Community Pharmacies Positioned to Ensure OTC Syringe Access
In a telephone audit, researchers attempted to quantify the frequency of patient barriers when looking to purchase sterile syringes from community pharmacies for over-the-counter use.
Community pharmacies are best-positioned to provide increased access to sterile syringes but have failed to do so because of many locations typically restricting access, according to data published in Harm Reduction Journal.1 Researchers believe community pharmacists are key to the facilitation of opioid harm reduction in the US and should be utilized to further address unmet needs.
“Syringe services programs (SSPs) and syringe exchange programs (SEPs) have long provided access to sterile syringes and injection supplies for those with substance use disorders,” wrote authors of the study.1 “Unfortunately, SSPs and SEPs are often inaccessible for many [people who inject drugs] (PWID) due to varying geographic coverage, restricted operating hours, and stigma-related barriers, creating a need for other access points for patients seeking sterile syringes. With an estimated 90% of people living within a 5-mile radius of a pharmacy in the US, pharmacies are highly accessible for PWID and others impacted by substance use disorder.”
Researchers wanted to better understand why so many US patients struggled to gain access to OTC syringe products, a necessary health care tool since the development of the opioid crisis in the US. Along with naloxone initiatives designed to reduce opioid overdose rates, OTC syringes are also a useful harm-reduction resource.
Increasing access and facilitating pharmacists’ willingness to sell OTC syringe products are paramount. | image credit: florynstudio3 / stock.adobe.com
READ MORE: Significant Gaps Identified in Access to OTC Naloxone, Nonprescription Syringes
“Community pharmacies can protect the health of people who use drugs (PWUD) by facilitating access to naloxone and syringes,” wrote authors of a study published in JAMA Network Open.2 With identifiable gaps in access to these products, the study showed that just 25% of pharmacies commonly sold both OTC naloxone and nonprescription syringes.
With consistent reports of lacking access to opioid harm-reduction products, researchers of the current study wanted to further understand the common barriers to these products within community pharmacies in Oregon.
“Understanding these barriers is particularly important in Oregon given recent surges in opioid-related deaths, high rates of hepatitis C virus, and ongoing, high-profile public dialogue on drug use policies,” wrote the authors.1 “Using a ‘secret shopper’ methodology…this study addresses this need by quantifying access to a 10-pack of OTC syringes through Oregon community pharmacies.”
Researchers conducted a telephone-based audit, otherwise known as the secret shopper method, to understand trends in access to syringes at Oregon-registered pharmacies and dispensing facilities. They considered factors related to both pharmacy type (chain or independent) and county characteristics, including rurality, syringe service program presence, and overdose rate.
The final analysis included a total of 425 community pharmacies (84.9% independent; 62.8% in urban counties) in Oregon contacted between December 2023 and March 2024. Pharmacies were willing to sell syringes 56.7% of the time, with 12.4% of pharmacy staff asking about the need for syringes and 17.8% requesting specific product information.
“A lack of access to sterile syringes increases the transmission of bloodborne diseases and other injection-related health risks,” they said.1 “Among community pharmacies in Oregon, we identified barriers for patients seeking syringes, as nearly half of pharmacy staff members reported an unwillingness to sell a 10-pack of syringes without a prescription. This was most prevalent in community pharmacies in urban areas, with urban pharmacies being twice as likely to restrict the sale of OTC syringes as compared to rural counterparts.”
While there were several limitations and unique factors that impacted this study’s findings, it successfully identified an increasingly growing need for better access to OTC syringes and other harm-reduction products. Despite the apparent need for better access to these resources, this study’s existence in the context of the state of Oregon further highlights the complexity of the aforementioned harm-reduction supplies.
In order to address unmet public health needs, increasing access and facilitating pharmacists’ willingness to sell these products are paramount.
“As the opioid crisis continues in the US, multi-level interventions are needed to improve the health and well-being for PWID,” concluded the authors.1 “Community pharmacies have already emerged as key partners in naloxone provision, and it is critical that the pharmacy profession embrace other strategies to expand access to harm-reduction materials. Pharmacy-directed efforts are needed to ensure access to sterile syringes and address unmet health needs of PWID.”
READ MORE: Pharmacists’ Expertise Can Improve Patient Outcomes in Transitions of Care
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