When politicians and bureaucrats start making medical decisions, they usually don’t know what they are doing and they look pretty much like dangerous  fools.  Let’s take the issue of methotrexate.

In the rheumatology world methotrexate is considered a safe basic drug for rheumatoid arthritis. It may be used alone. It may be used in combination with other drugs. When a patient is started on a biologic medication,  methotrexate is usually added as it improves response. It is not recommended for use during pregnancy. It is an inexpensive drug that has been used since the 50’s.

In the Texas law S.B. 4 methotrexate has been added to the list of drugs that can cause abortion. The reason for this comes from faulty information. In a normal healthy woman methotrexate will not cause an abortion. However, methotrexate can be used to end an ectopic pregnancy. This is a condition where the fertilized egg is implanted outside the uterus. It is not viable.  If the egg is not removed, the woman’s life is at grave risk.

Although provision has been made for the other uses of methotrexate, such as RA or Lupus, pharmacists are at risk when they fill a prescription. They are especially at risk for lawsuits from overzealous citizens authorized to fight abortion especially in states like Texas. Once started  these lawsuits could take years to resolve. It is easier just not to prescribe the drug.

In Texas, although there are exceptions, many pharmacists will not fill methotrexate prescriptions and some rheumatologists are not writing orders for it. They are afraid of being sued.

The politicians are influencing  medicine with their faulty edicts and they are putting the lives of women at risk.

Here we go again. During the opiate scandal, the same thing happened. Doctors were afraid to prescribe opiates for those in pain. They feared being ostracized or sued. They slowly came to the conclusion that patients didn’t really need pain medication. So unless you had cancer, those in severe pain were given no relief. The medical community came up with a lot of mumbo jumbo to rationalize their behavior. Were there more suicides? Probably. More depression? Of course.

So, yes here we go again. My advice is to be strong and to be determined.  There are doctors and pharmacists who practice good medicine without fear. You are entitled to have your methotrexate prescription filled even if you live in Texas.