Despite some opposition, BC pharmacists to dispense morning-after pill without prescription.

F ive hundred BC pharmacists are preparing to dispense the " morning after pill " without a prescription, in part to help reduce the amount of violence against physicians who perform abortions. Three Canadian physicians who have performed abortions, including one from Vancouver, have been wounded in sniper attacks since 1994. (Arrest warrants have been issued in Canada and the US for an American antiabortion activist, who is also wanted for the murder of a New York doctor.) " With the shootings, we thought we had to do something to reduce the need for abortions , " says Brenda Osmond, deputy registrar of the College of Pharmacists of BC. Improving the availability of emergency postcoital contraception (EPC) is also a public health issue because of the increasing number of teen pregnancies and abortions, she says. According to the Society of Obstetricians and Gynaecologists of Canada (SOGC), the number of teen pregnancies grew by 18% between 1987 and 1994. Making EPC more available is an " urgent health care need, particularly in more remote areas, " says Os-mond. In February, the college was considering 2 options that would allow pharmacists to prescribe levonorgestrel and ethinyl estradiol, which has been packaged under the brand name Preven, as an emergency contraceptive. The combined oral contraceptive, known as the Yuzpe regimen, came on the Canadian market last fall. The first option is to let BC's provincial health officer, Dr. Perry Kendall, delegate all properly trained pharmacists to dispense the drug without a prescription. This follows the precedent set in many Canadian hospitals , where physicians authorize pharmacists to dispense certain drugs without a specific prescription. This method is also used to dispense emergency contraception in about 20 US states. Alternatively, BC could add Preven to its list of schedule 2 medications, which pharmacists can dispense at their discretion. This isn't normally done at a provincial level, but Osmond explains that federal legislation stipulates that a practitioner is a physician, dentist or any " health care professional " given prescribing authority by a provincial government. This allows BC midwives, for example, to have limited prescribing rights. Officials were confident that the delegation route will be followed. With both options, the BC Pharmacy Association would provide pharmacists with special training in therapeutic protocols, patient counselling and referrals on contraception, sexually transmitted disease and related subjects. They would also be trained to identify victims of abuse or …