IN THEIR OWN WORDS Oregon Victory in Women’s Health By Representative Knute Buehler, MD (R-Bend) On July 6, Oregon became the second state in the nation to pass legislation that significantly expands access to oral contraceptives for women. Now–just a few months later–Oregon is on track to be the first state to implement the expansion and allow women to purchase oral contraceptives without a doctor’s prescription. HB 2879 allows a woman 18 years or older to obtain an oral or hormonal patch contraceptive directly from a pharmacist without a prescription, upon the completion of a self-screen risk assessment. Women under the age of 18 may obtain a contraceptive dispensed by a pharmacist with proof of a prior prescription. California, the only other state with similar legislation, remains bogged down in complicated rulemaking and credentialing. I worked on the House side and Senator Steiner Hayward, MD (D-NW Portland/ Beaverton) was the champion on the Senate side to pass this law. Oregon's provider community solidified themselves as innovative leaders in preventive women’s health care. The overwhelming data shows women can effectively self-screen for contraindications and that a prescription is an unnecessary barrier to contraceptive access. A study conducted by researchers at the University of California, San Francisco and the nonprofit Ibis Reproductive Health found that allowing women to purchase oral contraceptives over-the-counter can reduce unintended pregnancies by 25 percent. Eliminating a quarter of unintended pregnancies will result in healthier families, improve financial stability and combat poverty. Improved access to birth control will have a profound impact on women’s health. Oregon is setting the standard for the rest of the nation. This bold initiative would not have been possible without the leadership and broad support from the medical community. The Oregon Medical Association, Oregon Nurses Association, OHSU and many others played a pivotal role shepherding this concept through the legislative process. At the national level, the American Congress of Obstetricians and Gynecologists has endorsed making oral contraceptives available over the counter since 2012. The commitment to women's health from medical professionals helped relieve concerns and assured elected leaders that this change is safe and effective. On behalf of families across Oregon who will benefit from increased access, thank you to the medical professionals who helped guide this policy through the session and are still guiding it through the rule-making process. We have come a long way and our work is not done yet. The target implementation date for the new law to take effect is January 1, 2016. The medical community will be key in educating the public and overseeing the process. We encourage all physicians to learn more about the new delivery system, educate your patients, and continue to champion what is clearly best practice for women’s health in the 21st century. E-Cigarettes & Vapor Inhalants: Not the Safe Alternative By Senator Elizabeth Steiner Hayward, MD (D-NW Portland/Beaverton) As a physician, I am constantly focused on what we, at the legislative level, can do to focus on prevention of public health problems. E-cigarettes are worthy of regulation for all ages. My colleague, Representative Kathleen Taylor (D-Milwaukie), took up the issue on the House side, and we focused on what is common sense: e-cigarettes contain nicotine, nicotine is a very addicting drug and is especially bad for the teenage brain. I was very uncomfortable with the idea that teenagers had access to e-cigarettes with limited restrictions. HB 2546 expands existing state tobacco laws to include inhalant delivery systems, and adds e-cigarettes to the Indoor Clean Air Act, ensuring that public places have the same protections from these products as traditional tobacco products. We don’t know what chemicals are in vapor inhalants, we simply wanted to push a logical extension of the Indoor Clean Air Act to protect people from potential harm. Surprisingly, the e-cigarette and vapor industry wasn’t as opposed to the regulation as one might think. I was surprised at the lack of interest at the national level of antitobacco and public health advocacy groups: they have a larger agenda, but progress was made and this feels like a victory. As for next steps in tobacco control, I’ve got my eye on handling retail licensure and I will be a huge advocate of that work whether I introduce the legislation or my colleague Laurie Monnes Anderson (D-Gresham) does. In 2017, I am looking to explore moving the legal age for buying cigarettes and tobacco from 18 to 21 years. This would be a major victory for so many reasons and a crowning achievement for this family physician who can see what a toll tobacco products take on all users, to the environment and to our air quality. 18 Medicine in Oregon www.TheOMA.org
OMA Medicine in Oregon Fall 2015
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