Offer emergency OCs to sexually active teens: expert opinion.(Gynecology)

CAMBRIDGE, MASS. -- Although controversy rages about whether emergency contraception should be available without a prescription in the United States, as it is in 25 other countries, "medically, there's no reason it shouldn't be over-the-counter," Dr. M. Sheila Desmond reported at a meeting on primary care pediatrics sponsored by Harvard Medical School.

"It's extremely safe. There are virtually no contraindications to its use, and there's no abuse potential," said Dr. Desmond of the Chelsea (Mass.) HealthCare Center. The regimens are easy to dose and to use. There are no important drug interactions.

In 2001, the American College of Obstetricians and Gynecologists endorsed over-the-counter dispensing.

Every sexually active adolescent who de sires it should be offered a prescription for emergency contraception, in Dr. Desmond's opinion. "You can tell girls to think of this as their fire extinguisher--it's something she can have easily available to put a fire out."

"Only about 11% of women have a prescription for emergency contraception on hand," she noted.

A pilot project in Washington state examined the implications of over-the-counter emergency contraception there from February 1998 to June 1999. After a 3-month media campaign introducing the project, 130 pharmacies offered emergency contraception on demand. The 1,500 participating pharmacists were trained to dispense the drugs through physician-pharmacist partnerships. Usage was reviewed quarterly. Patients paid $30-$40 for the pills.

Almost 28,650 women obtained emergency contraception during the study period. Abortion rates for that period decreased by 5%, and teen pregnancy rates decreased by 7% (Family Planning Perspectives 33[4]: 172-75, 2001).