The Texas bill would classify abortion drugs as controlled substances

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A Louisiana law that designated abortion pills as controlled substances has made it more difficult for doctors to treat a wide range of gynecological conditions, doctors say.

Now, a similar proposal has been made in Texas.

Texas Rep. Pat Curry, a new Republican from Waco, said the goal of House Bill 1339 is to make it harder for people, especially young people, to order mifepristone and misoprostol online to end their pregnancy. Doctors in Louisiana say the measure has done little to strengthen the state’s impending ban on abortion, but has increased fear and confusion among doctors, pharmacists and patients.

“There is no sense in it,” said Dr. Nicole Freehill, OB/GYN New Orleans. “Although we always tried to tell them how often [these medications] they were used for other things and how safe they were, it didn’t matter. It’s just a backdoor to prevent more abortions.”

These drugs are often used to remove the uterus after a patient has had a miscarriage, and are often prescribed before an intrauterine device is inserted. Misoprostol is often the best treatment for postpartum hemorrhage, a potentially life-threatening condition in which women can bleed to death within minutes. Since Louisiana’s law went into effect, hospitals have taken medications from their delivery carts and placed them in a locked, password-protected vault.

The hospital is already conducting an exercise to get drugs to patients on time, and reported, on average, a delay of two minutes since before the law went into effect, reported the Louisiana Illuminator.

“In obstetrics and gynecology, minutes or even seconds can be the difference between life and death,” Dr. Stella Dantas, president of the American College of Obstetrics and Gynecologists, said in a statement after the Louisiana law passed. “Forcing a doctor to jump regulatory hurdles in order to find safe, effective medications is medically unjustified and extremely dangerous.”

Curry said the restrictions would not prevent doctors from prescribing the drugs when needed, but would stop the “abuse” of drugs to avoid an imminent state ban on abortion.

Curry said he consulted with a Louisiana lawmaker, as well as OB/GYNs in Texas to draft the bill. He said doctors who have criticized the law present these concerns as “smokestacks” because they don’t want more restrictions.

“I understand that. We don’t need or want all kinds of regulations,” he said. “Especially as a Republican, regulation shouldn’t be at the top of our list, but in this case it’s a necessary evil.”

Texas implements Louisiana law

In March 2022, Mason Herring, a Houston attorney, spiked his wife’s water with misoprostol to force her to have an abortion. Catherine Herring was pregnant with the couple’s third child, a daughter born 10 weeks early. He survived, but has severe developmental delays, according to the Associated Press.

Mason Herring was charged with aggravated abortion, and pleaded guilty to injury to a child and assault on a pregnant woman. He was sentenced to 180 days in jail and 10 years of probation.

Catherine Herring’s experience prompted her brother, Louisiana State Representative Thomas Pressly, to introduce a bill that would have made it a crime to force someone to have an abortion.

But at the last minute, the bill was amended to reclassify abortion drugs as controlled substances, according to the Louisiana Illuminator, leaving hospitals and doctors scrambling to comply with the new restrictions. The state’s health department advised keeping medications in a locked area in an emergency cart, which at least some hospitals have said is not possible.

“We had to adjust the way we use misoprostol across our hospitals,” Freehill said. “Labor and delivery, chemists, nurses, you name it, they were all concerned about knowing how to stay within the law but still use these drugs that we need to get.”

It is rare for a government to decide on its own to classify a drug as a controlled substance. Often, the federal government decides which drugs should be “banned,” based on their medical benefit and potential for abuse. Schedule I drugs, such as heroin, have no medicinal use and are mostly used recreationally; Schedule IV and V drugs are good but have the potential for abuse, like Xanax or Valium.

There are enhanced penalties for possession of a controlled substance without a prescription, and more restrictions on how doctors can dispense it. Pharmacists must report any prescriptions of controlled substances to the National Prescription Monitoring Program, and physicians must check the database before issuing certain controlled prescriptions. Law enforcement also has access to that database.

Physician surveillance has been key to combating the opioid epidemic by identifying physicians who were overreferring and patients receiving prescriptions from multiple providers. But with so much political attention on mifepristone and misoprostol as abortion drugs, doctors are worried about being tested more often for prescribing these common drugs.

“We had to fix a problem that wasn’t broken,” said Freehill. “There is no reason for it to be Schedule IV. It’s not something people abuse. It is not something people can get addicted to. It is very safe. ”

A group of Louisiana health care providers recently filed a lawsuit that the law discriminates against people who need mifepristone and misoprostol for other conditions, and they’re challenging whether last-minute changes to the bill are legal. Louisiana Attorney General Liz Murrill said the new restrictions are clear and should not delay care. “Those who tried to spread confusion and doubt,” he said in a statement, “are benefiting from misinformation.”

When the law went into effect, Anna Legreid Dopp, senior director of government relations for the American Society of Health-System Pharmacists, told CNN that the group expects other countries to consider similar measures.

“Almost immediately, our members raised concerns that if this is done in one country, it could be a model for other countries to use,” Dopp said.

Medication restrictions

Curry, who recently won a special election to fill the seat held by Rep. He expects it to receive significant support from his fellow lawmakers.

Since Roe v. Wade was overturned, conservative groups have turned their attention to restricting access to abortion pills. A group of anti-abortion doctors filed a lawsuit to revoke the Food and Drug Administration’s approval of mifepristone, which the United States Supreme Court ultimately rejected.

Curry says there are reasons to keep these drugs on the market without abortion, but they need stricter restrictions.

“You can lie about your age, you can lie about your name, you can lie about your address, there’s no evidence whatsoever,” he said, referring to online doctors. the color And it’s sent to a 15-year-old girl, a 13-year-old girl.

It is already illegal to ship abortion pills in Texas, and many online pharmacies operate in legal territory outside US jurisdiction. Others operate in states that have “safeguard laws” that protect doctors’ ability to prescribe and ship pills in states that prohibit abortion. None of these international legal questions have been tried in court regarding abortion.

Freehill said he would encourage Texas doctors to learn from what happened in Louisiana as they prepare to advocate against the bill in this study.

“There’s a lot of learning to be done about what this means and what these drugs are actually used for,” he said. “I don’t know that we would have been able to mislead people, even with the passage of time, but at least we can teach why this is not appropriate at all and is indeed a theft of the government.”