As California and the nation mark the 20th anniversary of the first reported cases of AIDS on June 5th, Assemblywoman Dion Aroner (D-Berkeley) expressed concern that California is failing to do all it can to prevent new HIV infections among its residents, and urged support for Assembly Bill 1292, the Pharmacy Sale and Disease Prevention Act (Aroner), which would allow for the sale of syringes at licensed pharmacies without a prescription.
“Studies show that broadening access to sterile syringes helps prevent the spread of diseases such as HIV and hepatitis C, and yet California continues to be one of only six states that require a prescription to purchase syringes,” stated Aroner, who Chairs the Democratic Caucus. “As home to the first reported AIDS cases, you might think that California would lead the nation, but in this regard, we are lagging far behind. Unfortunately, this failure to lead is costing lives.”
AB 1292 would allow licensed pharmacies to sell sterile syringes without a prescription, and would also protect individuals from prosecution for possessing syringes, which is currently a misdemeanor crime in California. AB 1292 would also require that pharmacists provide information to consumers about safe disposal of syringes and would allow pharmacists to provide information about the availability of drug treatment, HIV testing and other services in the area. Participation in the program by state-licensed pharmacists would be voluntary.
"This bill recognizes the important role pharmacists play in public health and disease prevention,” said Elizabeth Johnson, Pharm.D., Senior Vice President of the California Pharmacists Association, which endorsed the bill. “By participating in such a program, pharmacists would not only help prevent HIV and hepatitis C among injection drug users, but would also provide an important service to diabetics and others with health conditions that require them to obtain prescriptions.”
A new national survey by the independent Kaiser Family Foundation shows that 61 percent of Americans favor allowing injection drug users to purchase clean needles from a licensed pharmacist in order to stop the spread of HIV. Support for this policy is particularly strong among those in the Western region of the country, where 65% favor non-prescription sales (compared with 58 percent, 59 percent and 62 percent in the Midwest, South and Northeast, respectively). (Complete results of this HIV public opinion survey can be found on the Kaiser Family Foundation’s website at: www.kff.org/docs/AIDSat20)
“On the issue of syringe access, public opinion is clearly ahead of public policy,” stated Aroner. “It’s time for the Legislature to follow the lead and adopt this important disease prevention measure.”
State law in five states (California, Illinois, New Jersey, Delaware and Massachusetts) and pharmacy regulation in one (Pennsylvania) prohibit the sale of syringes without a prescription. Though originally designed to deter drug use, there is no evidence to suggest that prescription laws have led to lower levels of injections drug use in these six states.
In contrast, evidence from Connecticut -- which amended its state law to allow for over-the-counter sale of syringes in 1992 – shows encouraging results. Following the change in state law, the percentage of injection drug users (IDUs) who reported syringe sharing during the past 30 days decreased by 40 percent (52 percent before versus 31percent after). In addition, more IDUs reported having purchased a syringe from a pharmacy after the new law (19 percent before versus 78 percent after) and fewer IDUs reported obtaining syringes from the street (74 percent before versus 31 percent after). Since Connecticut’s action, New York, Maine, Minnesota, New Hampshire and Rhode Island have also amended their state laws to allow for the sale of syringes through pharmacies without a prescription.
Currently, injection drug users must purchase syringes on the streets, where quality is uncertain and costs are high. If they live in a community that has a needle exchange program, they may exchange used, potentially contaminated syringes for new ones in order to protect themselves from disease transmission. However, needle exchange programs are not available statewide due to California law that requires the declaration of a local emergency in order to legalize syringe exchange.
Since the U.S. Centers for Disease Control and Prevention (CDC) reported the first cases of AIDS on June 5, 1981, more than 120,800 Californians have been diagnosed with AIDS, the most advanced form of HIV disease, and nearly 74,000 have died. The California State Office of AIDS reports that 19 percent all AIDS cases were related to injection drug use with contaminated syringes. The link between injection drug use and HIV is particularly strong for women. In California, 37 percent of cumulative AIDS cases among women were IDU-related.