ARI SHAPIRO, HOST:
The New Orleans Health Department has created a new map to help its residents find pharmacies that stock a restricted reproductive health drug. Misoprostol is a key medication for managing miscarriage or stopping bleeding after labor. It's on the World Health Organization's model list of essential medicines. Last fall, Louisiana became the first state to reclassify the drug as a controlled dangerous substance because misoprostol can also induce abortions, usually in conjunction with another drug, mifepristone, which the state has also reclassified as a dangerous substance. Louisiana already has a near-total abortion ban.
Joining us now to talk about the new misoprostol map is Dr. Jennifer Avegno. She's director of the New Orleans Health Department. Welcome.
JENNIFER AVEGNO: Thank you. Glad to be here, Ari.
SHAPIRO: Why did you decide to make this map?
AVEGNO: The major complaints or issues we were hearing were that people were having trouble accessing this drug as - at outpatient pharmacies for a wide variety of reasons.
SHAPIRO: Like what?
AVEGNO: Well, some of them, even if they had a valid signed prescription with all the requirements it needed to have to get filled, the pharmacist would say, we can't fill this. Or pharmacies were requiring additional steps, like calling the doctor's office to say, did you really mean to write this prescription for what you said on the prescription? Or just a lot of confusion as to where to go, how long it would take to get filled - there were delays in it getting filled, such that patients were unable to access it in a timely manner. This is a time-sensitive medication in many cases, and if you can't get it within a certain time window, then you can't get that procedure, or then you can't manage your miscarriage appropriately. So we really wanted to dive in and find out which pharmacies had it and which didn't so we could inform everyone.
SHAPIRO: Have you had any pushback from state leaders who want to restrict access to this drug or said, why are you telling people where they can get a controlled dangerous substance?
AVEGNO: These pharmacies and many more not on our map carry controlled substances all the time. It's things like Valium, things like Percocet, Vicodin, opioids - right? - that we know have significant abuse potential, significant, you know, public health issues. And the interesting thing is that I could write a prescription today for Valium for a patient, and I have never gotten a call from the pharmacist wanting to confirm I was really writing it for the thing I said I was writing it for, right?
So these pharmacies do controlled substances all the time, and they do not enact this additional layer of barrier to really make sure that that prescription is what it says it is. And I think that just highlights when you put in a confusing, sort of nonscientifically based regulation on a medication, then you are introducing lots more fear. And what fear does is it makes people make it even harder to get the drugs that they need.
SHAPIRO: Now that Louisiana is several months into this reclassification of misoprostol as a controlled dangerous substance, what can you tell us about how that has changed the use of the drug in clinical settings?
AVEGNO: I know that our physicians are wonderful, and they are really committed to communicating and giving extra education to their patients about where to get the drug, how to get the drug and why they might be using it. I also know of physicians who have their own practices, who might have kept misoprostol on hand to facilitate procedures like IUD insertions or, you know, uterine scopes. Now they're not able to have that on hand, so they're limited in how they can care for their patients in these very, very routine ways, and that's frustrating to them.
You know, this is not the standard of care, and our physicians work every day to do everything they can to give the highest standard to their patients. But in this case, they're being restricted from doing so by the legislation.
SHAPIRO: That's Jennifer Avegno, director of the New Orleans Health Department. Thank you for speaking with us.
AVEGNO: Thank you so much, Ari. Transcript provided by NPR, Copyright NPR.
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