Individual and Structural Influences Shaping Pharmacists’ Decisions to Sell Syringes to Injection Drug Users in Atlanta, Georgia

Taussig, Jennifer; Junge, Benjamin; Burris, Scott; Jones, T. Stephen; Sterk, Claire E.

doi:10.1331/1086-5802.42.0.s40.taussig

Cited by 40 publications

(27 citation statements)

References 25 publications

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“…33 Educational programmes should stress the current understanding that drug addiction is a chronic, relapsing, treatable medical condition. 34 Pharmacists themselves expressed the need for guidance about how to deal with drug misusers. For successful training, professional pharmacy associations should be involved, and involving pharmacists in planning the interventions should help to break down barriers.…”

Section: Discussionmentioning

confidence: 99%

Should Pharmacists have a Role in Harm Reduction Services for IDUs? A Qualitative Study in Tallinn, Estonia

et al. 2009

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Despite the high number of injecting drug users (IDUs) in Estonia, little is known about involving pharmacies into human immunodeficiency virus (HIV) prevention activities and potential barriers. Similarly, in other Eastern European countries, there is a need for additional sources for clean syringes besides syringe exchange programmes (SEPs), but data on current practices relating to pharmacists' role in harm reduction strategies is scant. Involving pharmacies is especially important for several reasons: they have extended hours of operation and convenient locations compared to SEPs, may provide access for IDUs who have avoided SEPs, and are a trusted health resource in the community. We conducted a series of focus groups with pharmacists and IDUs in Tallinn, Estonia, to explore their attitudes toward the role of pharmacists in HIV prevention activities for IDUs. Many, but not all, pharmacists reported a readiness to sell syringes to IDUs to help prevent HIV transmission. However, negative attitudes toward IDUs in general and syringe sales to them specifically were identified as important factors restricting such sales. The idea of free distribution of clean syringes or other injecting equipment and disposal of used syringes in pharmacies elicited strong resistance. IDUs stated that pharmacies were convenient for acquiring syringes due to their extended opening hours and local distribution. IDUs were positive toward pharmacies, although they were aware of stigma from pharmacists and other customers. They also emphasized the need for distilled water and other injection paraphernalia. In conclusion, there are no formal or legislative obstacles for providing HIV prevention services for IDUs at pharmacies. Addressing negative attitudes through educational courses and involving pharmacists willing to be public health educators in high drug use areas would improve access for HIV prevention services for IDUs.

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Section: Discussionmentioning

confidence: 99%

Should Pharmacists have a Role in Harm Reduction Services for IDUs? A Qualitative Study in Tallinn, Estonia

et al. 2009

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“…25 Despite this promise, pharmacies and pharmacists often erect barriers to such purchase of syringes. 21,[26][27][28] Other alternatives include physician syringe prescription for IDUs. 29 A third method for access to sterile syringes is through vending machines, but this does not have support in the United States.…”

Section: Discussionmentioning

confidence: 99%

A Multistate Trial of Pharmacy Syringe Purchase

Compton

Horton²,

Cottler

et al. 2004

Journal of Urban Health: Bulletin of the New York Academy of Me

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“…12 It appears to be more a lack of knowledge about laws governing harm reduction practices than the laws themselves. 36 Company directives regarding harm reduction services for IDUs also influence pharmacists' involvement in these services. Company policies toward syringe exchanges range from fully supportive to prohibitive.…”

Section: Barriers To Developing Harm Reduction Programsmentioning

confidence: 99%

“…33 Similar to barriers cited for introducing other new services in community pharmacies, lack of time, training, space and appropriate remuneration are also cited as reasons for not initiating or offering limited harm reduction services. 24,36 Finally, an interesting barrier noted by Hall and Matheson was that the lack of interdisciplinary teamwork contributed to decreased pharmacist commitment to harm reduction services. 33 This feeling of disconnect also led to an inability of pharmacists to refer clients to appropriate social and health care resources.…”

Section: Barriers To Developing Harm Reduction Programsmentioning

confidence: 99%

Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes

Watson

Hughes

2012

Can Pharm J

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Conclusion:As one of the most accessible health care providers, community pharmacists are in an ideal position to provide meaningful services to injection drug users. However, in order to do so, pharmacists require additional support in the form of better health team and system integration, as well as remuneration models. Can Pharm J 2012;145:124-127.e2. health promotion and traditionally refers to policies or programs that are aimed at decreasing the adverse health, social and economic consequences of high-risk behaviours such as drug and alcohol use. 4 For the purposes of this paper, harm reduction services refer to strategies aimed at minimizing the harmful consequences associated with injection drug use and high-risk sexual activity, which are 2 significant social and health issues. Injection drug use accounts for 17% of new cases of HIV infection and approximately two-thirds of new cases of hepatitis C in Canada. 5,6 While the economic burden related to injection drug use is difficult to determine, the lifetime cost of treating each case of HIV infection is $150,000 and it has been estimated that the cost of treating hepatitis C in injection drug users (IDUs) in Canada between 2006 and 2026 will be $3.96 billion. 7,8 With the sequelae of injection drug use and high-risk sexual activity being so costly and burdensome, the implementation of more effective programs aimed at reducing these problems is a priority.Throughout the literature, community pharmacists are acknowledged as important, underutilized resources in preventing the spread of HIV and other blood-borne infections. Pharmacists are recognized as one of the most accessible health care professionals for the general population and are in an ideal position to reach IDUs, who are often socially marginalized and often wish to maintain anonymity. Potential harm reduction roles for community pharmacists that have been identified include the sale of condoms and other safer-sex products, educating on safe-sex practices, selling clean needles/syringes, providing a site for disposal of used needles and syringes and dispensing oral methadone for the treatment of opiate dependence.The purpose of this paper is to provide an overview of pharmacists' involvement in harm reduction services, with a particular focus on research that has evaluated pharmacists' attitudes and barriers toward provision of these services. A review of the literature from 1995 to 2011 was conducted through MEDLINE, PubMed and Scopus using the search terms pharmacist, harm reduction, disease prevention, health promotion, attitudes, competence and barriers. Relevant references of articles identified by the search were also reviewed by both study investigators. To be included in this review, studies had to focus on harm reduction services involving pharmacies, pharmacists' attitudes and identified barriers toward providing such services or both. Articles were excluded if they were not in English or did not meet the above inclusion criteria. Results Current practices in harm reductionOne of t...

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Individual and Structural Influences Shaping Pharmacists’ Decisions to Sell Syringes to Injection Drug Users in Atlanta, Georgia

Cited by 40 publications

References 25 publications

Should Pharmacists have a Role in Harm Reduction Services for IDUs? A Qualitative Study in Tallinn, Estonia

Should Pharmacists have a Role in Harm Reduction Services for IDUs? A Qualitative Study in Tallinn, Estonia

A Multistate Trial of Pharmacy Syringe Purchase

Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes

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