Expanding access to sterile syringes through pharmacies: Assessment of New York's Expanded Syringe Access Program
James M. Tesoriero, PhD; Haven B. Battles, PhD; Susan J. Klein, MS; Erin Kaufman, MPH; Guthrie S. Birkhead, MD, MPH
J Am Pharm Assoc (2003) 2009;49:407-416. doi:10.1331/JAPhA.2009.07127


Objectives  To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State.

Design  Longitudinal study.

Setting  New York State in 2002 and 2006.

Participants  506 (2002) and 682 (2006) managing pharmacists (response rates ∼70%) at ESAP-registered pharmacies (n = 346 in both years).

Intervention  Mailed surveys (2002 and 2006).

Main outcome measures  Pharmacist practices, attitudes, and experiences with ESAP over time.

Results  Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time.

Conclusion  Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

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