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Work remains on North Carolina’s new birth control law
Charlotte Observer - 3/22/2022
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Work remains on birth control law
The writers are co-founders of Points True North, a consulting firm. They have years of experience helping expand access to contraception in NC.
It was encouraging to see the recent editorial about the new N.C. law that allows access to birth control directly from a pharmacist without presenting a prescription. North Carolina joined 18 other states with similar laws. It was a huge advancement for women’s health and a rare show of bipartisanship.
But impediments to access still exist. It’ll take effort, collaboration and compromise among stakeholders to resolve them, just as we witnessed from legislators. Interest groups must commit to compromise, focus on the law’s overarching goal and work together to ensure it is well implemented.
Adequate reimbursement for pharmacists is crucial. If we want to truly expand access this means acknowledging the surfeit of contraceptive deserts where over 600,000 women of reproductive age reside.
Because of the additional time-consuming responsibilities of counseling and referring, privately-owned pharmacies may not be able to provide this service without adequate reimbursement. There is already precedent to pay pharmacists for services that increase access to care.
Perhaps the most critical issue is education of potential beneficiaries. Many women aren’t yet aware of the law or received inaccurate information about it.
If it is to be truly helpful there must be a concerted consumer marketing campaign with stakeholders from the reproductive health, rights and justice community involved. Ideally, the campaign is aligned with the N.C. DHHS, given that the Family Planning Medicaid program is one avenue those uninsured or underinsured could be eligible for free contraception.
Many consumers are also not aware that North Carolina is one of few states to have the benefit of Upstream, a nonprofit offering free training and technical assistance to health agencies. Patients could be referred to an Upstream trained facility.
Although North Carolina will continue to learn from other states that have successfully implemented pharmacy-based contraceptive provision, the ultimate goal is to make our state’s implementation and programming the gold standard. This can only be done through collaboration of all stakeholders.
Treat opioid users in NC jails, prisons
Deaths from opioid overdose have skyrocketed in recent years and drug overdose is a leading cause of death among those recently released from incarceration.
As a rising physician at UNC’s medical school, I am dismayed that while overdose deaths are preventable many people continue to die due to lack of treatment, especially in the first two weeks post-release.
Despite the increasing number of opiod users jailed and imprisoned each year, most N.C. detention settings fail to adequately support recovery efforts during incarceration. Scientific evidence supports that medications for opioid use disorder (MOUD) improve recovery efforts by mitigating withdrawal symptoms, inhibiting the effects of opioid drugs, and saving lives.
Treatment consists of one of three medications — naltrexone, methadone and buprenorphine — which alleviate cravings. A 2020 Brown University study showed that expanding access to these medications in prisons and jails can reduce overdose deaths by 31.6% in certain circumstances.
Durham County Jail is one of the few N.C. detention centers that allows individuals to continue MOUD treatment while detained. It also allows users to begin treatment while incarcerated. In other parts of the state, individuals may be required to discontinue treatment while incarcerated, increasing their risk of overdose or recidivism once released.
Detention centers can play a key role in curbing the rates of opioid misuse in communities by connecting individuals with life-saving treatment and breaking the cycle of recidivism for drug-related offenses. Stopping the cycle of opioid misuse and recidivism would benefit the public health and safety of all of us. It’s time to do something about it.
Meghan Pavelka, Chapel Hill
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