groups have focused on restricting access to abortion-inducing drugs. A group of anti-abortion doctors filed a lawsuit seeking to overturn the Food and Drug Administration’s approval of mifepristone, but the U.S. Supreme Court ultimately rejected the lawsuit.
Currie said there are other reasons to keep these drugs on the market besides abortion, but stricter regulations are needed.
“You can lie about your age, you can lie about your name, you can lie about your address, but there’s no verification whatsoever,” he said, referring to online prescribers. “And it goes to 15-year-old girls, 13-year-old girls.”
Mailing abortion-inducing drugs is already a crime in Texas, and many online pharmacies operate in a legal gray area outside of U.S. jurisdiction. Others work in the state of “.shield law” protects doctors’ ability to prescribe and mail the pills to states that ban abortion. None of these interstate and international legal issues regarding abortion have been heard in court.
Freehill said he encourages Texas doctors preparing to campaign against the bill this Congress to learn from what happened in Louisiana.
“There needs to be a lot of education about what this means and what these drugs are actually used for,” she said. “Even if we had more time, I don’t know if we would have been able to sway people, but we can at least educate them about why this is totally inappropriate and is actually government overreach.”
