Two abortion-inducing drugs could soon be reclassified as controlled and dangerous substances in Louisiana under a first-of-its-kind bill that received final legislative passage on Thursday and is expected to be signed into law by the governor.
Supporters of the reclassification of mifepristone and misoprostol, commonly known as “abortion pills”, say it would protect expectant mothers from coerced abortions. Numerous doctors, meanwhile, have said it will make it harder for them to prescribe the medicines they use for other important reproductive healthcare needs, and could delay treatment.
Louisiana currently has a near-total abortion ban in place, applying both to surgical and medical abortions. The GOP-dominated legislature’s push to reclassify mifepristone and misoprostol could possibly open the door for other Republican states with abortion bans that are seeking tighter restrictions on the drugs.
Current Louisiana law already requires a prescription for both drugs and makes it a crime to use them to induce an abortion in most cases. The bill would make it harder to obtain the pills by placing them on the list of Schedule IV drugs under the state’s Uniform Controlled Dangerous Substances Law.
The classification would require doctors to have a specific license to prescribe the drugs, which would be stored in certain facilities that in some cases could end up being located far from rural clinics. Knowingly possessing the drugs without a valid prescription would carry a punishment including hefty fines and jail time.
Supporters say people would be prevented from unlawfully using the pills, though language in the bill appears to carve out protections for pregnant people who obtain the drug without a prescription for their own consumption.
More than 200 doctors in the state signed a letter to lawmakers warning that it could produce a “barrier to physicians’ ease of prescribing appropriate treatment” and cause unnecessary fear and confusion among both patients and doctors. The physicians warn that any delay to obtaining the drugs could lead to worsening outcomes in a state that has one of the highest maternal mortality rates in the country.
In addition to inducing abortions, mifepristone and misoprostol have other common uses, such as treating miscarriages, inducing labor and stopping hemorrhaging.
Mifepristone was approved by the US Food and Drug Administration in 2000 after federal regulators deemed it safe and effective for ending early pregnancies. It’s used in combination with misoprostol, which the FDA has separately approved to treat stomach ulcers.
The drugs are not classified as controlled substances by the federal government because regulators do not view them as carrying a significant risk of misuse. The federal Controlled Substances Act restricts the use and distribution of prescription medications such as opioids, amphetamines, sleeping aids and other drugs that carry the risk of addiction and overdose.
Abortion opponents and conservative Republicans both inside and outside the state have applauded the Louisiana bill. Conversely, the move has been strongly criticized by Democrats, including the vice-president, Kamala Harris, who in a social media post described it as “absolutely unconscionable”.
Meanwhile, Louisiana’s Democratic party chairman Randal Gaines released a statement on Wednesday in which he called the bill “yet another example of [House Republicans’] pursuit to take away reproductive freedoms for women in Louisiana.
“Thanks to Donald Trump, who proudly claims credit for ripping away women’s freedoms, women in Louisiana live in constant fear of losing even more rights … [this] action is a harrowing preview of how much worse things could get under governor Landry and the extreme GOP leadership,” he added.
Now that Louisiana House Republicans have passed SB 276, legislation to criminalize possession of abortion medication, Louisiana Democratic Party Chair Randal Gaines today issued the following statement: pic.twitter.com/2toJZRVMbj
— Louisiana Democrats (@LaDemos) May 22, 2024
The US supreme court heard arguments in March on behalf of doctors who oppose abortion and want to restrict access to mifepristone. The justices did not appear ready to limit access to the drug, however.
The Louisiana legislation now heads to the desk of conservative Republican governor Jeff Landry. The governor, who was backed by former president Donald Trump during last year’s gubernatorial election, has indicated his support for the measure, remarking in a recent post on X: “You know you’re doing something right when @KamalaHarris criticizes you.”
Landry’s office did not respond to an emailed request for comment.
A recent survey found that thousands of women in states with abortion bans or restrictions are receiving abortion pills in the mail from states that have laws protecting prescribers. The survey did not specify how many of those cases were in Louisiana.
Louisiana’s near-total abortion ban applies both to medical and surgical abortions. The only exceptions to the ban are when there is substantial risk of death or impairment to the pregnant person if they continue the pregnancy or in the case of “medically futile” pregnancies, when the fetus has a fatal abnormality.
In 2022, a Louisiana woman carrying an unviable, skull-less fetus was forced to travel 1,400 miles to New York for an abortion after her local hospital denied her the procedure. “Basically … I [would have] to carry my baby to bury my baby,” the woman, Nancy David, said at the time.
Currently, 14 states are enforcing bans on abortion at all stages of pregnancy, with limited exceptions.
According to a study released in March, in the six months following the overturn of Roe v Wade, approximately 26,000 more Americans used abortion pills to induce at-home abortions than would have done had the supreme court not overturned the federal law in 2022.
In 2023, medication abortions involving mifepristone, as well as misoprostol, accounted for more than 60% of all abortions across the US healthcare system, marking a 53% increase since 2020, according to the Guttmacher Institute.
The medication abortion counts do not include self-managed medication abortions carried out outside healthcare systems or abortion medication mailed to people in states with total abortion bans.
