Thursday, August 24, 2006

next issue

Now, most of you know that I don't much like discussing politics, and I know a wide range of political views read this blog-- so, I'm not trying to start a left-wing/right-wing war. Please be open-minded to others' views... and be kind. But I want to take a moment to discuss Plan B. (G, you are our resident pharmacology expert - and flaming liberal *wink*, so I'd love your input.)

The news today states that Plan B will be available over-the-counter for any woman over the age of 18. (Children 17 and under will still need a prescription.) Now, I'll be the first to admit that I probably don't know enough about it to make an educated opinion - but how can Plan B be available over the counter when birth control isn't? It's basically just a more concentrated dosage of the hormone in The Pill, right? So, you have to get a prescription to make a mature, responsible decision about your sex life, but if you don't make that decision ahead of time, you can just run to the store? It doesn't make any sense to me.

I'm not trying to say that it shouldn't be available. I absolutely think that it should. But I also think it should be a last option. We are not teaching safer sex with girls (or boys) if this is something you can just go pick up with gum and a Snapple. And let's be frank, kids are having sex whether they are taught abstinence or safer sex or nothing- so shouldn't we be teaching them both, in fervent hopes that something gets through? In case anyone wonders where on the fence I sit with this particular issue, I DON'T think that high schoolers should be having sex but I DO think that we should teach them about birth control and disease control anyway, and Plan B SHOULD be available at Planned Parenthood and your doctor's office, but not Walgreen's.

There are many, many issues surrounding teenage pregnancy and sex, not the least of which is global overpopulation. In 1830, our planet hit 1 billion people. In 1930, 2 billion. By 1960, it was 3 billion. 1974, 4 billion. 1987, 5 billion. Today? Roughly 6.5 billion people. About 300 million of those people live in our country. About 74 million of those Americans are children. 22 million of those children are under the age of 6. (On a complete tangent - thanks Tom - I think these stats prove that this is far from merely a WOMEN'S issue; it is an American issue; it is a people issue.)

One in five Americans have a sexually transmitted disease. One in five!! About 2/3 of those people are under the age of 25. So... let me break out the calculator... that's about 40 million people under the age of 25 (basically, kids) that have an STD. And people still don't think we should teach them about condoms? It's estimated that over a million Americans are HIV-positive and over 400,000 are living with (and dying from) AIDS. And we, my fellow Americans, are not even close to having the most dire statistics.

These statistics, although heartbreaking, don't remotely address the psychological, emotional, and social consequences of teenage sex. So yes, I so think we should be teaching our children about abstinence AND birth control and disease prevention. And yes, I do think that Plan B is a medicine that should be available.

But, if I need a prescription for an 800-mg ibuprofen tablet, when I could just as easily take 4 Advils, shouldn't one also need a prescription to take a higher dose of a medicine that is regulated by a doctor to begin with?


Blogger Giovanna said...

The pharmacist is in. LOL (Where's my nickel? :p) The push to loosen restrictions on dispensing of Plan B is based on access. For women in urban areas it may not be as difficult to go to a clinic/ER/HMO center when the condom breaks (because it's not always about irresponsible sex) as it is for some girl in Nowhere, MN. Since women's reproductive health issues are such a high profile subject, and reproductive rights in general always under threat, this is something that could be a "win" for women's rights.

J, what I would offer to you in way of an explanation to how this can be dispensed OTC while OCP's and Motrin 800mg is literally a safety profile. The serious adverse effects associated with using birth control pills come with chronic use, like blood clots. Prolonged use of high doses of ibuprofen causes ulcers and kidney failure. Plan B, while a slighter higher does of levonorgestel, requires a small number of tablets, and side effects are generally related to stomach upset, headache, and bleeding (duh.) and self limiting.

I highly doubt you will see Plan B on the shelf next to the KY and the Monistat. I would suspect that it will still be kept behind the counter and need to be asked for, so a pharmacist can properly counsel the patient asking for it. Which isn't that much different than what is current practice, where an RPh has a contract with a local MD and can dispense it without an Rx.

Of course this subject can go in so many other directions and tangents within the political climate today, LOL. Good subject.

August 24, 2006 9:21 PM  
Anonymous Scotticus said...

G, I read J's underlying concern as the implications of the "access" you refer to above, and how it might lead our youth to inappropriate sexual behavior due to a false sense of security.

August 25, 2006 7:28 AM  
Blogger Giovanna said...

See Scott, I don't buy into that; it's almost the same argument made by those against teaching about sex/birth control in schools and making condoms available: that it will promote promiscuity. The problem lies in so many other problems in society today too numerous to count. Everything now is a band-aid, because it's too hard now to reverse how we've evolved. We need to teach girls to love and respect themselves and their bodies not feel like they need to have sex to be with a boy or fit in or whatever.

I'm sure this pill will not be cheap. It's not like your average teen can afford to say, "Eh, don't worry about a condom, I can just grab a Plan B on my way home," every time she has sex on a Friday night. She certainly can't go to mummy or daddy for it like it's a vitamin either.

But there are so many stories of women raped, not necessarily even violently but by dates or spouses who fear the consequences of a pregnancy and can now do something about it safely. The time window to use it effectively is so small, that the sooner you can take it the better.

And at this moment as my kids are pissing and moaning and whining I wish I never had sex my whole life. *snort*

August 25, 2006 9:31 AM  
Blogger Bee said...

My only fear is that men can also buy plan B. I don't even want to think of the reasons why they would want to have the pill.

August 25, 2006 9:36 AM  
Blogger Giovanna said...

The was something else... lol. All those statistics, population, pregnancy, STD rates, all imply the consequences of not using a condom with sex. While this pill is meant to deal with a consequence of not using a condom, it is not directly causing such problems, if anything Plan B helps, no? I guess what I mean is that citing the rise of STD's and pregancy is more of an argument toward better education, a push to use condoms, and making them more available, than it is to saying Plan B shouldn't be more available.

If all the education we give our kids fails, and they get pregnant, should we then make them deal with the consequences like they had to 50 years ago? They didn't learn their lesson then, as look where we are now.

August 25, 2006 9:50 AM  
Blogger hello jamie: said...

I agree, G- I do think we should be educating our kids to be more responsible, and I DO think Plan B should be available, just not necessarily at the corner store.

I didn't think about the price being prohibitive though, so I'm glad you mentioned that. Do you know how much it's going to cost at a drugstore?

August 25, 2006 10:38 AM  
Blogger Brain Diva said...

I'm all for Plan B to be available OTC. As Gina mentioned, since it is a one-shot medication, it is certainly much less dangerous to have available OTC than medications you take chronically and which can cause increase in BP, like the regular pill. I don't have personal experience using the morning-after pill, but I've had friends who had to use it (broken condoms happen), and let me tell you, they felt so nauseous from the boost of hormones you get from taking it. I think it would discourage most women from using it as a regular contraceptive.

Certainly, as Gina mentioned, I think the OTC availability is particularly important for regions where seeing a doctor on short notice might be impossible or where doctors feel like acting as a gateway against abortion in any form (not that I consider taking the morning-after pill abortion since it prevents implentation of an embryo). I was reading an article in Jane Magazine (shut up!) last month about reproductive rights in South Dakota, and I was really disturbed by the fact that there was one Planned Parenthood clinic in the WHOLE state(!), and that they had to fly in a doctor from St. Paul to perform abortions because they couldn't recruit anyone in the community to do it because of threats made to previous doctors. Anyway, not that I want to venture doing the abortion question, but I'm just saying, we can't take reproductive rights for granted everywhere, and women should be able to make their own decisions.

As in any other area, education is power. I agree that children need to learn about the good, the bad, and the ugly when it comes to sex. Not to scare them, but to make them take the topic seriously. You can hope to guide them to make the right choices that way. And yes, that implies explaining that Plan B is a last resort, not what you should be commonly using. By the way, I was seriously disturbed when I heard that there has been in increase in oral sex activities in young kids (like 11 or 12) because they believe it's not sex. Something is really wrong there. Education is not quite getting to them. FWIW, I don't necessarily mean only education in school. I learned as a teen from reading sex columns in Seventeen magazine and such. I remember my mom used to read it sometimes to use it as a jumping point for discussion between us, which I think was pretty smart of her.

August 25, 2006 2:03 PM  
Blogger Brain Diva said...

One more thing... As for the overpopulation issue, while we should be concerned about it, less and less children are being born every year in industrialized countries. The consequences of teenage pregnancy are not less important, but I don't think that has really much to do in this debate. Education is key in issues of overpopulation, but we are not the countries who should be targeted in that regard.

August 25, 2006 2:17 PM  
Blogger pants said...

i'm glad there is someone else who realizes the scam that is prescription advil.

September 04, 2006 10:17 AM  

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