Last Friday, Obama’s press secretary called this “the right, common sense approach.” It’s anything but. Think of all the drugs that wouldn’t be sold over the counter if the measure is whether a 10- or 11-year-old might misuse it. As three scientists wrote in the New England Journal of Medicine (including the journal’s editor), “a 12-year-old can purchase a lethal dose of acetaminophen in any pharmacy for about $11, no questions asked.” The common brand name for acetaminophen is Tylenol—swallow a bottle and you can die. The side effects of Plan B, by comparison, are nausea and delayed menstruation.
Other drugs that would have to be taken off the over-the-counter market if Sebelius actually applied the rule that she set: laxatives, cough suppressants, and analgesics (drugs for pain relief). Korman points out that in 2003, the FDA approved a heartburn medication for over the counter sale even though “safety in adolescents has not been established.” The agency merely required a warning label saying the drug hadn’t been approved for use by children or teenagers. The diet drug Alli is also for sale on the shelves under similar circumstances.
The singling out of Plan B for special restrictions, based on the faint possibly that a young girl will buy the drug with her Lifesavers, is blocking access for older teenagers and women, too. Korman cites a report from researchers for the Journal of the American Medical Association, who called around to pharmacies to ask for Plan B, saying they were 17. One in 5 stores said they didn’t have the drug on hand. And 19 percent said a 17 year old couldn’t buy Plan B at all. The rate of misinformation was highest in poor neighborhoods.
“This case is not about the potential misuse of Plan B by 11-year-olds,” Judge Korman baldly states. “The motivation for the secretary’s action was obviously political.” This was the first time a cabinet member had stepped in to block a decision by the FDA. Though Sebelius didn’t say so, it surely hasn’t helped Plan B (or other morning-after pills, like ella) that anti-abortion advocates claim that it works by preventing an embryo for implanting—in other words, that it’s not birth control, but rather an abortifacient. Again, as Pam Belluck detailed in this important article, the scientific evidence suggests otherwise, though it’s hard to do a study to definitively rule this out, so it’s a claim you’ll keep hearing.
Given the alarmist reaction to Judge Korman’s ruling, it’s not surprising that the Obama administration didn’t want to embrace greater access to Plan B in the middle of an election. That doesn’t make Sebelius’ decision any less disappointing, though. Every time a president sets himself against solid science, he makes it easier for the next administration to do the same. And crying wolf about child safety is especially bad in the realm of teen sex, where adult fears can block all kinds of sensible education and birth control efforts.
Now that the election is over, Judge Korman’s ruling offers the Obama administration an easy way out: All the government has to do is not appeal. That’s wimpy, but it will put Plan B on the drugstore shelves faster. Korman told the FDA to figure out how to do that within 30 days—an extremely unusual direct order that reflects Korman’s frustration level, since judges usually send administrative cases like this back to the agency to sort out next steps. As Amanda Hess pointed out on Slate, Plan B is already freely available in 63 countries, including Britain and France. It’s past time for the United States to put aside its prudishness and get on that list.
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