Why New Abortion Bans Are Keeping Some People From Getting Essential Medication

As abortion bans continue to go into effect, women, girls, and people capable of pregnancy continue to lose access to life-saving medications that have nothing to do with ending pregnancies. Patients with Crohn's, colitis, lupus, and many forms of arthritis — including the incredibly debilitating rheumatoid — are being denied medications that help with daily living because, in this new post-Roe era, there's no clear understanding of what is legal for who (via Healthline).

On June 24, the Supreme Court's ruling in the case of Dobbs v. Jackson Women's Health Organization unleashed a tidal wave of trigger laws and unforeseen consequences. Not only are states banning abortions now that there is no longer the protection of the 1973 Roe v. Wade ruling, but even patients who aren't pregnant — or aren't trying to get pregnant — are feeling the impacts. Methotrexate, for instance, is a life-changing anti-inflammatory that can terminate pregnancies if given in high doses.

Now that the decision about reproductive healthcare rights is being left up to individual states, there's a distinct lack of clarity about what is and isn't legal. The Washington Post adds that the question of legality also stretches to who is liable: the patient who takes the medication, the pharmacist who gives it, or the doctor who prescribes it?

With so many questions, and with careers on the line, doctors and pharmacists are opting to not prescribe medications, leaving many feeling "muzzled" when it comes to what they can and can't say to their patients. 

Shortly after the Dobbs v. Jackson Women's Health Organization ruling, the Arthritis Foundation issued a statement warning that access to Methotrexate may be interrupted. According to the organization, at least 90% of rheumatoid arthritis patients have been on the anti-inflammatory medication at some point during their treatment. In July, the American College of Rheumatology joined the Arthritis Foundation in calling on lawmakers to continue to make Methotrexate accessible by including "legal safeguards" to protect everyone from doctors to patients who are using the medication to treat autoimmune diseases.

Methotrexate has been named specifically as a banned medication in some states like Tennessee because, as The Washington Post explains, the medication is given to help end ectopic pregnancies — pregnancies where "an embryo implants outside the uterus," a situation where not only can the embryo not survive but can cause "life-threatening complications" for the pregnant person if the embryo is not removed from their body.

For people who can get pregnant, pharmacists and rheumatologists are hesitant to prescribe Methotrexate because of the potential for birth defects. Even if the patient would want an abortion, things like legality and the necessity of out-of-state travel to have the medical procedure must now be considered.

But with so much uncertainty around laws and the penalties for breaking them, denying patients — some as young as 14 — medical care is being seen as the safest decision, per ABC's "Good Morning America."

Arizona is one the latest states where an abortion ban has gone into effect, and arthritis patients on Methotrexate have already run into problems. While the ban has only been the law of the Grand Canyon State for a few weeks as of publication, ABC's "Good Morning America" reports there have already been multiple lawsuits filed over the "significant confusion" the ban has created.

In a statement, Walgreens told "Good Morning America" that the "new laws in various states require additional steps for dispensing certain prescriptions," but assured customers that their "pharmacists work closely with prescribes as needed, to fill lawful, clinically appropriate prescriptions." 

But the question of what's "lawful" hangs over many patients' and prescribers' heads. Deborah Jane Power, a Tucson-based pediatric rheumatologist, took to Twitter after one of her pediatric patients was denied Methotrexate "purely because she's a female, barely a teenager." The patient, Emma Thompson, was diagnosed with juvenile idiopathic arthritis at the age of 3. Now 14, she needs Methotrexate to do basic tasks like walk, brush her hair, and go to school.

Katie Glenn, the state policy director of Susan B. Anthony Pro-Life America, told The Washington Post there shouldn't be any confusion or concerns from pharmacists or doctors because of "intent." To Glenn, a rheumatologist doesn't perform abortions so they shouldn't have an issue prescribing any medication. Despite this assurance, many pharmacies are opting to practice caution when prescribing banned medications.

Why there needs to be medication validation is unclear to many in the medical field. According to the Arthritis Foundation, patients being prescribed Methotrexate as an anti-inflammatory generally get a maximum dose of 25mg a week — a third of the dose required for an abortion.

Arizona isn't the only state where patients seeking cancer and chronic illness care are being denied because of these laws. Twitter users from Tennessee, South Carolina, Michigan, and even California are seeing Methotrexate prescriptions denied.

Publicly, pharmacy chains have made statements assuring customers that their prescriptions would still be filled. Mike DeAngelis, CVS's executive director for corporate communications, told The Washington Post that in some states, filling prescriptions now includes an extra step to make sure you're not using the drug for an abortion. But, a new report by USA Today warns major chains like CVS have changed their policies, allowing their pharmacists to practice "professional discretion."

Even in states where abortion hasn't been banned, Methotrexate is no longer being prescribed, or pharmacies are requiring proof of intent. In Virginia, 27-year-old Becky Schwarz used to take Methotrexate to help control her lupus symptoms. But with no legal protections for abortion, her doctor chose to no longer prescribe Methotrexate because it's "considered an abortifacients," per Newsweek.

Despite the lack of an abortion ban or trigger laws currently in Virginia, there also aren't legal protections for abortions, either — an issue that is expected to push more voters to the polls in November.