Accutane is a godsend for anyone who has cystic acne, a horribly disfiguring skin problem that causes social as well as health problems for young people who suffer from it. Unfortunately, it also causes pretty awful birth defects in children whose mothers took it while pregnant. The ideal use of the drug is for 4 months at relatively high doses, but some doctors prescribe it for longer periods at lower strengths--not sure why. The drug itself is packaged interestingly--not just in a bubble pack, but a package that is almost impossible to open, and to do so, you have to break a seal that has a little picture of a pregnant belly with a big red cross through it.
A new program by the manufacturer called, iPledge, restricts prescribing for the drug to those who promise to use birth control, make doctors do pregnancy tests, and in general increase surveillance on patients using the drug so that they do not get pregnant while on it. Some men have been asked to take a pregnancy test and there are many complaints about how cumbersome the process is.
And with all this attention, and money, "Nothing has worked," according to a New York Times article Feb. 11th."The federal government has undertaken more than 40 efforts over the last 23 years to prevent women from becoming pregnant while taking Accutane." About 170,000 people take accutane, half of them women. I appreciate this admission that even when you pay attention, when the consequences are horrible, when you put the weight and money of the government and a pharmaceutical company behind your efforts, it is STILL very difficult to NOT get pregnant!!!
It is very hard, because getting pregnant is as natural for humans as it is for rabbits and cats and all of God's creatures. You have to work really hard not to get pregnant, and no one makes that easy--not the drug companies that keep even generic birth control very pricey. Not the Planned Parenthoods who cut people off their pill if they miss an appointment. Not the schools, churches, and parents who fail to tell kids how to protect themselves. Not the legislatures who don't fund sex education and family planning, but who do fund abstinence only education which not only don't teach the facts kids need to know, but actually MISLEAD kids with messages like "condoms are not effective."
The one group that I know that consistently tries to push birth control, educate women on health, and contraception, and pregnancy are ABORTION CLINICS!! And we might have some more suggestions for the makers of Accutane: Talk about abortion in your literature. Don't just say, "Don't get pregnant on this medication." which is pretty useless advice. Say: "You must use birth control while you are on this medication if you might possibly be sexually active, either voluntarily or not, during the time you are on the medication. If you become pregnant while taking Accutane, you must get an abortion due to the severe side effects associated with the drug. If that is not acceptable to you, DO NOT TAKE THIS MEDICATION." That's what we would call informed consent, and we would probably throw in a description of the problems of these deformed babies.
Unfortunately, the intersection of politics and medicine precludes such honest discussion of risk. So, what we have is expensive posturing that does no good. Bad politics and bad medicine yielding heartache for real people.