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New Orleans health officials say state'level reclassification of mifepristone and misoprostol has reduced access and should be repealed
Summary
The New Orleans Health Department reported that a 2024 Louisiana law reclassifying mifepristone and misoprostol as Schedule IV drugs has produced pharmacy stockouts, delays in inpatient and outpatient care and patient harm; the department recommended repeal and statewide monitoring.
The New Orleans Health Department presented findings to the City Council on a year-long evaluation of the 2024 law that reclassified mifepristone and misoprostol as Schedule IV controlled substances, saying the change has reduced pharmacy availability and delayed urgent care.
The department'wide evaluation, introduced by Director Jennifer Avegno, MD, and briefed by Deputy Jeannie Donovan and analysts, found that only about half of pharmacies in Orleans and Jefferson parishes stock misoprostol and that stocking and dispensing declined after the law took effect on Oct. 1, 2024. The department said delays affected inpatient emergency care, postpartum hemorrhage treatment and outpatient management of miscarriage and other reproductive-health needs.
The report said pharmacists told student surveyors they stopped stocking the drug because the new rules imposed additional administrative steps; providers reported having to anticipate and pre-order medication for situations that previously relied on same-day dispensing. In one example cited by the health department, a patient undergoing a cesarean delivery needed misoprostol for a uterus that would not contract; the drug had been ordered but did not arrive immediately, creating a delay in care.
"These are medically necessary, frequently used medications," Jeannie Donovan said in the presentation, adding that misoprostol is designated an essential medicine by the World Health Organization and has long been FDA-approved for several obstetric uses. Ryan, a department analyst who led the pharmacy survey, said availability varied by parish: roughly 61% of Orleans pharmacies stocked misoprostol versus 42% in Jefferson.
Citing national context, the department noted several states proposed similar reclassification bills in 2025 but none advanced to hearings; the department called Louisiana's approach "an outlier" and recommended repeal of the Schedule IV reclassification. The report also recommended state-level monitoring, targeted pharmacist education and exploration of federal avenues to limit misuse of controlled-substance scheduling.
Michelle Ehrenberg, executive director of advocacy group LIFT Louisiana, told the council the organization has filed a lawsuit challenging the state law and said the rhetoric from state officials has further chilled dispensing. "These are life-saving medications and they need to be accessible and available," Ehrenberg said.
Council members asked how the city could respond. Vice President Moreno introduced a resolution accepting the department's findings; the council voted by voice to adopt the resolution, with members saying the data supported urgent state and federal advocacy and local mitigation steps to protect patient access.
The health department said it would keep the council updated as it continues monitoring pharmacy stocking, patient incidents and provider experiences and as litigation and potential legislative remedies proceed.
