文章基本信息

标题：Increased Access to Unrestricted Pharmacy Sales of Syringes in Seattle–King County, Washington: Structural and Individual-Level Changes, 1996 Versus 2003
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作者：Ryan J. Deibert ; Gary Goldbaum ; Theodore R. Parker 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2006
卷号：96
期号：8
页码：1347-1353
DOI：10.2105/AJPH.2003.032698
语种：English
出版社：American Public Health Association
摘要：We examined pharmacists’ attitudes and practices related to syringe sales to injection drug users before and after legal reform and local programming to enhance sterile syringe access. We replicated a 1996 study by conducting pharmacist phone surveys and syringe test-buys in randomly selected pharmacies. Test-buy success increased from 48% in 1996 to 65% in 2003 ( P =.04). Pharmacists agreeing that syringes should be available to injection drug users through pharmacy purchase increased from 49% to 71% ( P <.01). Pharmacy policies and pharmacist attitudes were strongly associated with syringe access. Structural changes, including policy reform and pharmacy outreach, appear to increase syringe access. Interventions should address pharmacy policies and pharmacist attitudes and policies. INJECTION DRUG USE accounts for approximately one third of all new HIV cases and approximately 60% of hepatitis C virus (HCV) infections in the United States. 1 ^, 2 Transmission of blood-borne viral infections among injection drug users (IDUs) results from shared use of drug injection equipment, including syringes, drug cookers, and filtration cotton. 3 ^, 4 Access to sterile injection equipment is associated with lower frequency of unsafe injection practices and reduced risk of infections. 5 ^– 10 Access to sterile syringes does not appear to increase drug use, either by increasing the number of individuals injecting drugs, or by increasing frequency of injection. 11 ^– 13 Worldwide, community pharmacies contribute to blood-borne disease prevention among IDUs by dispensing controlled substances with a prescription, selling new syringes, operating needle exchange services, and disposing of used syringes. 14 ^– 17 Pharmacists in Minnesota, New Hampshire, New Mexico, New York, and Washington State are partnering with public health jurisdictions to increase pharmacy access to sterile syringes, generally resulting in increased pharmacy syringe sales without prescription, decreased HIV risk behaviors among IDUs, and increased syringe disposal options. 18 Although most US states have legal restrictions on the sale and possession of syringes, pharmaceutical practice guidelines often allow pharmacists discretion in syringe sales decisions; this may lead to wide variation in syringe sales by individual pharmacists and to discrimination based on gender, age, race, ethnicity, or socioeconomic status. 19 ^– 23 Individual-level factors associated with pharmacists’ relative willingness to sell syringes include familiarity with customers; concerns about deception, disease transmission, improperly discarded syringes, and staff and customer safety; business concerns, including fear of theft and harassment of other customers by IDU patrons; and fear of increased drug use because of easier syringe access. 24 ^– 27