Published2 days agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Robin Levinson-KingBBC NewsAnti-abortion activists won a historic victory at the Supreme Court last year, but the debate over one of America’s most divisive issues is far from over, with focus now shifting to over-the-counter abortion pills.Since 2000, the Food and Drug Administration (FDA) has approved mifespristone as the first step in a two-drug process to abort early pregnancies.Last January, the FDA changed its regulations to allow retail pharmacies to give out the drug – previously, only a handful of pharmacies and specialised clinics and doctors could dispense it. The change in the law could make it easier for millions of women to obtain an abortion, since such pills are currently the most common method.Pharmacies will have to apply to be certified to distribute the drug, and meet certain safety and privacy requirements, say US regulators. The expansion has coincided with a number of legal and political battles over the future of mifepristone in several states. The back and forth could affect access to the drug for millions of women across the US. Here are three states where the battle intensified this week.California retaliates against pharmacy giantSoon after the FDA said it would allow pharmacies to distribute mifespristone, over 20 Republican attorney generals signed letters threatening several of the nation’s top pharmacies with legal action if they were to dispense the drug in their state.”We emphasize that it is our responsibility as State Attorneys General to uphold the law and protect the health, safety, and wellbeing of women and unborn children in our states. Part of that responsibility includes ensuring that companies like yours are fully informed of the law so that harm does not come to our citizens,” a letter signed by 20 Republican attorney generals read. After receiving a similar letter from Kris Kobach, Kansas’ attorney general, a Walgreens executive responded.”Walgreens does not intend to dispense Mifepristone within your state and does not intend to ship Mifepristone into your state from any of our pharmacies. If this approach changes, we will be sure to notify you,” wrote Walgreens executive vice-president Danielle Gray.Abortion pills a new front in culture warsThe text that gets abortion pills sent in secretThis ignited a backlash, because abortion remains legal in the state. Since the Supreme Court last summer overturned Roe v Wade, the 1973 ruling granting a constitutional right to abortion for US women, the power to legislate for or against abortion has been given to the individual states.Since then, 13 states have banned abortion outright, while one state, Georgia, has outlawed it after six weeks of pregnancy. Others have signalled that they will restrict abortion in the future, or are fighting in court to ban it.Last year, Kansas held a referendum on whether to make a change to the constitution to explicitly say there was no right to abortion. Voters rejected that proposed change, which meant that abortion remains legal.The Democratic governor of California, Gavin Newsom, has hit back at Walgreens by refusing to renew the state’s $54m (£45m) contract with the pharmacy giant.Since then, Walgreens has tried to clarify its response, saying its position has always been that once it is certified to distribute mifepristone by the FDA, it will only sell it in states where abortion was legal. “We want to be very clear about what our position has always been: Walgreens plans to dispense Mifepristone in any jurisdiction where it is legally permissible to do so,” said a Walgreens spokesperson in an email to the BBC. “Once we are certified by the FDA, we will dispense this medication consistent with federal and state laws. Providing legally approved medications to patients is what pharmacies do, and is rooted in our commitment to the communities in which we operate.”It has not addressed the fact that it said it would not sell it in Kansas, where abortion is legal.Michigan repeals 1931 abortion lawOn Wednesday, Michigan repealed a law from 1931 that made abortion drugs illegal. The state’s top court ruled the law unconstitutional last September.”Today’s repeal of this antiquated law is a victory for millions of Michigan residents who, like myself, value bodily integrity and personal freedom,” Michigan Attorney General Dana Nessel said in a news release.The legislature also repealed the part of the law that made it illegal to advertise “any pills, powder, drugs or combination of drugs”.For years abortion had been legal in the state because of federal law. But when Roe v Wade was overturned, it created confusion. Old laws, like the 1931 ban, which had not been enforced, could suddenly be applied. Last year, pro-choice campaigners managed to get a question on whether abortion should be a right on the November election ballot.Over 55% of the population voted in favour of making abortion a protected right in the state constitution, which trumped the 1931 law.Texas takes aim at FDAOver in Texas, the second most populous state in the US, a judge is weighing a decision on whether mifepristone should be legal at all.Although the drug was approved over two decades ago, a lawsuit filed by anti-abortion groups claims that it is unsafe and that the FDA ignored reported side effects. Currently, the FDA says it is safe as part of a two-drug regimen to have an abortion at home, up until 10 weeks of pregnancy. The World Health Organization also says it is safe as part of a two-drug procedure, up to 12 weeks. Leading health organisations and physicians’ associations have filed briefs in the lawsuit, including the American Medical Association and the American College of Obstetricians and Gynecologists, which say the drug is effective and safe.The FDA has reported a total of 26 deaths associated with mifepristone since it was approved – a rate of about 0.65 deaths per 100,000 by-pill abortions. For comparison, the death rate associated with habitual aspirin use is about 15.3 deaths per 100,000 aspirin users. Now all eyes are on Judge Matthew Kacsmaryk, a Trump-appointee. If he decides the FDA erred in its approval, it could affect the drug’s status nationwide, and millions of women.But not so fast, say legal experts.In order to withdraw approval of a drug, the FDA is legally required to conduct hearings and new deliberations – a lengthy process that could take years. Earlier this year, US Attorney General Merrick Garland – the country’s top lawyer – said states could not ban the FDA-approved medication.If Judge Kacsmaryk does overturn the approval, the federal government may appeal, which means the battle over abortion pills might make its way all the way to the Supreme Court.With additional reporting by Holly HonderichMore on this story12 US states sue to expand access to abortion pill24 FebruaryUS pharmacies can now sell abortion pills4 JanuaryAfter Roe, anti-abortion activists eye new target12 July 2022

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesUS sprinter Sha’Carri Richardson will be missing the Tokyo Olympics because she tested positive for marijuana during the US Track & Field trials. With cannabis legal in many states across America, why is it still outlawed in sports?With her flowing tangerine orange hair, killer smile and lightning speed, Sha’Carri Richardson was unmissable in the lead-up to the Olympic Games. Considered the sixth-fastest woman in history, with a best-ever time for the 100m of 10.72, the Texas sprinter was expected to be a major contender for the Gold medal in Tokyo.But when her teammates take to the track for the women’s 100m heats on Friday, she won’t be there.In early July, it was announced that Ms Richardson would not be representing the US at the games because she had tested positive for cannabis use during the qualifying race.As punishment, the US Anti-Doping Agency banned her from competing for one month and expunged her qualifying victory. Although the 30-day suspension technically ended during the Tokyo games, US Athletics chose not to include her on the team.Her disqualification has reignited a long debate over marijuana prohibition in Olympic sports. image copyrightGetty ImagesGiven that it is legal in many US states, and that its performance-enhancing properties are disputed, many wonder why cannabis should still be banned.A ‘performance enhancing’ substance?Marijuana (cannabis) has been banned by the World Anti-Doping Agency (Wada) since the organisation first created its list of prohibited substances in 2004. Items on the list meet two out of three criteria:Criteria 1: They harm the health of the athleteCriteria 2: They are performance enhancingCriteria 3: They are against the spirit of sportIt is the second point that people seem to take the most issue with when it comes to weed, and it has become the subject of many late-night punchlines.”The only way it’s a performance-enhancing drug is if there’s a big [expletive] Hershey bar at the end of the run,” joked the late comedian Robin Williams.In 2011, Wada defended the ban on cannabis in a paper published in the journal Sports Medicine. Citing a study on marijuana’s ability to reduce anxiety, Wada found cannabis could help athletes “better perform under pressure and to alleviate stress experienced before and during competition”.image copyrightGetty ImagesBut those findings aren’t enough to warrant concluding marijuana is a performance-enhancing drug, argues Alain Steve Comtois, director of the department of sports science at the University of Quebec at Montreal.”You have to take the big picture,” he tells the BBC. “Yes anxiety levels go down, but in terms of actual physiological data, it shows that performance is reduced.”Mr Comtois was one of the authors of a 2021 Journal of Sports Medicine and Physical Fitness review of research on marijuana use before exercise and its capacity to enhance athletic performance.The paper found that most research points to marijuana hindering physiological responses necessary for high performance, by raising blood pressure and decreasing strength and balance.The paper did not look at the effects of marijuana on anxiety, but Mr Comtois says its other negative effects would counteract any benefits, giving the idea that marijuana can enhance athletic performance “no merit”.image copyrightGetty ImagesDrugs and the spirit of sportBut there is more to Wada’s rule than just a ban on performance-enhancing drugs.Founded in 1999 after several high-profile doping scandals at the Olympics, Wada aimed to lead the charge to end doping in sports around the globe. When coming up with its list of banned substances in 2004, marijuana was illegal in almost every country in the world.”They didn’t want to get in social respectability trouble,” says John Hoberman, a cultural historian who researches the history of anti-doping at the University of Texas-Austin.Its status as an illicit drug was cited by Wada in the 2011 paper as one of the reasons why marijuana offended the “spirit of sport” (criteria 3) and was “not consistent with the athlete as a role model for young people around the world”. The rule has led to reprimands for not only Ms Richardson, but also dozens of other athletes.In 2009, Michael Phelps was banned from competition for three months, and lost his Kellogg’s sponsorship, after photos of him smoking marijuana were leaked online. image copyrightGetty ImagesUS sprinter John Capel was banned for two years after testing positive for a second time in 2006. Before Wada created the prohibited drug list, the International Olympic Committee tried to take away Canadian snowboarder Ross Rebagliati’s gold medal because he tested positive. It was returned after a court ruled there was no official rule against it – the IOC banned it two months later. Why are so many countries now saying cannabis is OK?But over the past decade, marijuana’s legal status – and society’s attitude towards it – has begun to shift. Uruguay was the first to make it legal to buy and sell marijuana for recreational use in 2013, with Canada following suit in 2018.Many more countries have decriminalised it to a some degree, including South Africa, Australia, Spain and the Netherlands. In the US, it is illegal federally, but it is legal in about a third of states – including the state of Oregon where Ms Richardson tested positive.image copyrightGetty ImagesThere has also been an increasing acceptance of cannabis use for medical purposes, with many countries, including the UK, allowing medical marijuana.In fact, in 2019, Wada removed cannabidiol (CBD), a component of cannabis, from the banned list, even though the chemical remains illegal in some countries, like Japan, where the Olympics are hosted this year.Could CBD become ‘like protein shakes’?’CBD oil helps me cope with my anxiety’These changes have fuelled the current criticism of Ms Richardson’s ban.The runner told NBC News that she had used marijuana to cope with the death of her mother a week before the qualifier.”I greatly apologise if I let you guys down – and I did. This will be the last time the US comes home without a gold in the 100m,” she said. Amid an outpour of sympathy for Ms Richardson, Wada faced a dilemma. As Mr Hoberman puts it: “You can’t run an organisation that is rules bound, and simply dissolve a rule at a convenient moment”.Because the cannabis ban is still on the books, an exception could not be easily made for Ms Richardson.”And so this young woman was victimised by the existence of this rule,” says Mr Hoberman.What next?It’s unclear if or when Wada will reconsider the ban on cannabis but pressure is mounting for it to do so.Ms Richardson’s suspension prompted US President Joe Biden to question the current law, although he fell short of saying it should be overturned, prompting rumours the White House could step in.”Rules are the rules. Everybody knows what the rules are going in,” Biden told reporters Saturday in Michigan. “Whether they should remain that way, whether that should remain the rule, is a different issue.”Even the United States Anti-doping Agency, the American authority that enforces Wada’s rules, said “it’s time to revisit the issue.”Until then, Ms Richardson, and other athletes like her, will have to stay away from cannabis, or stay on the sidelines.