Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions

Meyerson, Beth E.; Davis, Alissa; Agley, Jon; Shannon, D.J.; Lawrence, Carrie; Ryder, Priscilla T.; Ritchie, Karleen; Gassman, Ruth A.

doi:10.1016/j.drugpo.2018.02.024

Cited by 37 publications

(25 citation statements)

References 37 publications

(42 reference statements)

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“…However, there is great variation in state laws regulating pharmacy sales of syringes, and even when state laws permit sales, perceived pharmacists' stigmatizing attitudes toward PWID and concerns over privacy can greatly restrict pharmacy sales and use by PWID. 50 Support to empower pharmacies and pharmacists in partnering to end the HIV epidemic among PWID and considerable public advocacy are needed to reach their full potential.…”

Section: Minimize Distance Maximize Accessmentioning

confidence: 99%

Syringe Services Programs’ Role in Ending the HIV Epidemic in the U.S.: Why We Cannot Do It Without Them

Broz

Carnes

Chapin-Bardales

et al. 2021

American Journal of Preventive Medicine

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Section: Minimize Distance Maximize Accessmentioning

confidence: 99%

Syringe Services Programs’ Role in Ending the HIV Epidemic in the U.S.: Why We Cannot Do It Without Them

Broz

Carnes

Chapin-Bardales

et al. 2021

American Journal of Preventive Medicine

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“…Therefore, pharmacist attitudes and pharmacy policies have a large influence on NPS availability. Over 50% of pharmacists surveyed in Indiana in 2016 reported feeling uncomfortable dispensing syringes to anyone without a prescription [ 7 ]. Negative experiences related to NPS sales, such as discovering used syringes on the store floor or persons who inject drugs (PWID) refusing to wait their turn in line during busy times, were reasons Connecticut pharmacists refused to sell NPS [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Negative experiences related to NPS sales, such as discovering used syringes on the store floor or persons who inject drugs (PWID) refusing to wait their turn in line during busy times, were reasons Connecticut pharmacists refused to sell NPS [ 8 ]. Notably (and paradoxically, given ample evidence on the benefits of NPS), pharmacies located in areas with high rates of opioid overdose mortality are often less likely to sell syringes without a prescription [ 7 ]. PWID report that pharmacies are where they most frequently purchase sterile syringes, and those residing in urban settings may have easier access to sterile syringes than those in rural areas [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmacist attitudes and provision of harm reduction services in North Carolina: an exploratory study

et al. 2021

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Background Pharmacists are among the most accessible healthcare providers in the United States and uniquely positioned to provide harm reduction services. The availability of pharmacy-based harm reduction services and pharmacist attitudes toward delivering these services have been understudied to date. We examine North Carolina (NC) pharmacists’ experiences with and attitudes about harm reduction services and explore differences between rural and urban pharmacists. Methods A convenience sample of NC pharmacists participated in an anonymous, online survey regarding harm reduction services: non-prescription syringe sales; naloxone dispensing; and human immunodeficiency virus (HIV) and hepatitis C virus (HCV) screening. Urban–rural differences were analyzed using Pearson’s chi-square or Fisher’s exact tests. Open-ended responses were analyzed thematically. Results Three hundred pharmacists responded to the survey; 68 (23%) practiced in rural counties. Dispensing non-prescription syringes and naloxone at least occasionally was reported by 77% (n = 231) and 88% (n = 263) pharmacists, respectively. Pharmacy-delivered HIV or HCV screening was rare. Urban pharmacists dispensed naloxone more frequently than rural pharmacies (p = 0.04). Only 52% of pharmacists agreed that persons who inject drugs should always be allowed to buy non-prescription syringes. Rural pharmacists’ attitudes toward harm reduction services for persons who inject drugs were statistically, though marginally, less supportive when compared to urban pharmacists’ attitudes. The most common barrier to non-prescription syringe access was requiring patients to provide proof of prescription injection medication use, which 21% of pharmacists reported was required by their pharmacy’s policy on non-prescription syringe sales. Conclusions Although most pharmacies distributed naloxone and sold non-prescription syringes, pharmacy store policies and personal beliefs inhibited naloxone and non-prescription syringe dispensing. NC community pharmacies infrequently offer HIV and HCV screening. Paired with disseminating the evidence of the positive impact of harm reduction on individual and public health outcomes to NC pharmacists, institutional and systems changes to practice and policy may be important to promote harm reduction service availability, particularly for rural NC residents. Trial registration: N/A.

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“…It is notable that only the HRM technicians questioned the usefulness of naloxone in stopping opioid misuse and expressed prejudice in the provision of syringes, as others have documented in the pharmacy. 40,41 In places such as HRMs that are heavily affected by the opioid overdose crisis, it may be even more important to take the time to reinforce the goals of harm reduction and rescue medication provision, explain the chronic nature of addiction, and to be explicit about the need to build resilience and address compassion fatigue among all health care and service providers. Future efforts that focus on shifting pharmacist's and physician's attitudes toward pharmacy-based harm reduction strategies should consider including technicians in their efforts.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians

Kurian¹,

Baloy²,

Baird³

et al. 2019

Journal of the American Pharmacists Association

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Objectives: There is limited research on the attitudes of pharmacy technicians toward pharmacy naloxone provision, despite their widespread role in the pharmacy. We examined attitudes and perceptions of pharmacy technicians in the provision of naloxone in a sample of Massachusetts pharmacies. Design: Thirty-nine community retail pharmacies from 1 U.S. chain were purposely sampled in 13 municipalities across Massachusetts. Pharmacies were divided into high-risk municipalities (HRMs) versus low-risk municipalities (LRMs) based on the state average opioid-related death rate from 2011 to 2015. Setting and participants: A pharmacy technician working in each pharmacy was administered an in-person survey. Survey topics included technician beliefs about current naloxone provision practices; patient groups at greater risk of overdose; whether individuals filling prescriptions would benefit from naloxone; and whether individuals purchasing syringes would benefit from naloxone. Outcome measures: Closed-ended responses were analyzed by Mann-Whitney U, Fisher exact, and chi-square tests. Open-ended responses were summarized for themes and then contrasted by municipality risk status. Results: Technician participation was 100% (n ¼ 39). Technicians in both groups believed they could identify patient groups at risk of overdose in their practice, but HRM technicians recognized the need for naloxone for more of their at-risk patients (81% in HRM vs. 33% in LRM believed > 25% of patients need naloxone, P < 0.01). A willingness to provide naloxone was high (> 89%) in both groups. Open-ended responses revealed commonalities between groups, including the belief that patients need lower-cost naloxone, and a lack of patient and technician awareness that naloxone could prevent overdose in individuals at risk through use of prescription opioids not just through use of illicit drugs. Conclusion: Pharmacy technicians would benefit from overdose prevention training and are well positioned to recognize overdose risk and offer preventive interventions, such as naloxone. Among technicians, there is a high willingness to be involved in implementing broader naloxone access in pharmacies.

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Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions

Cited by 37 publications

References 37 publications

Syringe Services Programs’ Role in Ending the HIV Epidemic in the U.S.: Why We Cannot Do It Without Them

Syringe Services Programs’ Role in Ending the HIV Epidemic in the U.S.: Why We Cannot Do It Without Them

Pharmacist attitudes and provision of harm reduction services in North Carolina: an exploratory study

Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians

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