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Plan B restrictions — better, but not best

In the United States of 2013, any youngster can walk into a store and buy a bottle of aspirin, acetaminophen, ibuprofen or some other pain reliever without showing any identification, parental consent or a doctor's order. They don't have to be 15 or 17 or even old enough to know how to make exact change if the cashier will help them out.

So what's the big deal about a bottle of a common analgesic, you may ask? Well, it may be the most dangerous over-the-counter drug available. Each year, poison control centers across the nation get thousands of calls from people who have overdosed on painkillers, particularly acetaminophen, which some people deliberately take to commit suicide, as it can cause acute liver failure if consumed in sufficient quantity. About 50 people die of acetaminophen overdoses each year in this country.

Meanwhile, it's also perfectly legal for anyone to buy condoms in that same store. A 5-year-old could buy a pack without so much as a relative in the room, let alone a prescription. The U.S. Supreme Court struck down the last of the so-called Comstock laws — state restrictions on such birth control — nearly 50 years ago.

So why is anyone up in arms over the news this week that the Obama administration has lowered the age at which someone can buy Plan B One-Step — though not the two pill, generic version — over the counter from 17 to 15? It can't be because young people didn't have access to contraception. And safety seems like a bit of a red herring as well, since Plan B One-Step is a single pill, while a bottle containing 500 doses of Extra Strength Tylenol is far more dangerous.

In reality, the only outrage ought to be directed at the White House and Health and Human Services Secretary Kathleen Sebelius for not going far enough and lifting age restrictions entirely, as the U.S. Food and Drug Administration was ordered to do last month by a federal judge in New York who recognized that the Obama administration had put politics ahead of science. Instead, the administration has unwisely decided to appeal that order.

The FDA's own experts judged two years ago that Plan B is safe and effective and should be available to women of any age. But for some reason, Ms. Sebelius seems dead-set against it. In December 2011, campaign politics may have played a role when she decided that customers would have to be 17 years or older. But why now?

Is this some exercise in face-saving, or does HHS now see a big distinction between girls of 15 and 17 — essentially, high school sophomores and seniors? Then perhaps someone can properly answer why the one-pill version of the drug is fine but the two-pill generic version is not? If a 15-year-old can't follow that direction, how can she be trusted with a bottle of Tylenol?

We've said it before, and we'll say it again. Let's pay a bit more attention to the more serious and costly health issue — underage pregnancy — and less to setting up arbitrary roadblocks to emergency contraception. The point is to make the drug as easily available as possible. It's not meant as a front-line "Plan A" form of contraception.

And it's certainly not the equivalent of RU-486, or mifepristone, the drug that can cause an abortion and should be medically supervised. Plan B works just like birth control pills and can be taken up to five days after unprotected sex to prevent pregnancy, though it is most effective when used as soon as possible. It has no effect against sexually transmitted diseases, another reason why it shouldn't be used as a primary contraceptive.

Once again, conservatives seem to think that making contraceptives more available is a bad thing. But studies show that teen use of contraceptives is up, yet teens are actually waiting longer to have sex than they did in the past. According to the Guttmacher Institute, 11 percent of never-married females ages 15-19 had sex before age 15 in 2008, compared with 19 percent in 1995.

Condoms are cheap but Plan B costs $50 a pop, so does anyone seriously believe teen girls might still prefer the latter and risk STDs, pregnancy and side effects? Any girl who can be trusted with a bottle of painkillers can be trusted with that decision. The only poor decision-making is by the Obama administration for ignoring common sense and clinging to its Plan B age restrictions at the expense of the nation's teens — and taxpayers.

Copyright © 2015, The Baltimore Sun
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