The University Health Center dispensed 115 packets of the prescription drug known as the morning-after pill this past academic year. The amount is about two times what was prescribed to students fearing unwanted pregnancies last year, according to Health Center administrator Kathleen Maloney, who has been following the budding on-campus use of the only contraceptive that works after intercourse.
For Maloney, the increased use of what medical professionals call the Emergency Contraception pill, or EC, raises a slew of questions.
"Do we have more students who are sexually active?" she asked. "Is the Health Center doing a better job at informing the community about services? Is the sexual activity related to drugs and alcohol? Does access to the morning-after pill increase promiscuity? Are condoms being used incorrectly?"
While Maloney was loath to attribute the rise to any one reason, she did suggest that students opting to be sexually active should take birth control pills. However, female students at Brandeis, she said, seem to be less inclined to go on birth control than in previous years.
Maloney said the Health Center, in light of increases in EC usage and increasing attempts at educating female students, "should be encouraging students to make an appointment with the nurse practitioner to discuss birth control options."
EC is available by prescription only, a status prolonged by an FDA decision on May 6 not to allow over-the-counter distribution of the drug.
EC has been prescribed with the FDA's approval since 1998, when Preven, its first form, was introduced to the agency. Plan B, a more widely known and used form of emergency contraception, was approved for sale in 1999. Unless Barr Laboratories reapplies for over-the-counter distribution, EC will remain available with a prescription only.
EC contains many of the same ingredients used in birth control pills for years: progestin and levonorgestrel, a synthetic hormone. Plan B's main job is to step in when other forms of contraception-excluding birth control medications-fail or are not present.
The FDA's decision upset many feminist groups. The decision was a further blow to these groups since it came only two weeks after nearly a million people marched in Washington, D.C. for the reproductive options of women.
Advocates of nonprescription EC sale also point to the fact that an FDA advisory panel voted 23 to 4 to approve over-the-counter sale of the drug.
The members of the Nonprescription Drugs Advisory Committee and the Advisory Committee for Reproductive Health met jointly to consider the safety and effectiveness data of nonprescription use of Plan B this past December. The committee was made up of a panel of medical and scientific experts from outside the federal government. Although the joint committee recommended to FDA that EC be sold without a prescription, some of its members, including the chair, questioned if the data used could be reliably generalized to the overall population of nonprescription users, mainly because of the small sample size of younger age groups.
A prescription of Plan B has been available to Brandeis students for $20 a piece since 2000. As each year goes by, the number of EC pills being sold on campus has increased steadily. According to the records kept at the Health Center, in the 2000/2001 school year, 37 packets of Plan B were sold to students on campus. The following year, the number of EC pills sold jumped to 52. During the 2002/2003 year, EC was prescribed 69 times.
Maloney said she believes a decision to make the drug over-the-counter would have both positive and negative effects. "I would like to see it available over the counter but I would worry about misuse," she said. She said she believed EC sales would skyrocket if the drug were available without a prescription.
The Brandeis health center is open on weekends, so the obstacles created by prescription-only sales are not as much of an issue here. Still, students are aware of over-the-counter debate.
Tristin Klein '04, a coordinator of The Student Sexuality Information Services (SSIS), said there is a conception that students are more inclined to use the emergency contraception pill as a form of regular birth control.
"That is not the case," Klein said. She attributed the increased usage of EC to better publicity of EC by the Brandeis chapter of the Feminist Majority Leadership Alliance (FMLA) and SSIS.
Still, Klein said she understands why one would assume that increased availability of EC would lead some couples to take fewer steps to ensure sexual safety before intercourse. "I think that if people are using EC as a primary contraception that would be a negative consequence," she said.
"I think that maybe for whatever reason, students have more fear of pregnancy and perhaps that's why EC use is up," Erica Friedman '06, another SSIS member, said. "Also, its name is getting around campus and people know about it more than in past years."
Supporting Klein and Friedman's conjectures, Kimberly Leiken '07 said she learned about EC mainly from fliers posted around Brandeis. "My CA did not really say much about EC on campus-but my CA was a guy," she said.
Leiken said that while some people may be lazy and purposely choose to skip regular birth control, she agreed that the increased use of EC is more likely due to more knowledge of the drug. "I just think people are a little more aware of possible pregnancy after sex and are probably more concerned that it's a possibility and use EC just to be safe."
Melissa Young '07 also said that her CA did not speak to her about EC, but that she encountered informative fliers. She said that EC can help prevent the anxiety of a pregnancy scare. "If [EC is] easy to use and get, and there was unprotected sex, there is no reason to stress and wait to see if you're pregnant, but instead, just take EC right away," she said.
Young did say, though, that an increase in alcohol and drugs and "just irresponsible behavior" could possibly account for the rise in EC usage.
Friedman said she does not believe that the increased use of EC reflects a decrease in condom use, at least not as indicated by the quantity condom sales by SSIS. "Every semester, we ask the [Student Union Senate] for more money because our condom sales go up," she said.
Joshua Ritz '05, SSIS treasurer, confirmed Friedman's statement about spending. "We redistributed our budget for next year to allow us to sell more products ... we sold out of many products this year."
Ritz said he does not see easy access to contraception-either over-the-counter EC pills or SSIS wares-as a catalyst for more sexual behavior. "I think that sex would be there regardless," he said.
"I think that as far as how people act sexually, [better availability] makes them more responsible," Ritz said. "It just provides more options for people."
He said he would not foresee a huge shift in behavior if EC were sold over the counter. "It's not usually an abused option right now," he said. "I think that making it more readily available and having more information is a good thing.