The two drugs used in medication abortion are officially controlled substances in Louisiana after a law took effect that criminalizes their possession without a prescription.
The first-of-its-kind law reclassified mifepristone and misoprostol as Schedule IV controlled substances, the same category as opioids, ephedrine and antidepressants. Critics fear it could be used as a model for other Republican states with abortion bans to tighten restrictions on the drugs.
“This new law sets a dangerous precedent by mischaracterizing safe medications that are neither addictive nor dangerous, but rather are standard of care for a variety of women's health and other conditions,” Jennifer Avegno, director of the New Orleans Health Department, said in a statement.
During a medication abortion, mifepristone is given first, followed by misoprostol one to two days later.
Schedule IV drugs have a currently accepted medical use, but “abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances,” according to state law.
To prescribe controlled substances, physicians in the state need a special license, and the state tracks the patient, physician and pharmacy involved in each prescription. The drugs will still be available in hospitals, but now must be stored under lock and key in a secure cabinet.
The new law criminalizes possession for anyone who doesn’t have a prescription or is a licensed provider, and subjects violators to a fine of up to $5,000 and up to five years in prison.
It exempts from prosecution pregnant women who possess the pills “for her own consumption,” but anyone who helps her get the pills would be at risk, even if they never perform an abortion.
The law creates the crime of “coerced criminal abortion by means of fraud” — where someone knowingly gives abortion pills to a pregnant woman without her knowledge or consent.
State Sen. Thomas Pressly (R) said he sponsored the legislation because his sister was secretly drugged with abortion-inducing medication by her then-husband.
Critics said the law was not based on science or public safety, but was meant to stop women from finding workarounds to the state’s abortion ban.
Louisiana already bans almost all surgical and medication abortions except to save a patient’s life or because a pregnancy is “medically futile.” Abortion pills are illegal to get through the mail in Louisiana, but shield laws in blue states have allowed physicians to thwart state bans and continue prescribing and sending them through online telehealth.
The new law in Louisiana could stop that. It would seemingly make it illegal for a woman to have the pills on hand even if she isn’t pregnant and imminently planning to take them, a practice known as “advance provision” that’s become increasingly popular in states with abortion bans.
Aside from abortion, the two drugs have other medical uses and the new restrictions could limit access to safe and needed medications.
Misoprostol especially has wide-ranging applications in reproductive health including for labor induction, to soften the cervix during surgical procedures and medical management of miscarriage. It’s also on the World Health Organization Model List of Essential Medicines.
“This is a nuisance at best, and fatal at worst, as misoprostol is typically one of the first medications administered in a postpartum hemorrhage, which can become life threatening within minutes,” said Jane Martin, a maternal fetal medicine physician in Louisiana. “Louisiana already faces one of the highest maternal mortality rates in the country, and I worry that this law will only make it worse, especially in rural areas with limited access to care.”
State officials pushed back on that assertion. Attorney General Liz Murrill (R) in a statement said there's nothing in state law that stands in the way of doctors providing care that stabilizes and treats emergency conditions for women.
Anyone who says otherwise is pushing disinformation "intended to create confusion and intimidate women from seeking care they may need in an emergency situation."
"This legislation does not limit a healthcare provider’s ability to use, prescribe, or fill these medications for legitimate health purposes nor does it impose restrictive burdens on access for emergency purposes," Murrill said.
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