A qualitative study on pharmacy policies toward over-the-counter syringe sales in a rural epicenter of US drug-related epidemics

Harm Reduction Journal

Umed Ibragimov¹  Monica Fadanelli¹  April M. Ballard¹  Hannah L. F. Cooper¹  Patricia R. Freeman²  April M. Young³ 

[1] Emory University Rollins School of Public Health, 1518 Clifton Rd, 30322, Atlanta, GA, USA;University of Kentucky College of Pharmacy, Lexington, KY, USA;University of Kentucky College of Public Health, Lexington, KY, USA;

关键词: People who inject drugs;    Rural;    Syringe sale;    Pharmacy;    Attitudes;    HIV;    HCV;    Risk environment framework;    Qualitative;   

DOI  :  10.1186/s12954-021-00569-2

来源: Springer

【 摘 要 】

BackgroundExpanding access to sterile syringes in rural areas is vital, as injection-related epidemics expand beyond metropolitan areas globally. While pharmacies have potential to be an easily accessible source of sterile syringes, research in cities has identified moral, legal and ethical barriers that preclude over-the-counter (OTC) sales to people who inject drugs (PWID). The current study builds on prior urban-based research by elucidating (1) pharmacy OTC policies and (2) pharmacists’ rationale for, and barriers and facilitators to, OTC syringe sales in a US rural area hard hit by drug-related epidemics.MethodsWe conducted 14 semi-structured interviews with pharmacists recruited from two Eastern Kentucky health districts. Interview domains included experiences with, and attitudes toward, selling OTC syringes to PWID. Constructivist grounded theory methods were used to analyze verbatim transcripts.ResultsMost pharmacists operated “restrictive OTC” pharmacies (n = 8), where patients were required to have a prescription or proof of medical need to purchase a syringe. The remainder (n = 6) operated “open OTC” pharmacies, which allowed OTC syringe sales to most patients. Both groups believed their pharmacy policies protected their community and pharmacy from further drug-related harm, but diverging policies emerged because of stigma toward PWID, perceptions of Kentucky law, and belief OTC syringe sales were harmful rather than protective to the community.ConclusionOur results suggest that restrictive OTC pharmacy policies are rooted in stigmatizing views of PWID. Anti-stigma education about substance use disorder (SUD), human immunodeficiency virus (HIV), and Hepatitis C (HCV) is likely needed to truly shift restrictive pharmacy policy.

【 授权许可】

CC BY