Abortifacient Drugs

What is an abortifacient and why can’t people access them in some states?
Abortofacient drugs are meds that can be used to induce an abortion, but can be used to treat a variety of other conditions, too. Since the fall of Roe, trigger bans have begun affecting people’s (particularly those the state has deemed “women of child-bearing age”) access to lifesaving medication like these. The most common denial we’ve been seeing is for methotrexate, a drug that in high quantities can be used to end an ectopic pregnancy or manage a miscarriage, but is much more commonly used to treat rheumatoid arthritis and autoimmune conditions like lupus and Chron’s disease. Because it is a low-grade form of chemotherapy, it can also be used to treat several kinds of cancer.

Doctors and pharmacists are wary of prescribing and dispensing methotrexate and other drugs for fear that they will face legal action. They are confused about the legality of this while trying to keep up with changing guidance and state governments that may not be providing the clarity they need.

Are there other drugs this could affect?
Other abortifacients include misoprostol and mifepristone. Misoprostol can treat ulcers and mifepristone is FDA-approved as a treatment for Cushing’s syndrome, but research suggests that it could be useful for a plethora of other conditions—research that might be stalled because of Dobbs. Some Texas pharmacies have pulled heartburn medication that has a similar makeup to abortion pills. There are certain Republican lawmakers seeking to limit access to emergency contraception (Plan B) as an extension of abortion bans in their states. In certain states, some hospitals and pharmacies have already stopped issuing emergency contraception because of the ambiguity of the laws post-Roe. In some states, it’s already legal to not fill contraceptive prescriptions for moral reasons.

Is anyone trying to stop this from happening?
The federal government has urged pharmacists to continue filling prescriptions, as not doing so may be considered discriminatory on the basis of sex or disability. Because the Dobbs decision is affecting many rheumatology patients, the American College of Rheumatology has assembled a task force to identify how to ensure access to necessary medications.

It’s likely that these restrictions will lead to legal challenges, either because of patients suing for their right to get their meds or from anti-abortion extremists suing pharmacies or doctors for dispensing/prescribing abortifacient drugs. Then, it’ll be up to state courts to decide if abortifacient medications can be prescribed for patients to treat other conditions.

What should we do if we need these drugs?
You can ask your prescribing doctor to note specific indications for why they’re prescribing a drug like methotrexate and to write you a physician’s letter delineating medical necessity. Ordering the drug by mail is an option, unless it becomes illegal to send abortifacients across state lines. The Arthritis Foundation has a toll-free helpline and email address for arthritis patients struggling to access methotrexate.