Women’s Health News

Women’s health news, information, and resources from a medical librarian

Archive for the 'Drugs' Category


OBOS Post: Expanded Discussion of Nitrous Oxide for Labor Pain Relief

Posted by Rachel on May 14, 2008

Today at Our Bodies Our Blog, we have additional discussion of a topic raised last week, nitrous oxide for pain relief in labor, including a lengthy commentary from midwife/epidemiologist Judith Rooks in reply to a comment left on the original post.

The original post linked above also has a bit of background on nitrous oxide and its popularity in other nations, and citations for additional reading.

Big thanks to Web Manager Extraordinaire Kiki Zeldes for coordination and editing on this one.

Posted in Access, Rights, & Choice, Birth, Drugs | No Comments »

Public Citizen Petitions FDA to Take Contraceptive Patch off the Market

Posted by Rachel on May 10, 2008

Now for something completely different, an organization is petitioning the FDA to take a contraceptive off the market, and it seemingly has nothing to do with religious/political ideology. Public Citizen is advocating for a phased withdrawal of the patch from the market, noting in their petition to the agency the increased estrogen exposure and risk of blood clots as compared with the pill. Earlier this year, the FDA revised the patch’s labeling to note these same issues. The organization argues that these increased risks come with no real improvement in pregnancy prevention.

I almost don’t know how to respond when an org wants the FDA to make a contraception decision and the argument has nothing to do with restricting access for purely ideological reasons. No, seriously, it’s been too long. ;)

Posted in Access, Rights, & Choice, Contraception, Drugs, Women's Health | 2 Comments »

Drug-Addicted Women Need Medical Care, Not Jail

Posted by Rachel on April 24, 2008

I want to spend some more time looking at research/writings on this topic in general, but at first blush I’m more than a little appalled by this story, in which a 7-month-pregnant Tennessee woman was taken to jail after seeking medical care for chest pains because she had cocaine in her system.

I think we can all agree that it’s better if pregnant women don’t use drugs that could potentially harm the fetus (although you might want to do a little reading about the myth of the crack baby and the racist/classist undertones that fueled that particular bit of hysteria), and we know that illegal drug use is, well, illegal, even if the particular laws are unjust or insensible. Let’s just start from those two bits of assumed shared knowledge, to avoid the “But it’s illegal!” comments that don’t really address the heart of the situation. We’ll get to that later.

To assume that hauling a pregnant woman to jail for drug use is the best option, you need to assume that:
-Treatment for drug addiction isn’t a better solution (both immediately and in the long term) than jail, either for the individual or for society.
-Jail provides some kind of incentive to cease drug use, and/or drugs are not available in prison.
-Jail/prison provides adequate healthcare that does not endanger the woman or fetus beyond what is experienced in her community.
-Policing pregnant women who are attempting to seek medical care won’t discourage future women from seeking care and further endangering women and fetuses.

That’s an awful lot of assumptions.

Obviously, there are some folks arguing that jail was appropriate because the rights of the fetus at some point trump the rights of the woman. Tennessee Right to Life’ president said, “If she used cocaine, she put her baby in jeopardy. It is child abuse. It certainly is.” I’d like to know where this would stop - if you ride in a car, go to work, go home to an abusive spouse, leave an abusive spouse, smoke a legal cigarette, drink a legal beer, live in a polluted neighborhood, and so on, you may “put your baby in jeopardy.” All of those items may result in the exposure of the fetus to potentially harmful actions or substances. If the “protect the baby at all costs” argument is to prevail and suggest that pregnant women willingly being exposed or exposing oneself to potentially harmful acts or substances constitutes “child abuse,” logically it must prevail not only for illegal potentially harmful exposures. The emphasis here is on “potentially,” because not every exposure of any of these substances/actions will result in adverse outcomes in the fetus.

However, if we put aside the question of the woman’s rights and decide we want to protect the fetus/child at all costs, is jail the right place for the pregnant woman, who carries the fetus? Medical care in jail/prison is notoriously bad, and completely inadequate for pregnant women, who may have complications and need immediately available specialized care. Likewise, this woman “faces one to two years of probation or jail” - does it make sense that it’s better to throw this woman away by sending her to jail, putting her kid in the system, rather than simply providing her the adequate medical care she needs to address her drug use issues? Is that best for the child?

The article on this story provides a pretty good snippet about concerns about discouraging care:

In addition to deterring women from seeking treatment, Mark J. Bliton, a Vanderbilt University associate professor of medical ethics, said arresting pregnant women doesn’t solve the problem. He said studies have shown that drug treatment is more effective than jail in preventing future drug use.

This is a misguided way to help the most vulnerable pregnant women and fetuses,” Bliton said. “The right way to handle this is to provide prenatal support and treatment.”

Bliton said he has grave concerns that Jones’ privacy rights may have been violated.

“In general, health-care information shouldn’t be shared with people who are not involved in providing health care,” he said.

Finally, back to the argument about “but cocaine is illegal!” The arresting deputy has stated that she never would have arrested the woman if she hadn’t been pregnant. The deputy attorney general has said that the woman might be charged with “reckless endangerment with a deadly weapon,” the weapon being cocaine. We are so not talking about the do drugs=go to jail issue here, it’s not even funny.

I am by no means the first person to talk about what a misguided approach this is. Please see the website of the National Advocates for Pregnant Women, especially their statement on pregnancy and drug use.

Recent related post: Pregnant Drug Users in Alabama Getting Jail Time Instead of Help

[Hat tip to Katie Allison Granju at Knoxville Talks]

Posted in Access, Rights, & Choice, Drugs, Ethics, Laws, Legislation, & Courts, Pregnancy, Women's Health | 11 Comments »

OBOS Post: More Controversy Surrounding Merck and Vioxx

Posted by Rachel on April 17, 2008

Yesterday at Our Bodies Our Blog, I posted a brief overview of the new debate about possible ghostwriting and data manipulation surrounding Merck and Vioxx, stemming from publications in the current issue of JAMA. Links to the freely available full-text investigations are provided, as is a timeline of Vioxx from approval to market withdrawal and beyond.

Posted in Drugs, Ethics | No Comments »

Our Daily Meds - Reporting Drug Reactions

Posted by Rachel on March 24, 2008

Over at Our Bodies Our Blog today, we’re talking about the new book, Our Daily Meds, as well as direct-to-consumer pharmaceutical advertising and ways to report serious reactions to your prescription drugs.

Posted in Drugs | No Comments »

Preliminary Discussion of Adverse Health Effects in DES Granddaughters

Posted by Rachel on March 18, 2008

If you’re not familiar with DES (Diethylstilbestrol), it’s a drug that was given to women to prevent miscarriages and premature births from 1938-1971, a practice that ended when the FDA issued a warning because of unusual vaginal cancers found in the daughters of women given the drug. The CDC estimates that “5-10 million pregnant women and the children born of these pregnancies were exposed to DES,” and that the grandchildren of these women are just now reaching an age at which third generation effects can be studied.

In fact, a CDC bibliography of research publications on effects in the 3rd generation currently includes only six papers. A newly released and very preliminary study in the journal Epidemiology suggests that ovarian cancer rates may be increased in these “DES granddaughters,” although it is based on only three cases. The authors clearly point out that “[the] finding may be due to chance or possibly to bias, and should be considered preliminary,” but that “our observation reinforces the need for continued follow-up of the third-generation women.”

More information for those who think they may have been exposed to DES is available from the CDC. To learn more about the history of DES, visit this page. It points out that “In 1953, published research showed that DES did not prevent miscarriages or premature births.” In other words, the drug was prescribed for nearly two decades after it was demonstrated that it did not work for its intended purpose.

Posted in Cancer, Drugs, Ethics, Pregnancy, Women's Health | 2 Comments »

Pregnant Drug Users in Alabama Getting Jail Time Instead of Help

Posted by Rachel on March 16, 2008

A recent New York Times article profiles the problem of pregnant drug users, focusing on an Alabama law used to jail the women and a district attorney who apparently believes this is a reasonable solution. An excerpt:

The environment can be unforgiving. Rachel Barfoot, 31, who had been charged before with beating her niece, told her probation officer that she was pregnant. When she tested positive for cocaine, she was arrested.

 

“I was in shock,” said Ms. Barfoot. “I told the truth, but the truth got me nowhere,” she said in an interview. Three months pregnant, already a mother of four, she spent five weeks in the Covington County Jail.

 

“It was hell,” said Ms. Barfoot, now jobless and struggling. Police affidavits make it clear that local doctors are cooperating in these investigations.

 

The women are sent off to county jails, state prisons, or drug rehabilitation clinics, and often emerge bitter at the collaboration of police, prosecutors, judges, doctors and social workers they say is less keen on help — Mr. Gambril insists otherwise — than punishment.

 

“In Covington County, I don’t think they’re interested in helping mothers,” Ms. Hitson said. “They’re just sending people straight to prison. It doesn’t help their drug problems.”

Although the article doesn’t point to the specific new law that is used to jail these women, but I assume it is Section 26-15-3.2 of Alabama code, which makes it a class C felony to “Knowingly, recklessly, or intentionally causes or permits a child to be exposed to, to ingest or inhale, or to have contact with a controlled substance, chemical substance, or drug paraphernalia as defined in Section 13A-12-260. A violation under this subdivision is a Class C felony.” This piece of law makes no distinction for pregnant women to take into account the dismal health care of prison and the inappropriateness of that environment for a pregnant woman. It also ignores the option of rehabilitation as a potentially more socially responsible fix, at least on a situation-by-situation basis. The article does note that some women have been sent to rehab, but the law as written doesn’t seem to specifically call for that option.

The times should have spoken with someone from National Advocates for Pregnant Women on this issue; the organization explains their position:

By combining claims of fetal rights with the war on drugs, new laws that punish pregnant women and families are being enacted and enforced. There is consensus in the medical community that addiction is a public health issue and that treating drug use during pregnancy as a crime undermines the health of both women and children. Yet fetal rights advocates in some states have convinced police, prosecutors, judges that addiction itself may be punished if the addict or drug user is a pregnant woman and that a pregnant woman’s addiction should be treated as a form of civil child abuse. These cases and statutes are having a devastating effect on women’s reproductive and human rights as well as public health, drug policy reform efforts, family life, and efforts for racial equality.

More information on this issue is provided at http://www.advocatesforpregnantwomen.org/issues/punishment_of_pregnant_women/

Posted in Access, Rights, & Choice, Birth, Drugs, Pregnancy | 15 Comments »

Drugs in the Drinking Water

Posted by Rachel on March 10, 2008

The findings, and what you can (okay, you can’t, really) do to avoid pharmaceuticals in your drinking water, today at Our Bodies Our Blog.

Oh, and there’s a link to the FDA document that lets you know how many insect parts and rodent hairs are allowable in your food, too.

Posted in Drugs | No Comments »

Dr. Rob’s Antibiotic Myths

Posted by Rachel on March 8, 2008

With $4 antibiotic prescription availability popping up everywhere, you might be tempted to ask for or take these drugs “just in case.” For many of your common ailments, however, they’re neither needed nor effective. “Dr. Rob” addresses this very issue in his piece (intended as a patient handout), Common myths about infections and antibiotics. His list of common misconceptions includes:

  • If mucous is green, it is time for antibiotics.
  • When a fever starts, it is time for antibiotics.
  • Sinus pain means you need antibiotics.
  • Bronchitis requires antibiotics.

See his post for explanations of these and other common myths, and why it’s important to use antibiotics appropriately.

The husband recently had a little bronchitis - he didn’t really need medical care, but did need a note for work (aggravating - sometimes bureaucracy overrides the best medical judgment, and common sense to boot). He was told to keep doing what he was doing (rest, liquids, a mucous loosener), and given, on a Friday, an antibiotic prescription, and was told *only* to use it if he didn’t get better. Sure enough, he was ready to work on Monday, prescription unfilled. Your mileage may vary, but do keep in mind Dr. Rob’s (and your own healthcare provider’s) advice. The CDC also has a good set of frequently asked questions to help people understand antibiotic resistance and the best use of the drugs.

Posted in Drugs, Infectious Diseases, Web Resources | 1 Comment »

If Mifepristone Were Really Like Ecstasy and Weed, It Would Probably Be *More* Popular

Posted by Rachel on March 7, 2008

As further proof that some people who want to restrict abortion access don’t bother with logical consistency, a bill that just passed in the Missouri house (and was intended to deal with the sale of drugs that can be used in meth production, such as cold medicines with pseudoephedrine) now has an amendment added by Rep. Ray Salva which adds mifepristone (a medical abortion drug) to the list of Schedule I Controlled Substances. The specific criteria for Schedule I is that the substance has high potential for abuse; and has no accepted medical use in treatment in the United States or lacks accepted safety for use in treatment under medical supervision. This class includes drugs such as ecstasy, heroin, marijuana, and LSD.

I wonder if the Representative knows that mifepristone is not only approved and legal for medical abortion, but can also be used for cervical ripening and induction of labor, either at term or following intrauterine fetal death? It’s not exactly a “street drug” with no accepted medical uses, and is not addictive.

The amendment is expected to be removed if it gets anywhere in the state Senate.

Related news coverage is available from the Kansas City Star and Missourian.

Posted in Abortion, Access, Rights, & Choice, Drugs, Government, Women's Health | 6 Comments »