Participation and practices in non-prescription syringes sales (NPSS) by pharmacies in Los Angeles and San Francisco, 2007

Objective: To describe participation by pharmacists in non-prescription syringe sales (NPSS) to injection drug users (IDUs) and to determine pharmacy-specific factors associated with NPSS in Los Angeles (LA) and San Francisco (SF).

Methods: Telephone and in-person interviews with a pharmacy staff person in zip-codes with high proportions of IDUs in publically-funded substance abuse treatment in LA and SF were conducted. A total of 238 pharmacy surveys were completed in 2007 (n=67 in SF; n=171 in LA) with a response rate of 72%. Survey items covered whether pharmacies had registered with the county, engage in NPSS, required other information to sale, attitudes regarding HIV and HCV prevention for IDUs, and if they refused to sell syringes under certain conditions. Descriptive, bivariate and multivariate statistics were used to examine these data.

Results: Overall, 42% of pharmacies reported NPSS (81% in SF; 28% in LA) although only 33% had registered with their county government as required by law (76% in SF; 17% in LA). In multivariate analyses, NPSS was associated with SF city, some attitude items, and being a chain pharmacy. Many pharmacies required proof of medical condition (55%) for NPSS (31% in SF; 80% in LA). Many pharmacies reported refusing NPSS if the customer was a known or suspected IDU (74% in LA & 33% in SF).

Discussion: More research is needed to understand factors pharmacy decision-making regarding NPSS. Additional educational and advocacy efforts are required to increase pharmacy participation and lower obstacles to NPSS among pharmacies that do sell.