Day: July 9, 2022

When Melissa, a nurse in the U.S. state of Alabama, went to pick up her regular prescription medication for rheumatoid arthritis last week, she was told the drug was on hold while the pharmacist checked she wasn’t going to use it to induce an abortion.

“He said, ‘Well I have to verify if you’re on any contraceptives to prevent pregnancy.’ ”

“The hell you do,” she recalled thinking.

Melissa, who is in her early 40s and asked to be identified only by her first name for fear that speaking out might affect her livelihood, then called her doctor, who succeeded in having the pharmacy in the Southern U.S. state release the medicine.

“I picked it up a couple hours later, but I felt violated,” she told AFP. She said that she’d had a hysterectomy six years ago and that her lack of recent contraceptive history might have led the pharmacist to suspect she was pregnant.

Consequence of court ruling

Stories of people facing similar struggles have come to light in the weeks since the U.S. Supreme Court overturned Roe vs. Wade on June 24, highlighting an overlooked consequence of new state-level bans or severe restrictions on abortion.

It’s not yet clear how widespread the cases are, but national organizations including the Lupus Foundation of America and the American College of Rheumatology said they were aware of such concerns and were asking people affected to come forward.

“The Arthritis Foundation supports unencumbered access to and coverage of FDA-approved drugs for managing arthritis in alignment with scientific and clinical guidelines, as well as evidence-based medical recommendations,” the organization said.

The issue centers on methotrexate, a drug that tempers inflammation and is commonly used against autoimmune conditions including inflammatory arthritis, psoriasis and lupus.

Methotrexate stops cell division and is given in higher doses as a cancer drug.

It can also sometimes be used in medical abortions, though not as frequently as the Food and Drug Administration-approved combination of two other drugs, mifepristone and misoprostol.

Nevertheless, many states have passed laws carrying threats of legal action against health care workers and pharmacies providing methotrexate.

Another woman contacted by AFP, a 20-year-old university student from Ohio, said she has had a methotrexate prescription since 2020 to treat her lupus, which affects her kidneys and liver and causes joint pain.

A pharmacist at a national chain told her they were “no longer accepting prescriptions for methotrexate unless it was for the FDA-approved use of [treating] breast cancer, or the patient was not presumably fertile,” she said.

She tried again, without success, to fill her prescription at a family-owned pharmacy, and this week got a letter from her doctor’s office stating the practice would no longer be prescribing methotrexate because of the number of patients having difficulty accessing it.

Though the first pharmacy later changed its position, the experience left her “annoyed and angry,” she said.

‘Provider approval’ needed

A third woman, Jennifer Crow, 48, a writer and produce gardener in Tellico Plains, Tennessee, told AFP she’d received an automated call from CVS Pharmacy saying her methotrexate refill had been declined “pending provider approval.”

Crow said methotrexate had helped her enormously in managing her inflammatory arthritis, allowing her to roll out of bed and get dressed without severe pain, and walk without a cane for the first time in years.

Though her doctor was able to resolve the situation, Crow, who has also had a hysterectomy, said she was worried for others with chronic illnesses who don’t have the same access to resources that she does.

In statements to AFP, national pharmacy chains CVS and Walmart confirmed they were working to adhere to new state regulations in light of the high court’s decision to revoke the constitutional right to an abortion.

“We encourage providers to include their diagnosis on the prescriptions they write to help ensure patients have quick and easy access to medications,” CVS added.

Alisa Vidulich, policy director of the Arthritis Foundation, told AFP she was hopeful the situation might be remedied quickly as medical professionals and pharmacies developed new guidelines.

“But that may not actually be the case in all states, and it may in fact turn into a longer-term issue,” she said.

Melissa, the nurse, said she was incensed at the double standard that allowed one of her best friends, who is a man, to get his methotrexate prescription filled right away with no questions asked.

“We’re headed in the wrong direction and it’s terrifying. I have two daughters. I don’t want to see this,” she said.
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A Texas judge issued an order Friday to continue blocking the state from investigating two families of transgender youth who have received gender affirming medical care and said she was considering whether to prevent additional investigations.

The ruling extends in part a temporary order issued last month blocking investigations against three families who sued and preventing any similar investigations against members of the LGBTQ advocacy group PFLAG Inc. The group has more than 600 members in Texas.

In her order Friday, Judge Amy Clark Meachum said she was still weighing whether to issue a similar order prohibiting similar investigations against the third family and PFLAG members. An order preventing those investigations had been set to expire Friday. An attorney last month said the third family of a transgender minor had learned after the lawsuit’s filing that the state had dropped its investigation into them.

The two families to whom Friday’s order applies would “suffer probable, imminent, and irreparable injury in the interim” without the order, Meachum wrote.

The ruling was the latest against the state’s efforts to label gender affirming care as child abuse.

The Texas Supreme Court in May allowed the state to investigate parents of transgender youth for child abuse while also ruling in favor of one family that was among the first contacted by child welfare officials following order by Republican Gov. Greg Abbott.

The latest challenge was brought by Lambda Legal and the American Civil Liberties Union on behalf of the families of three teenage boys — two 16-year-olds and a 14-year-old — and PFLAG.

“The Court recognized yet again that being subjected to an unlawful and unwarranted investigation causes irreparable harm for these families who are doing nothing more than caring for and affirming their children and seeking the best course of care for them in consultation with their medical providers,” the groups said in a statement.

The families had talked in court filings about the anxiety that the investigations created for them and their children. The mother of one of the teens said her son attempted suicide and was hospitalized the day Abbott issued his directive. The outpatient psychiatric facility where the teen was referred reported the family for child abuse after learning he had been prescribed hormone therapy, she said in a court filing.

A judge in March put Abbott’s order on hold after a lawsuit was brought on behalf of a 16-year-old girl whose family said it was under investigation. The Texas Supreme Court in May ruled that the lower court overstepped its authority by blocking all investigations going forward.

The lawsuit that prompted that ruling marked the first report of parents being investigated following Abbott’s directive and an earlier nonbinding legal opinion by Paxton labeling certain gender-confirming treatments as “child abuse.” The Texas Department of Family and Protective Service has said it opened nine investigations following the directive and opinion.

Abbott’s directive and the attorney general’s opinion go against the nation’s largest medical groups, including the American Medical Association, which have opposed Republican-backed restrictions filed in statehouses nationwide.

Arkansas last year became the first state to pass a law prohibiting gender-confirming treatments for minors, and Tennessee approved a similar measure. Judges have blocked laws in Arkansas and Alabama, and both of those states are appealing.

Meachum set a Dec. 5 trial on whether to permanently block Texas’ investigations into the families.
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Millions of Canadians found out Friday what it is like to live without access to the internet and mobile phone service.

Rogers Communications, the country’s largest mobile and internet provider, experienced a major outage, beginning Friday morning and lasting most of the day.

The outage affected retailers, credit card and debit transactions, court proceedings, government agencies, calls to emergency services and much more.

“Today we have let you down,” Rogers posted on Twitter, without offering an explanation. “We are working to make this right as quickly as we can. We will continue to keep you updated, including when services will be back online.”

Late Friday, the Toronto-based telecommunications firm said it had begun restoring services.
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The Canadian government is set to put health warnings on each cigarette and ban certain types of plastics, parts of a new round of regulations from the Trudeau government.

“Poison in every puff.” By 2023, this is the warning the Canadian government is planning on having on each cigarette sold in the country. This will make Canada the first in the world to do so, much as it did with graphic health warnings on packages of cigarettes in 2001.

Changes are also proposed for the health warnings on packages; they would be required to cover 75 percent of the back and front of each package and include warnings about colorectal cancer, stomach cancer, cervical cancer and diabetes. These are among the 16 diseases — besides lung cancer — believed caused by cigarettes.

Rob Cunningham, senior policy analyst with the Canadian Cancer Society, said putting a warning on each cigarette will make sure the health message gets delivered every single time one is lit.

“Sometimes you experiment by smoking, by ‘borrowing’ a cigarette from a friend or a brother or sister without directly touching the package. And so … this type of reach to kids experimenting is a very positive thing,” he said. “Sometimes smokers who go out for a smoke break will just take a cigarette, not the full package, when they go outside.”

The Canadian government is also banning the importing or manufacturing of plastic bags and containers, like those used for restaurant takeout meals, by the end of 2022. It will ban sales of the bags and containers by the end of 2023 and exports of them by year’s end in 2025.  

The government is also working toward abolishing many single-use plastics, like those for straws, stir sticks for drinks, cutlery and the plastic rings used to hold together six- and 12-packs of cans and bottles.

Plastic was listed as toxic under the Canadian Environmental Protection Act in 2021.

Sarah King, head of Greenpeace Canada’s oceans and plastics campaign, said the move is a good start, but there is still more work to be done.

“We still aren’t even at the starting line in terms of tackling Canada’s plastic waste and pollution problem,” she said. “So, you know, we definitely are keen to see the government take plastic reduction more seriously and start accelerating our transition to more reuse-, refill-centered systems.”

But Stewart Prest, a political scientist at Simon Fraser University in Vancouver, said some Canadians would be upset by the new initiatives, seeing them as examples of over-regulation and the extension of a so-called “nanny state.”

“I think reactions will be divided,” he said. “I think this is the kind of issue that’s going to fit very well within the existing political dynamic polarization that we see in Canada, where any attempt by the government to regulate — to try to nudge Canadians in a particular direction — is going to be met with great, extreme skepticism in some quarters.”

The next general election is expected to occur in October 2025, which is well after the new regulations take effect.
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