Why Has The Misleading Chemical Imbalance Theory of Mental Illness Persisted For So Long

Recently, one of my friends messaged frantically, asking if I had seen the big serotonin study that had been published by scientists at University College London. The study, an umbrella review critically evaluating pre-existing research, concluded that there was little support for the idea that depression was related to abnormally low levels of serotonin. As a philosopher of medicine and psychiatry, I had to confess that I had seen the study and was utterly unsurprised at the results.

It’s true that the authors of the study are controversial figures, vocal to sometimes vituperative critics of the mental health status quo, leaving heated debates in their wake with each new publication. But the authors’ conclusion has been an open secret within mental health circles for at least a decade. The very public dispelling of this “serotonin model” has also removed a key plank in the widely believed but oversimplified myth of mental illness being caused by a “chemical imbalance.” My friend was devastated.

The chemical imbalance myth has its roots in the late ’70s and ’80s when psychiatry was dominated by the desire to understand mental illness in primarily biological terms—as deviations in brain structure, neurochemistry, and genetics. When the first generation of selective serotonin reuptake inhibitors (or SSRI) antidepressants such as Prozac was introduced in the late ’70s, a key part of their marketing claimed that they targeted specific neurochemical imbalances.

Psychiatry is now interested in a wider range of factors contributing to mental illness—including genetics, gut microbiome, environmental influences, socioeconomic factors, and interpersonal stressors—and the marketing of psychiatric drugs is more tightly regulated.

However, as the authors of the new study point out, this initial starting point has already crept into everything from public health messaging to popular websites. For instance, though the American Psychological Association takes no stance on the serotonin model when describing SSRIs, Australia’s Department of Health, describes antidepressants in terms of the chemical imbalance model.

In the past year, 8.3 million people in the U.K. (about 12 percent of the population) took antidepressants. The most recent figures from the United States, collected between April and May by the National Center for Health Statistics, show that approximately 23 percent of adults took prescription medication for their mental health.

The vast majority of these prescriptions, including the one taken by my friend, are for SSRIs. And it’s no surprise that many people who have been prescribed an SSRI believe that they work by increasing the availability of serotonin, thereby correcting the abnormally low levels of serotonin responsible for her depression. Finding out that this story of how SSRIs work was unsubstantiated made her question whether she should be taking them in the first place.

This is a common reaction. As I write this, my social media channels are full of patients who say they now want to stop taking SSRIs. The response by concerned mental health professionals and skeptical commentators has been twofold: First, they are poking holes in the study—usually an important part of scientific method. But in this case I suspect it is sort of pointless, given that many experts already thought the serotonin model to be a nonstarter, and this is a review of existing work rather than new research. Second, they are correctly noting that though we are unsure how SSRIs and other psychiatric drugs work, we have reason to believe that they do—an important distinction.

Medical treatments, including psychiatric drugs, are primarily tested for efficacy, usually via randomized controlled trials rather than more primary research into how or why they work. In many ways, this makes sense: When there is a problem, especially with one’s health, the priority is fixing the problem rather than working out why this particular fix works. Indeed, there are many common medicines and treatments where we are not entirely sure how they work, despite being fairly certain that they do—including acetaminophen (or, as we call it in the U.K., paracetamol).

There are many people who swear SSRIs have improved their lives, and pooled reviews and meta-analyses point toward their efficacy. Based on such reviews,  they are recommended treatments for depression (and a host of other mental illnesses) via the U.K.’s National Health Service and the American Psychological Association. On the other side, critics point to a number of deep issues with this research such as the failure to publish negative results, the fact that trials tend to be funded by pharmaceutical companies, and the exclusion of severely depressed patients from the trials.

And then there is the perennial problem of taking experimental results about a broader population or group and applying them to a particular individual. I am inclined to think the debate over the efficacy has distracted from the main point of the study—in the case of mental health, how and whether something works both matter.

In many ways my friend and I are very similar: prone to severe depression, from the same ethnic background, of similar ages, both philosophers. We have both spent the vast majority of our adult lives in precarious environments that incentivized a certain kind of relentless pursuit of achievements. But unlike my friend, I made the choice, not just once but at many critical junctures in my life, not to take antidepressants. Because I knew that depression doesn’t necessarily come from a chemical imbalance, I knew that SSRIs would hardly be a silver bullet or the only thing that would help.

I also thought about what side effects they would have. One of the primary reasons I avoided antidepressants is because a common side effect of SSRIs is disruption to sleep. My mood is very responsive to sleep, and I worried that I would just be creating a whole new set of problems for myself; a number of people end up with prescriptions for both sleeping pills and SSRIs. The possibility of sleep disruptions, the fact that my mood was very responsive to other interventions, and other potential side-effects led me to my decision.

I do not think there is a correct answer to the question of whether any particular individual should take SSRIs. I can imagine someone in my shoes whose symptoms were more severe and had tried other options making a different decision. But the persistence of the chemical myth of depression obfuscates this kind of decision-making. Though mental health professionals and academic researchers understand the distinction between whether and how a treatment works, these two things come hand in hand for patients, and it has been disingenuous to pretend otherwise.

One of the main reasons my friend was so upset about the serotonin study was because she was now left with a great many questions. If she wasn’t depressed because of serotonin levels, how was she to understand her propensity to depression? Was something else wrong with brain? Her genetics? Most heartbreakingly, she wondered whether it was that she was simply weak. The serotonin model of depression had not only played a part in her decision to take antidepressants; it shaped how she thought about herself.

I have spent a great many years biting my tongue when friends or acquaintances described their depression in terms of chemical imbalances. I hesitated in part because I was fearful of affecting their treatment, something I did not feel professionally qualified to weigh in on. But my biggest fear was intruding on the way in which they understood themselves and their lives.

Because I have seen myself and my tendency toward depression in different terms, the results of the study have not disrupted my understanding of myself. Though I have sometimes wondered why I seem more inclined to low mood than other people and idly wonder whether it some variation in my particular neurochemistry or genetics, for the most part, when I am going through a depressive period, I recognize its relationship to something that is happening in my life which needs resolving or the fact that I work in a particularly demanding field.

I am not suggesting that SSRIs prevent people from considering what might underlie their depression, or that in all cases depression is situational. But when such a compelling story is put forward by authoritative sources, one that explains so tidily why someone feels the way they do and what can be done about it, people tend not to look elsewhere for explanations or solutions. Just as the chemical imbalance myth has clouded making choices about treatment, it has altered how people understand themselves and their lives.

It is a platitude to say that different treatments work for different people, but I find it interesting that both me and my friend have ended up in similar contented places. One of the reasons the study has been so painful for so many people is the sheer variety of experiences. Those who, like me, have refrained from taking SSRIs feel faintly resentful for the many years that they have been made to feel irrational about their choice.

More tragic are the people like my friend who are now questioning their choices and their understanding of themselves. More tragic still are those patients who had an adverse reaction to SSRIs and have spent many years trying to make the psychiatric establishment acknowledge the myth and the way in which it has hidden the trade-offs associated with SSRIs and other psychiatric drugs. Then there are the many patients for whom SSRIs have been beneficial and continue to advocate for their use in the fear that others will miss out on life changing treatment.

On the other side of the fence, I have colleagues I trust and respect with a wide spectrum of views. What is striking is that once you put the bruised egos and the usual financial vested interests aside, the debates, vicious as they are, seem mostly conducted in utter good faith. Both sides convinced that the other is not only mistaken but in danger of harming vulnerable patients either by peddling dangerous, ill-evidenced treatments or through vilifying treatments that many had found helpful. Though it has been upsetting, I cannot help but find it moving that for most parties involved, the priority is the patient and their well-being.

State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system—and how to make it better.

By Sahanika Ratnayake

Source: Why has the misleading chemical imbalance theory of mental illness persisted for so long?

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What Is Naloxone? Where To Get Narcan And How To Reverse Overdoses

The overdose crisis continues to worsen in the U.S., and overdose deaths reached an all-time high in 2021. Experts say that a simple drug — naloxone — is a key tool in preventing more deaths. But not enough people know about it, have access to it or actually carry it with them.

“Naloxone is a miracle drug,” Dr. Kimberly Sue, medical director for the National Harm Reduction Coalition and associate professor of medicine at Yale School of Medicine, told TODAY. “It’s literally a Lazarus drug that prevents people from dying of an opioid overdose.”

And in the midst of the overdose crisis, which claimed nearly 108,000 lives just last year, getting naloxone to those who need it is vitally important. Here, experts discuss what naloxone is, how to get it and how it can save lives.

How does naloxone work?

Naloxone, also referred to by the brand name Narcan, is what experts call an opioid antagonist, Dr. Sarah Wakeman, medical director for the Massachusetts General Hospital Substance Use Disorder Initiative, told TODAY. Narcan is not the only branded naloxone product; a high-dose nasal spray called Kloxxado works similarly, according to the FDA.

That means it “binds to the opioid receptors in the brain — the same receptors that opioid drugs or medications like oxycodone or heroin or fentanyl bind to — and then blocks those receptors,” Wakeman explained. In the event of an opioid overdose, naloxone “can actually kick off the opioid from the receptor, reverse the acute effects of an opioid overdose and save someone’s life.”

A standard dose of naloxone is effective against even fentanyl, Wakeman said. If they’ve taken an opioid and something else, or if they took something like cocaine that was tainted with illicit fentanyl, naloxone will still work against the opioid in their system.

“And naloxone won’t be harmful to someone who doesn’t have an opioid in their body,” Wakeman said. “So if there’s a possibility that you think someone is having an overdose … then it is always a good idea to give naloxone.”

When should naloxone be given?

Before using naloxone, check to see if someone has the telltale signs of an overdose, Dr. Ayana Jordan, an addiction expert and associate professor of psychiatry at NYU Grossman School of Medicine, told TODAY. She pointed to the Center for Disease Control and Prevention‘s tips to learn about the signs of an overdose.

According to the CDC, someone having an overdose may have:

  • Loss of consciousness.
  • Weak, slow or no breathing.
  • Small or constricted pupils.
  • Choking or gurgling sounds.
  • Limp body.
  • Clammy or cold skin.
  • Blue or discolored skin, especially around the lips. (However, Jordan notes that this may not apply to people with darker skin.)

In general, someone who is in the midst of an overdose will “have slowed and very shallow breathing to the point that, ultimately, they’ll stop breathing,” Wakeman said. “So they may look blue or cold and not be responsive.”

Giving someone naloxone

Once you’ve identified that someone might be having an overdose, you should call 911, the CDC says. Even if you’re able to reverse the overdose, they will likely still need emergency services. (Some states, but not all, have Good Samaritan laws, which protect people calling for medical help from some drug-related charges, Sue explained.)

From there, the right way to use naloxone depends on the specific formulation you’re using. For most people, that will likely be the nasal spray called Narcan, Wakeman said. In the hospital, naloxone may be given through an IV or as an injection into the muscle, she added.

After administering naloxone, the person should wake up within seconds to minutes, Wakeman said. And you should always start with as low a dose as possible. If someone is a regular opioid user and you give them a massive dose of naloxone all at once, “they’re going to immediately go into withdrawal,” Wakeman explained. While that isn’t necessarily harmful, it is pretty unpleasant and uncomfortable.

After giving someone naloxone, you should stay with them if you can until emergency medical help arrives. “Naloxone works very quickly, but it also wears off very quickly,” Wakeman said. In fact, the effects of naloxone can wear off within 30 minutes. And if someone still has the other opioid in their system, they may fall back into an overdose after the naloxone has worn off.

Where to get naloxone

If you use drugs, your doctor may give you a naloxone prescription as a regular part of their practice. “I make sure that everyone that sees me gets prescribed naloxone and that they understand how to use it,” Jordan said.

Depending on the state, you may be able to get naloxone at a local pharmacy without a prescription through the use of a standing order, Wakeman noted. (Standing orders allow pharmacies to give out prescription medications, like the annual flu vaccine, without requiring each individual person to have their own prescription.)

Another option is to connect with local harm reduction groups in your area, which frequently hand out naloxone kits, Wakeman said. These community-based organizations may also offer in-person or virtual trainings on how to use naloxone. Jordan noted that her research group also does large virtual naloxone training sessions for people who participate in their studies looking at drug use.

If you live in a state without a standing order and want to get naloxone to use on someone else, you can likely get a third-party prescription through a doctor, Sue said. She recommended looking at the local health department’s website for more information about where to get naloxone in your area.

It’s most important for people who use drugs to have access to naloxone. But if you know someone who uses drugs, you should consider carrying naloxone, too, the experts said. “Carrying naloxone is no different than carrying an epi-pen,” Jordan said.

And even though there are several ways to get naloxone now, there are still barriers to actually accessing and using it, Sue explained. She recalled a story of pharmacy staff being simply unaware of the standing order for naloxone, for instance, and noted that harm reduction groups are experiencing an ongoing naloxone shortage.

Additionally, naloxone is something that, by definition, people can’t use on themselves in the event of an overdose, Sue said. (If you are going to use by yourself, Sue recommended calling the Never Use Alone hotline so there is someone who can notify emergency services if you lose consciousness.)

Naloxone is a crucial tool in reducing overdose deaths, experts say

“Really, no one should die from an opioid overdose,” Wakeman said. “Not only do we know how to prevent overdoses and how to treat people who have an opioid use disorder, but we also have this life-saving, immediately-acting medication that will quickly reverse the effects of an opioid overdose.” 

The challenge for experts now is to make naloxone more accessible to those who need it. “There’s no moral or medical reason to keep this life-saving medication behind the counter,” Dr. Bobby Mikkamula, chair of the American Medicine Association’s Substance Use and Pain Care Task Force, told TODAY.

Earlier this year, AMA urged the Biden administration to remove naloxone’s prescription status, which would make it available over-the-counter. “It’s not the kind of thing that needs to be protected or that people need to be protected from,” Mikkamula said. “This saves their lives, and the fewer barriers we have to getting this into their hands and into their medicine cabinets, the better.”

For Jordan, the importance of naloxone comes down to one simple truth: “I can’t help people who are dead,” she said.

By

Source: What Is Naloxone? Where To Get Narcan And How To Reverse Overdoses

Related links:

Overdose Deaths Behind Bars Rise as Drug Crisis Swells The Good Men Project

Report details Alaska demographics hurt most by 2021 spike in drugoverdose deaths Alaska Public Media

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13:02 Fri, 29 JulOpioid Crisis Fentanyl
15:34 Mon, 25 JulNative Americans Pandemic Racism
01:14 Thu, 21 JulNative Americans CDC Alaska
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FatBlaster Max Has Just Been Banned Here’s Everything You Need To Know About Diet Supplements

Australia’s regulator has banned FatBlaster Max, an over-the-counter pill that claimed (with no evidence) to be able to help you lose weight. FatBlaster Max can no longer be purchased, after the Therapeutic Goods Administration (TGA) found the company behind the pills registered the medicine with no mention of weightloss properties and failed to produce any evidence substantiating its advertised claim it led to weight loss.

The ban has put over-the-counter weightloss pills back in the spotlight, shining light on an unregulated area that is immensely popular. Studies show one in seven people have tried an over-the-counter weightloss pill, undoubtedly enticed by their promises of helping people lose weight easily and rapidly. But do over-the-counter weightloss pills really work? Here’s everything you need to know about the weightloss supplements currently claiming a big share of Australia’s billion-dollar weight-loss industry.

What exactly are over-the-counter weightloss pills?

Broadly speaking, over-the-counter pills are anything you buy from a pharmacist without a prescription, like cold and flu remedies and paracetamol. Some over-the-counter medications are also available at retailers like supermarkets, service stations and health food stores. Over-the-counter weightloss pills are essentially dietary and herbal supplements marketed and sold with claims of assisting with weight loss.

The important distinction between over-the-counter weightloss pills and weightloss medications prescribed by a doctor is that prescription weightloss drugs – like all pharmaceutical drugs – must go through clinical trials and provide Australia’s drug regulator with evidence of their effectiveness and safety. Worryingly, the distributors of over-the-counter diet pills and supplements are not required to produce any evidence of their products’ efficacy and safety before they hit the Australian market. The TGA only requires them to hold, but not necessarily make freely available, evidence substantiating their claims.

How do over-the-counter weightloss pills help you lose weight?

Over-the-counter weightloss pills usually claim to have several herbal or natural ingredients that help you lose weight in one of four ways:

  1. by suppressing your appetite or making you feel full using ingredients like a tropical fruit called Garcinia cambogia or glucomannan, a dietary fibre made from the root of the konjac plant
  2. by speeding up your metabolism and your body’s ability to burn fat using components like the herb Ephedra sinica or a fatty acid (conjugated linoleic acid) found in meat and dairy products
  3. by blocking your body’s ability to digest things like carbohydrates and fat using Phaseolus vulgaris (also known as the common bean) or a variety of green tea leaf called Camellia sinensis
  4. by absorbing fat in the foods you eat, relying on ingredients like chitosan, a product created using the shells of crustaceans and insects.

Do these weightloss pills work?

In a word: no.

Most advertising for over-the-counter weightloss pills and dietary supplements will proudly claim a product’s results are backed by “clinical trials” and “scientific evidence”, but the reality is a host of independent studies don’t support these claims.Two recent studies by the University of Sydney examined data from more than 120 placebo-controlled trials of herbal and dietary supplements for weight loss, including products featuring the ingredients described above. None of the supplements provided clinically meaningful weight loss.

If they don’t work, why are they allowed to be sold?

Given there are few to no checks and even less accountability when compared to prescription weightloss drugs, the researchers’ findings should come as no surprise.

Recent studies suggest weightloss supplement companies have conducted very few high-quality studies. Many trials are too small, poorly designed and don’t accurately report the composition of the supplements being investigated. This is because there are no guidelines currently covering how these types of trials should be conducted.

The good news is the Australian regulator is taking some action on the claims made by distributors of these weightloss supplements, with the TGA recently banning the sale of FatBlaster Max. While the reality is the most likely thing to be damaged by over-the-counter weightloss pills is your hip pocket, the TGA’s action also serves as an important reminder that the safety of over-the-counter weightloss supplements can never be guaranteed.

Several products have been banned from sale around the world after causing serious health problems. This includes the TGA and America’s Food and Drug Administration banning dietary supplements containing ephedra in 2018, when supplements containing this stimulant herb were associated with cases of heart attack, seizure, stroke and sudden death.

Real harm is also caused by the over-the-counter weightloss industry feeding on people’s desire for a quick fix to achieve rapid weight loss. The reality is there is no wonder pill. Losing weight and achieving lasting results comes down to: following evidence-based care from health-care professionals and making meaningful changes to your diet, exercise and lifestyle that you can sustain for life. A spokesperson for FatBlaster said the company is disappointed with the TGA’s decision and it is evaluating options for next steps.

It said the TGA’s requirements had changed during the years that FatBlaster Max Tablets have been on the market and the company has taken great care to update all packaging, advertising and claims to ensure compliance with these requirements. The listing cancellation does not impact the wider FatBlaster range.

By :

Source: FatBlaster Max has just been banned. Why? Here’s everything you need to know about diet supplements

Critics  Mayo Clinic Staff

Are you an adult who has serious health problems because of your weight? Have you tried diet and exercise but haven’t been able to lose enough weight? If you answered yes to these questions, a prescription weight-loss drug may be an option for you. You should know, however, that prescription weight-loss drugs are used in addition to — not instead of — diet and exercise.

Who is a candidate for weight-loss drugs?

Your doctor may consider a weight-loss drug for you if you haven’t been able to lose weight through diet and exercise and you meet one of the following:

  • Your body mass index (BMI) is greater than 30.
  • Your BMI is greater than 27 and you have a serious medical problem related to obesity, such as diabetes or high blood pressure.

Before selecting a medicine for you, your doctor will consider your history and health challenges. Then your doctor will talk with you about the pros and cons of prescription weight-loss drugs. It’s important to note that weight-loss drugs aren’t for everyone. For example, prescription weight-loss drugs shouldn’t be used if you’re trying to get pregnant, are pregnant or are breast-feeding.

How well do weight-loss drugs work?

Prescription weight-loss drugs approved for long-term use (more than 12 weeks) produce significant weight loss compared with placebo. The combination of weight-loss medication and lifestyle changes results in greater weight loss than lifestyle changes do alone. Over the course of a year, that can mean a weight loss of 3% to 7% of total body weight above that achieved with lifestyle changes alone. That may seem like a modest amount. But a sustained weight loss of 5% to 10% can have important health benefits, such as lowering blood pressure, blood sugar and triglyceride levels.

What you should know about weight-loss drugs

Mild side effects, such as nausea, constipation or diarrhea, are common. They may lessen over time. Rarely, serious side effects can occur. For this reason, it’s important to thoroughly discuss treatment options with your doctor.Weight-loss drugs can be expensive and aren’t always paid for by insurance. Ask your insurance company about coverage. Many people gain back some of the weight they lost when they stop taking weight-loss drugs. However, adopting healthy lifestyle habits may help limit weight gain.

How long does drug therapy last?

How long you’ll take a weight-loss drug depends on if the drug helps you lose weight. If you’ve lost enough weight to improve your health and you haven’t had serious side effects, your doctor may suggest that you take the drug indefinitely. If you haven’t lost at least 5% of your body weight after three to six months on the full dose of a drug, your doctor will probably change your treatment and may switch you to a different weight-loss drug.

What drugs are approved for weight loss?

Four weight-loss drugs have been approved by the U.S. Food and Drug Administration for long-term use:

  • Bupropion-naltrexone (Contrave)
  • Liraglutide (Saxenda)
  • Orlistat (Xenical)
  • Phentermine-topiramate (Qsymia)

Most prescription weight-loss drugs work by decreasing appetite or increasing feelings of fullness. Some do both. The exception is orlistat. It works by interfering with absorption of fat.

Bupropion-naltrexone

Bupropion-naltrexone is a combination drug. Naltrexone is used to treat alcohol and opioid dependence. Bupropion is an antidepressant and quit-smoking aid. Like all antidepressants, bupropion carries a warning about suicide risk. Bupropion-naltrexone can raise blood pressure, and monitoring is necessary at the start of treatment. Common side effects include nausea, headache and constipation.

Liraglutide

Liraglutide is also used to manage diabetes. Unlike other weight-loss drugs, liraglutide is given by injection. Nausea is a common complaint. Vomiting may limit its use.

Orlistat

Orlistat is also available in a reduced-strength form without a prescription (Alli). Orlistat can cause bothersome gastrointestinal side effects, such as flatulence and loose stools. You need to follow a low-fat diet when taking this medicine. Rare cases of serious liver injury have been reported with orlistat. However, no cause-and-effect relationship has been established.

Phentermine-topiramate

Phentermine-topiramate is a combination of a weight-loss drug (phentermine) and an anticonvulsant (topiramate). Phentermine has the potential to be abused because it acts like an amphetamine. Other possible side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Topiramate increases the risk of birth defects. Phentermine by itself (Adipex-P, Lomaira) is also used for weight loss. It’s one of four similar weight-loss drugs approved for short-term use (less than 12 weeks). The other drugs in this group aren’t widely prescribed.

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As Medication Abortion Becomes Dominant, Red States Restrict Pills

The abortion drug mifepristone was approved by the FDA more than 20 years ago. The FDA recently relaxed some of the rules for dispensing the drug. Now, some legislatures are trying to restrict access.

For most of the almost 50 years since the Roe v Wade Supreme Court decision legalized abortion nationwide, clinics have been the focus of the battle over abortion rights.

Protesters gather outside on sidewalks. And Republican state lawmakers try to regulate what happens inside — through laws restricting which healthcare providers can perform abortions, the kind of counseling required and which procedures are allowed.

But now, more than half of abortions are taking place with pills.

According to data released by Guttmacher earlier this year, abortion pills – not surgical procedures – accounted for 54 percent of abortions in 2020. That makes medication abortion the dominant choice in the United States for the first time since the Food and Drug Administration approved an abortion pill, mifepristone, more than 20 years ago. It’s part of a two-drug protocol approved to terminate pregnancies up to 10 weeks gestation. That protocol also is prescribed to manage some miscarriages.

During the pandemic, the FDA relaxed rules so that the tightly regulated drug mifepristone could be obtained through telehealth appointments and mail-order pharmacies, rather than in person. That made it easier for patients in some states to get a medication abortion at home. The Biden administration recently made those changes permanent.

Now, Republican lawmakers in several states are pushing back. In South Dakota, Gov. Kristi Noem recently signed legislation designed to restrict access to the drugs.

Already, more than a dozen states restrict limit the use of telemedicine to provide abortion pills. And this year, Planned Parenthood says new restrictions have been introduced in two dozen states, some of which would ban the pills altogether if Roe v Wade is overturned.

In Georgia, Republican state Sen. Bruce Thompson sponsored SB 456, a bill banning abortion pill delivery by mail and requiring doctors to examine patients in person before prescribing them. During floor debate, Thompson said his bill was intended “to protect the cherished doctor-patient relationship.”

But that position is at odds with that of major medical groups, including the American College of Obstetricians and Gynecologists and the American Medical Association, who’ve long supported easing access to the pills and called for lifting the in-person dispensing requirement.

Thompson opposes abortion rights, but he claims this bill is all about patient safety.

“Why would we not do everything within our power to protect women’s health and safety during this difficult time in their lives?” he said.

But opponents say the bill would make patients less safe. Several lawmakers noted that Georgia is among the states with the highest rates of maternal mortality – and that those death rates are dramatically higher for Black women.

State Sen. Kim Jackson, a Democrat, noted that many people, particularly in rural areas, lack access to pregnancy care.

“What’s really cruel about this bill is that those who are already the most vulnerable are the ones who are most likely to be burned by this injustice,” Jackson said. “People who are poor, people who live in rural communities. People with disabilities, and people of color.”

The bill passed Georgia’s state senate on March 1 and is awaiting a vote in the House.

“As soon as the FDA made medication abortion more accessible, Georgia pretty much turned around and was like, ‘No, we actually want to make it really difficult for people to get one,'” said K. Agbebiyi, a Georgia-based advocate with the reproductive rights group URGE, which is fighting the bill.

Agbebiyi said medication abortion could become the only option for a growing number of people in states where clinics are few and far between because of abortion restrictions.

“We know, and our opponents know, that medication abortion is going to grow in popularity if Roe is overturned,” Agbebiyi said. “And that’s precisely why they’re trying to put as many barriers in place as possible.”

It’s more difficult to put up barriers on the internet, where abortion pills are available through mail-order pharmacies and other groups.

Ushma Upadhyay, a reproductive health researcher at the University of California, San Francisco, warned that if states try to block access to abortion pills, patients will find them online without a doctor’s help.

“That is what I’m concerned about,” she said. “It is extremely safe, but all patients should have the access to clinical support if they need it, if they have questions about how to take it, or whether what’s happening is normal.”

Meanwhile, some states are trying to make access to medication abortion easier. A bill moving forward in Delaware would allow a wider array of healthcare providers to prescribe the pills to their patients.

By:

Source: Republican state lawmakers are working to restrict access to abortion pills. : NPR

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Critics:

By: Shefali Luthra

“Medication abortion is the existential threat of the anti-abortion movement,” said Greer Donley, an assistant professor at the University of Pittsburgh Law School who specializes in laws surrounding medication abortion access. When they’re on the precipice of getting the Supreme Court to overturn Roe v. Wade, there’s a technological advance that has made it impossible to control abortions.” 

Texas, which is so far the only state that has ended access to abortions after six weeks of pregnancy, provides some insight. The number of Texans receiving abortions has only fallen somewhat — a far larger number of people are now making journeys out of state or ordering medication abortion pills online from the European nonprofit Aid Access, which operates outside the U.S. health care system but has worked to provide Americans with telemedicine-based medication abortions since 2018.

In a post-Roe world, the options would likely look different. With more states banning or severely restricting abortion access, travel likely poses a greater burden, especially for people who live where neighboring states also have legislatures that have restricted access. But health care providers in states where abortion rights are protected could, under the new FDA guidance, could potentially prescribe pills through a phone call or video-chat and mail them to people in other states.

There are accessibility questions. Not everyone has sufficient internet access to find a virtual provider, noted Abigail Aiken, an associate professor at the University of Texas at Austin who has studied the Texas law’s impact on medication abortion requests. And not everyone knows about services like Aid Access or other ways to navigate the health care system and find an out-of-state provider.

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The Coronavirus Crisis

More Patients Seek Abortion Pills Online During Pandemic, But Face Restrictions

Consider This from NPR

The New Texas Abortion Law Is Putting Some Patients In Danger

National

With Abortion Restrictions On The Rise, Some Women Induce Their Own

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CDC Recommends Cutting Covid Isolation Time To 5 Days For Some Healthcare Workers

With hospitals in some areas struggling with staffing shortfalls amid a nationwide surge of Covid-19 cases, the U.S. Centers for Disease Control revised its guidelines Thursday to recommend that healthcare workers who contract Covid-19 but display mild-to-moderate symptoms and are not moderately or severely immunocompromised can return to work five days after symptoms first appear, down from 10 days previously.

Key Facts

Healthcare workers who contract the virus should also wait until at least 24 hours after their last fever without the use of fever-reducing medications and must wait until symptoms like coughing and shortness of breath have improved, according to the guidelines.

Some hospitals have voluntarily adopted a seven-day isolation period for infected staff, the New York Times reported.

The Centers for Disease Control and Prevention (CDC) advises someone who tests positive to go into isolation for 10 days. Critics say that the policy does not take into account how the pandemic has developed over the last two years.

Omicron is now the dominant strain in the U.S. Although more transmissible than prior variants and amid a spike in breakthrough infections among the fully vaccinated, the strain so far appears to be causing milder symptoms.

The CDC also recommended that hospitals cancel all non-essential procedures and visits if necessary to mitigate staffing shortages. Other new CDC guidelines also revised rules for workers who have higher-risk exposure to Covid-19, such as having their eyes, nose or mouth exposed to material possibly containing the virus, but who are not confirmed to have been infected.

In general, asymptomatic workers who have been exposed to the virus in this way do not require any restriction from work if they have received all recommended vaccine doses, including boosters, the CDC said.

Fauci told CNN reducing the 10-day isolation recommendation would help those without symptoms return to work or school, although added “no decisions” had been made yet.

Key Background

As the spread of the highly transmissible omicron variant raises infection rates across the U.S., hospitals have struggled with worker burnout and understaffing. In Massachusetts, New York and Ohio, the National Guard has been deployed to reinforce overburdened hospital staff, Spectrum News reported. “When it comes to the workforce, it’s fair to say we’re facing a national emergency,” American Hospital Association President Rick Pollack told NPR.

Tangent

Airlines for America, a trade association representing most of the nation’s largest airlines, asked the CDC on Thursday to shorten its quarantine recommendation to five days for fully vaccinated people who have a breakthrough Covid-19 case. A4A CEO Nicholas Calio cited potential worker shortages and operation disruptions amid the omicron coronavirus surge if the quarantine time isn’t reduced.

However, flight attendant union chief Sara Nelson pushed back against the airlines’ call on Thursday, saying it would pose health risks. “Although breakthrough infections are mild, the 10-day isolation is extremely disruptive to people’s lives,” he told Newsweek. “It’s unnecessary if a person is contagious for a significantly shorter period of time,” Adalja noted.

Omicron is the most dominant COVID strain in the U.S., comprising of 73 per cent of new infections last week. But even if proven to have milder systems, there are fears the health care system could be overwhelmed if infections put medical workers out of action.

I cover breaking news for Forbes. Previously, I was editor for The Cordova Times newspaper in Cordova, Alaska. In 2018, I obtained a Master of Journalism

I am a Hawaii-based reporter covering breaking news for Forbes. I graduated from the University of Hawaii with a bachelor’s degree in Journalism and

Source: CDC Recommends Cutting Covid Isolation Time To 5 Days For Some Healthcare Workers

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