Wednesday, May 29, 2013

Texas Seeks To Restrict Abortion Pills

Currently RU-486, Mifeprex, is the only FDA approved abortion pill available in the United States. However, several others are being developed. Its primary purpose is to induce non-surgical abortions.

The Texas Senate is debating proposed regulations regarding the use and prescription of this type of drug. Those proposed regulations surrounding abortion pills are similar to those the state holds for surgical abortions. Since RU-486 is allegedly effective only during the first 49 days of gestation, late-term abortion considerations are not considered to apply.

Among the provisions concerning the use of abortion pills in Texas is that the drug must be proscribed by a physician, not a nurse practitioner or physician's assistant, and only after a full examination is completed. Part of that examination includes tests to determine the gestational age of the unborn child and health of the mother.

The Senate is set to vote on SB 97 in the near future. The full text of the bill as amended by the committees is available here.
       Sec. 171.053.  DISTRIBUTION OF ABORTION-INDUCING DRUG. (a)  A person may not knowingly give, sell, dispense, administer, provide, or prescribe an abortion-inducing drug to a pregnant woman for the purpose of inducing an abortion in the pregnant woman or enabling another person to induce an abortion in the pregnant woman unless:
             (1)  the person who gives, sells, dispenses, administers, provides, or prescribes the abortion-inducing drug is a physician; and
             (2)  the provision, prescription, or administration of the abortion-inducing drug satisfies the protocol tested and authorized by the United States Food and Drug Administration as outlined in the final printed label of the abortion-inducing drug.
       (b)  Before the physician gives, sells, dispenses, administers, provides, or prescribes an abortion-inducing drug, the physician must examine the pregnant woman and document, in the woman's medical record, the gestational age and intrauterine location of the pregnancy.

Abortion Pill Bill In Wake Of HHS Plan-B Announcement?

Among misconceptions regarding the abortion pill is confusion between Mifeprex and "Plan-B" emergency contraception pills. Plan-B is not an abortive. It is a high dose of a common birth-control pill that can delay ovulation and/or prevent implantation of a fertilized egg.

The moment of conception is still a subject of debate in the scientific community. Some see the zygote stage immediately after fertilization as the moment of conception. Other biologists contend that implantation is necessary to the development of the child. To them, successful implantation marks conception. Abortive miscarriages are defined for those that occur after implantation.

In either case, Plan-B is not considered an abortive. It is considered a form of contraception.

Some individuals consider SB 97 to be in reaction to the US Department of Health and Human Services' (et. al.) decree that Plan-B should be available to children under 16, over the counter, without prescription, and without parental consent.

However, the Abortion Pill Bill was introduced November 2012, several months before the HHS announcement.

Individual Rights, OTC Medications, and Minors

The abortion pill and plan-b debates draw to a deeper concern in individual liberties. Many drugs restricted  to prescription-only controlled distribution may serve better if sold over-the-counter. Doing so with many drugs may assist in lowering prescription and medical costs of individual citizens.

Among the mass of OTC medications available is the "mystery drug" known as acetyl salicylic acid. This drug was little studied before being approved for over-the-counter sales. The side-effects were little known, and several have come to light in recent years. Its uses, as well, were little known. In the past few decades, new uses have been discovered. Acetylsalicylic acid is also known as "aspirin". It thins the blood. That is beneficial for individuals with high blood pressure as well as those with high cholesterol or arterial sclerosis. However, the drug can prove deadly for people engaging in other many other activities such as SCUBA diving, or Soldiers in a combat zone. Aspirin is also known to cause or aggravate peptic ulcers. It can aggravate many of the causes of rectal bleeding. It can also cause complications for menstruating women. In children, it can cause Reye's Syndrome.

Yet, this common OTC pain reliever is readily available over the counter. Most people understand the risks and do not overdose on it. That is because most adults are responsible.

Certain low-level antibiotics remain prescription-only in the US. One of the main concerns behind allowing low-dose penicillin available OTC is that there are people allergic to it. It seems reasonable. However, people are allergic to sesame seeds (and oil). It is still available in the grocery store. The same goes for peanuts and chocolate. While some nanny-state advocates would love to ban those, the fact remains they are still available at you local grocer. Those allergic to them simply stay away from them. The same should be true of penicillin.

Then come the arguments concerning minors' access to these medications. HHS wants Plan-B available OTC for minors. Yet schools will suspend or expel a minor student for taking an aspirin or acetaminophen pill. The answer to this is simple. As with alcohol, tobacco, and lottery tickets, it may, perhaps, be a good idea to prohibit sale to minors. it won't prevent them from getting them. It will, however, limit access, to a degree. It will also put the welfare of the child squarely where it belongs, with the parents. In addition, it would provide a degree of accountability among those who may sell such to minors.

Currently, a 12 year old can legally purchase a bottle of Nyquil and a bottle of Robotussin. Nyquil is 50 proof, slightly higher than common peach schnapps. It contains other drugs that affect the brain. In larger doses (such as a whole bottle), Robotussin is known to produce hallucinations. Kids can legally purchase these items and "get high".

The issue is one to consider. Several prescription-only drugs are such in order to inflate the price. Making them available OTC for responsible adults may make them much more affordable. Meanwhile, several OTC drugs are not for recreational use and may be easily abused, especially by minors. So, perhaps more drugs should be considered for OTC sales; OTC sales need to be better regulated in regards to purchase by minors.

In any case, women will need a full examination by a physician to get their abortion pills, if this proposed Texas bill passes.