California Renews Non-Rx Pharmacy Syringe Access—But How Accessible Are They?

October 1, 2020

Californians will continue to be permitted to purchase sterile syringes and needles at community pharmacies without a prescription, thanks to Governor Gavin Newsom’s September 29 signing of a bill to renew an exemption that would otherwise have expired at the close of the year.

The Pharmacy Access Bill (AB 2077) protects both pharmacists’ discretion to provide hypodermic syringes without a prescription and drug users’ right to possess the syringes without fear of prosecution.

The lawmaker behind the bill, state Assembly member Phil Ting of San Francisco, had previously renewed the program, statutorily initiated in 2011, with the passage of his 2014 bill—which additionally eliminated a 30-syringe cap on purchases, possession, sales and provisions. Due to pressure from law enforcement, that 2014 bill ended up including a January 1, 2021 sunset clause, making this latest measure necessary. In 2018, Ting also successfully sponsored a bill that created an industry-funded needle and drug take-back program.

“Although we haven’t assessed what the impact of the bill will be, we strongly believe that AB 2077 complements strategies to provide continued access to important programs like syringe exchange services and other public health resources that mitigate the impact of infectious diseases,” Jeannette Zanipatin, Drug Policy Alliance’s* California state director, told Filter. “Although not mandated, pharmacy access continues to be the best approach to promote statewide access and it is our hope that we’ll continue to see pharmacies statewide join this effort, especially during this difficult period impacting us all.”

While more syringe access is better than none, pharmacies are by no means welcoming to people who use drugs and there’s evidence to suggest that drug users’ access may be limited by stigma. Two studies conducted by epidemiologist Robin Pollini found widespread barriers in two Central Valley counties, Fresno and Kern, where injection drug use prevalence has respectively ranked second and fourth highest among nearly 100 US metropolitan areas.

In 2014, Pollini found that the majority of surveyed pharmacists were overtly opposed to selling syringes to people who use drugs. Out of slightly more than 400 pharmacists and other staff, the vast majority (79 percent) said they would sell nonprescription syringes to diabetic patients, yet only 113, or 29 percent, reported they would do the same for “a known or suspected injector of illicit drugs.”

About a year before, Pollini found that practical obstacles also stood between Californians accessing syringes at their local pharmacies. In 2013, Pollini’s team sent out four syringe purchasers—including white and Latinx women and men (presumably cisgender)—to almost 250 retail pharmacies in the two counties that would later be surveyed about their perspectives on drug users. Only one out of every five attempts (21 percent) to purchase syringes was successful.

Almost half (45 percent) of the pharmacies still required a prescription. Other common reasons for the failed attempts included being asked about their diabetes status (31 percent); the pharmacy not stocking the requested syringe size and type (10 percent) or not supplying syringes at all (9 percent); or the purchaser not providing a specific reason for the purchase (8 percent), which they are not required to do by law.

When buyers were successful, their experiences were still often not ideal. They frequently had to provide identifying information in a “log book,” something that seems prohibitory to drug users facing pervasive stigma. Raising even more concern, “only a few” of the pharmacists that sold syringes to the study participants even provided the statutorily required health education documents regarding substance use disorder treatment, HIV/hepatitis C and safe syringe disposal—all of which are accessible online.

The problems seen in the Central Valley have been shown to be present elsewhere in the state. In Los Angeles in 2010, researchers’ purchase attempts were granted at the same rate (21 percent) as in the two Central Valley counties. And while San Francisco pharmacists were far more inclined to sell syringes to study participants (63 percent), none provided the required health information.

“We are thinking through possible ways to address this barrier,” said Zanipatin.


Photograph of a pharmacy by Clean Walmart via Flickr/Creative Commons

* The Drug Policy Alliance has previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.

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