Evaluation of Bexar County community pharmacist attitudes toward harm reduction

Abstract

Introduction Harm reduction is a term for strategies that minimize the negative outcomes of drug use. Given the progressing opioid epidemic, identifying barriers to harm reduction dispensing in community pharmacies is essential. Methods This online, survey-based study assessed community pharmacist attitudes toward harm reduction and perceived dispense rates of both naloxone and needles/syringes to patients without verifiable injectable prescriptions. The online survey was distributed to members of the Bexar County Pharmacist Association and university alumni. The survey collected demographics, perceived dispense rates of naloxone, needles and syringes, availability of pharmacy protocols for dispensing these products, and Likert-scaled attitudinal questions. Responses were collected for 6 weeks. Results Thirty-two survey responses were analyzed. Participants were generally white (n = 14) or Hispanic/Latino (n = 14), had a median age of 37 years (interquartile range, 32-49 years), and had a median graduation year of 2011 (interquartile range, 1988-2016). Most pharmacists agreed or strongly agreed they should be involved in harm reduction (n = 26) and that pharmacies are an appropriate place to access these resources (n = 26). However, most reported never or rarely dispensing both naloxone (n = 19) and needles and syringes (n = 22). Naloxone or needle and syringe protocol use was reported by 66% (n = 21) and 47% (n = 15) of pharmacists, respectively. Pharmacy protocols significantly enhanced the likelihood of naloxone dispensing (P = .007) but not needle and syringe dispensing (P = .24). Conclusion Community pharmacists exhibited positive attitudes toward harm reduction but reported low rates of dispensing both naloxone and needles and syringes. Pharmacy protocols could be enhanced to better support community pharmacists in this area.

Nobody Wants to Be Narcan’d: A Pilot Qualitative Analysis of Drug Users’ Perspectives on Naloxone

“…Previous studies have indicated that non-opioid users hold overall positive opinions of naloxone. [12][13][14] A survey of lay persons found that while only 61% of respondents had heard of naloxone, most respondents (88%) felt naloxone was beneficial in preventing accidental opioid overdoses. 12 Both medical professionals and state government agencies support efforts to increase naloxone availability due to demonstrated benefits in reducing opioid overdose mortality.…”

Commentary Article: Study Protocol for the Respond to Prevent Study: A Multi-State Randomized Controlled Trial to Improve Provision of Naloxone, Buprenorphine and Nonprescription Syringes in Community Pharmacies

“…7,8 Laws to permit pharmacistfacilitated naloxone provision quickly disseminated across all states and the District of Columbia from 2015 to 2018, and permission to sell nonprescription syringes at community pharmacies exist in all but 14 states presently. 9 However, the attitudes and behaviors of pharmacists and other pharmacy staff, [10][11][12][13][14][15][16][17] stigma and discrimination against people who use drugs during pharmacy interactions, 18,19 and structural factors like stocking of medications [20][21][22][23][24][25] have been identified as key barriers to the dispensing or sale of naloxone, buprenorphine, and nonprescription syringes in pharmacies.…”

Community pharmacist engagement in HIV and HCV prevention: Current practices and potential for service uptake

“…, 46. , 47 , 48 , 49 , 50 Community pharmacist engagement in secondary and tertiary prevention efforts for HIV/HCV has been investigated to a lesser extent, often in approaches combining screening and referral to infectious disease treatment. 51 , 52 Across all levels of HIV/HCV prevention literature, variations in pharmacists' attitudes and beliefs, perceived barriers, and engagement in services emerge.…”