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A Louisiana law that reclassified abortion-inducing drugs 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 filed in Texas. Texas Rep. Pat Curry, a freshman Republican from Waco, said the intent of House Bill 1339 is to make it harder for people, especially teenagers, to order mifepristone and misoprostol online to terminate their pregnancies. Doctors in Louisiana say the measure has done little to strengthen the state’s near-total abortion ban, but has increased fear and confusion among doctors, pharmacists and patients. “There’s no sense in it,” said Dr. Nicole Freehill, an OB/GYN in New Orleans. “Even though we kept trying to tell them how often [these medications] are used for other things and how safe they are, it didn’t matter. It’s just a backdoor way of restricting abortion more.” These medications are often used to empty the uterus after a patient has a miscarriage, and are commonly prescribed ahead of inserting an intrauterine device. Misoprostol is also often the best treatment for obstetric hemorrhages, a potentially life-threatening condition in which women can bleed to death in minutes. Since the Louisiana law went into effect, hospitals have taken the medication off their obstetrics carts and put them in locked, password-protected central storage. One hospital has been running drills to practice getting the medications to patients in time, and reported, on average, a two minute delay from before the law went into effect, the Louisiana Illuminator reported. “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 clinician to jump through administrative hurdles in order to access a safe, effective medicine is not medically justified and is, quite simply, dangerous.” Curry said these restrictions won’t stop doctors from prescribing these medications when necessary, but will stop the “wide misuse” of the drugs to circumvent the state’s near-total abortion ban. Curry said he consulted with the author of the Louisiana law, as well as OB/GYNs in Texas to draft the bill. He said the doctors who have criticized the legislation are raising these concerns as a “smokescreen” because they don’t want more restrictions. “I understand that. We don’t need or want all kinds of regulations,” he said. “Especially as Republicans, regulations should not be high on our list, but in this case it’s a necessary evil given the situation.” 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 who was born 10 weeks premature. She survived, but has significant developmental delays, according to the Associated Press. Mason Herring was charged with felony assault to induce abortion, and pled guilty to injury to a child and assault to a pregnant person. He was sentenced to 180 days in jail and 10 years of probation. Catherine Herring’s experience led her brother, Louisiana state Rep. Thomas Pressly, to file a bill that would have made it a crime to coerce someone into having an abortion. But at the last minute, the bill was amended to also reclassify abortion-inducing drugs as controlled substances, according to the Louisiana Illuminator, leaving hospitals and doctors scrambling to comply with the new restrictions. The state health department advised storing the medication in a locked area on the crash cart, which at least some hospitals have said is not feasible. “We had to rework how we utilize misoprostol across our hospital systems,” Freehill said. “Labor and delivery, pharmacy, nursing staff, you name it, they were all involved with figuring out how to stay within the law but still use these medications that we need access to.” It’s rare for a state to decide on its own to classify a drug as a controlled substance. Most commonly, the federal government decides which medications should be “scheduled,” based on their medical usefulness and the potential for abuse. Schedule I drugs, like heroin, have no medical use and are often used recreationally; Schedule IV and V are medications that are useful but have a potential for abuse, like Xanax or Valium. There are enhanced penalties for having a controlled substance without a prescription, and increased restrictions on how doctors can dispense them. Pharmacists must report any prescriptions for controlled substances to the state Prescription Monitoring Program, and doctors are required to check the database before prescribing certain controlled substances. Law enforcement also has access to that database. Prescription monitoring has been key to combating the opioid epidemic by identifying doctors who were overprescribing and patients who were getting prescriptions from multiple providers. But with so much political attention on mifepristone and misoprostol as abortion-inducing drugs, doctors are worried about scrutiny for frequently prescribing these common medications. “We had to fix a problem that wasn’t broken,” said Freehill. “There’s no reason for it to be Schedule IV. It’s not something people abuse. It’s not something people can become addicted to. It’s extremely safe.” A group of Louisiana health care providers recently filed a lawsuit arguing the law discriminates against people who need mifepristone and misoprostol for other conditions, and challenging whether the last minute amendments to the bill were proper. Louisiana Attorney General Liz Murrill has said the new restrictions are clear and should not delay care. Those who “have attempted to sow confusion and doubt,” she said in a statement, “profit from misinformation.” When the law first went into effect, Anna Legreid Dopp, senior director of government relations for the American Society of Health-System Pharmacists, told CNN that the group expected other states to consider similar measures. “Almost immediately, our members raised concern that if this is being done in one state, it can easily be a template for other states to use it,” Dopp said. Curry, who recently won a special election to fill the seat long held by Republican Rep. Doc Anderson, said Pressly and Herring have offered to come testify in support of his bill this session. He anticipates it getting wide support from his fellow lawmakers. Since the overturn of Roe v. Wade, conservative groups have turned their attention to restricting access to abortion-inducing medications. A group of anti-abortion doctors filed a lawsuit to revoke the Food and Drug Administration’s approval of mifepristone, which the U.S. Supreme Court ultimately rejected. Curry said there are reasons to keep these medications on the market beyond abortion, but they need tighter restrictions. “You can lie about your age, you can lie about your name, you can lie about your address, there's no verification whatsoever,” he said, referring to online prescribers. “And it gets shipped to a 15-year-old girl, a 13-year-old girl.” It is already a crime to mail abortion-inducing medications in Texas, and many of the online pharmacies operate in a legal gray area outside U.S jurisdiction. Others are working in states that have “shield laws” that protect doctors’ ability to prescribe and mail pills into states that have banned abortion. None of these interstate and international legal questions have been tested in court with regards to abortion. Freehill said she would encourage Texas doctors to learn from what has happened in Louisiana as they prepare to advocate against this bill this session. “There's a lot of education that needs to be done surrounding what this means and what these drugs are really used for,” she said. “I don’t know that we would have been able to sway people, even with more time, but we can at least educate on why this is completely inappropriate and really governmental overreach.” This article originally appeared in The Texas Tribune at https://www.texastribune.org/2024/11/25/abortion-texas-pills-controlled-substance/ . The Texas Tribune is a member-supported, nonpartisan newsroom informing and engaging Texans on state politics and policy. Learn more at texastribune.org .MongoDB (NASDAQ:MDB) Reports Strong Q3, Stock Jumps 10.4%
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Why Miami’s Pop-Tarts Bowl appearance is important even after missing College Football PlayoffNoneAnother Marshon Lattimore update makes the Saints look like they knew more than anyone expectedForeign governments, including Russia, Iran, China and Israel, have responded to the fall of Syrian President Bashar al-Assad on Sunday. On Saturday evening and Sunday morning, Syrian rebels streamed into their country's capital of Damascus as the 24-year-old regime of President Assad reportedly collapsed with Reuters reporting that Assad had fled the city. The head of Syria's main opposition group abroad, Hadi al-Bahra, declared that Damascus is now "without Bashar al-Assad." The government evacuated the Damascus airport and halted all flights, according to pro-government radio station Sham FM. In response, several foreign countries are addressing the recent developments and are reaffirming the safety of their citizens in Syria. In a statement on Sunday the foreign ministry of Russia, a key Assad ally, said it was "closely following the dramatic events in Syria" and urged everyone "to refrain from using violence and resolve all issues through political means." It commented: "As a result of negotiations between B. Assad and a number of participants in the armed conflict on the territory of the Syrian Arab Republic, he decided to resign from the presidency and left the country, giving instructions for a peaceful transfer of power. Russia did not participate in these negotiations." In addition, according to the Moscow Times, Senator Konstantin Kosachev said the main priority for Moscow is "to ensure the safety" of Russian citizens in Syria. "For us, as Russians, the primary task is to ensure the safety of our compatriots and civilians, including diplomats and their families,"Kosachev said. Later on Sunday, the Associated Press reported via Russian media that Assad fled to Moscow on Sunday. The Russian agencies, Tass and RIA, cited an unidentified Kremlin source on Assad and his family being given asylum in Moscow, his longtime ally and protector. The Associated Press was not immediately able to verify the reports. Meanwhile, Iran has also responded, in a statement released on Sunday the Iranian Foreign Ministry reaffirmed Iran's policy to respect the unity, national sovereignty and territorial integrity of Syria, according to Tasnim, adding that only Syrians can decide the future of their country. In addition, Esmaeil Baqaei, spokesperson for the Iranian Foreign Ministry, announced on Sunday that they are ensuring the safety and security of the Iranian embassy staffers in Damascus, Tasnim reported. China's foreign ministry said in a statement it "is closely following the development of the situation in Syria and hopes that Syria returns to stability as soon as possible," according to Hong Kong Free Press. "The Chinese government has actively assisted Chinese citizens who are willing to leave Syria in a safe and orderly way and has maintained contact with... Chinese citizens who remain in Syria," the ministry said. It comes after China's ties to Syria have grown in recent years as Chinese President Xi Jinping and Assad announced a "strategic partnership" between their countries during Assad's trip to China in 2023. This is a historic day for the Middle East. The collapse of the Assad regime, the tyranny in Damascus, offers great opportunity but also is fraught with significant dangers. We send a hand of peace to all those beyond our border in Syria: to the Druze, to the Kurds, to the... pic.twitter.com/yJZE3AZZJn Meanwhile, Israeli Prime Minister Benjamin Netanyahu celebrated the fall of al-Assad during a visit to the Israeli controlled Golan Heights, along the border with Syria, on Sunday. According to an Israeli government press release, Netanyahu and his Defense Minister Yisrael Katz received a briefing from Major General Ori Gordin, who heads the Israel Defense Forces' (IDF) northern command, on the latest developments in Syria as Netanyahu said it was "a historic day in the history of the Middle East." He added: "The Assad regime is a central link in Iran's axis of evil—this regime has fallen. This is a direct result of the blows we have inflicted on Iran and Hezbollah, the main supporters of the Assad regime. This has created a chain reaction throughout the Middle East of all those who want to be free from this oppressive and tyrannical regime." Newsweek has reached out to foreign ministries of Russia, Iran, China, and Israel via email for comment. Assad's fall came after his main backers, Russia, Iran and its Lebanese ally Hezbollah, were either distracted or weakened by other conflicts. Since February 2022, Russia has been embroiled in a brutal war against Ukraine, while Hezbollah has suffered severely over the past few months in an Israeli campaign which killed the group's leader Hassan Nasrallah in September . Since the Syrian Civil War erupted in 2011, Israel has periodically carried out airstrikes targeting Iranian aligned militant groups and Iran's Islamic Revolutionary Guard Corps in the country. Israeli jets have also repeatedly targeted what they claimed were arms shipments being moved through Syria to Hezbollah. Meanwhile, following the fall of Damascus, President elect- Donald Trump mentioned several of these countries as he called for a ceasefire between Russia and Ukraine in a post on his Truth Social website. Trump said: "Assad is gone. He has fled his country. His protector, Russia, Russia, Russia, led by Vladimir Putin , was not interested in protecting him any longer. There was no reason for Russia to be there in the first place. They lost all interest in Syria because of Ukraine, where close to 600,000 Russian soldiers lay wounded or dead, in a war that should never have started, and could go on forever." "Russia and Iran are in a weakened state right now, one because of Ukraine and a bad economy, the other because of Israel and its fighting success. Likewise, Zelensky and Ukraine would like to make a deal and stop the madness. They have ridiculously lost 400,000 soldiers, and many more civilians." The president-elect concluded: "There should be an immediate ceasefire and negotiations should begin. Too many lives are being so needlessly wasted, too many families destroyed, and if it keeps going, it can turn into something much bigger, and far worse. I know Vladimir well. This is his time to act. China can help. The World is waiting!" President Joe Biden spoke Sunday at the White House about Assad's fall. "After 13 years of civil war in Syria, more than half a century of brutal authoritarian rule by Bashar al-Assad and his father before him, rebel forces have forced Assad to resign his office, flee the country...At long last the Assad regime has fallen," Biden said.