Role of Pharmacists in Harm Reduction: Syringe/Needle Exchange

Historically, harm reduction (public health initiatives to minimize injurious social and physical consequences of human behavior) has successfully contributed to declining rates of teen pregnancy and HIV. As a result of the persistent opioid epidemic, a current harm reduction initiative focuses on reducing adverse consequences in drug users.

Previous studies prove that pharmacy-based syringe and needle exchange programs (NEPs) effectively reduce risk behaviors among people who inject drugs (PWID). Removing barriers to implementing NEPs in community pharmacies could increase clean needle accessibility. Offering clean needles at chain/supermarket and independent pharmacies allows the greatest potential to reduce harm because these businesses are convenient.

The Harm Reduction Journal published a study focusing on clean syringe/needle exchange and found many Kentucky community pharmacists are willing to sell clean needles, but needle disposal is a serious concern.

Most states permit the nonprescription sale of syringes, but some, including Kentucky, require pharmacists to document the customer’s name, address, and intended use of the needles. Invasive requirements deter many community pharmacies from selling needles, and the subsequent lack of access for patients probably contributes to Kentucky’s unacceptable rates of acute hepatitis B and C infections.

In this study, willingness to dispose of dirty needles was 39% lower in chain/supermarket pharmacists than independent pharmacists. To successfully implement needle disposal protocols, both the chain/supermarket pharmacies and pharmacists must be willing to adjust workflow procedures.

PWID face a societal stigma, so all community pharmacists must promote harm reduction principles and attitudes actively and publically. Pharmacists who voluntarily participate in harm reduction strategies can have a significant public health impact. Pharmacists can combat increasing overdose mortality by providing patients resources for recovery, educating on clean syringe exchange, and limiting the spread of blood-borne infectious disease.

Universities and professional organizations are expanding access to harm reduction continuing education interventions for community pharmacists. Harm reduction modules should empower and help educate pharmacists on how to implement NEPs successfully in their community settings. Although some progress has been made, policy makers and professionals must mitigate remaining barriers to participation in syringe/needle exchange programs.

Reference

Goodin A, Fallin-Bennett A, Green T, Freeman PR. Pharmacists' role in harm reduction: a survey assessment of Kentucky community pharmacists' willingness to participate in syringe/needle exchange. Harm Reduct J. 2018 Jan 25;15(1):4.