Case P, Beckett G A, Jones T S
Department of Social Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18 Suppl 1:S94-101. doi: 10.1097/00042560-199802001-00017.
In October 1993, the Maine legislature repealed the prescription law regulating the sale of syringes. The new law allowed but did not require licensed pharmacists to dispense syringes without a prescription to anyone 18 years of age or older. From November 1995 to January 1996, we conducted a telephone survey of 208 Maine pharmacists to evaluate the sale of syringes with and without a prescription and to assess pharmacists' willingness to sell syringes without a prescription. We found that 94% of pharmacists were willing, in all cases or at the discretion of the pharmacist, to sell syringes without a prescription. However, when asked specifically about willingness to sell syringes without a prescription to suspected injection drug users (IDUs) > or =18 years of age, 47% were willing, 40% were not willing, and 13% did not know or declined to answer. Pharmacists reported other requirements for the purchase of syringes without a prescription, such as the requirement for the customer to provide a reasonable justification for the purchase. In all, there were 31 (15%) pharmacists in the sample willing to sell syringes to without a prescription with no additional requirements for purchase to suspected IDUs as permitted by law. There were few negative incidents reported involving IDUs and the sale of syringes without a prescription since amendment of the law. Although sales of syringes without a prescription were reported, the numbers sold fell short of the estimated number of syringes required for IDUs in Maine to use a new syringe for every injection. Despite the change in the prescription law intended to increase access to syringes, the data suggest barriers such as drug paraphernalia laws and pharmacy policies may prevent IDUs from purchasing syringes and contribute to ongoing transmission of HIV. Amendment of the drug paraphernalia and syringe possession laws, clarification of the legitimate medical purpose of access to sterile syringes for IDUs, and offering pharmacists continuing education on the prevention of blood-borne disease appear to be necessary steps in the effort to decrease the transmission of HIV among IDUs in Maine.
1993年10月,缅因州立法机构废除了规范注射器销售的处方法。新法律允许但不要求有执照的药剂师向18岁及以上的任何人无处方配给注射器。1995年11月至1996年1月,我们对208名缅因州药剂师进行了电话调查,以评估有无处方情况下注射器的销售情况,并评估药剂师无处方销售注射器的意愿。我们发现,94%的药剂师愿意在所有情况下或根据药剂师的判断无处方销售注射器。然而,当被具体问及是否愿意向18岁及以上的疑似注射吸毒者无处方销售注射器时,47%的人愿意,40%的人不愿意,13%的人不知道或拒绝回答。药剂师报告了无处方购买注射器的其他要求,例如要求顾客为购买提供合理理由。总体而言,样本中有31名(15%)药剂师愿意向疑似注射吸毒者无处方销售注射器,且无需法律允许的额外购买要求。自法律修订以来,很少有涉及注射吸毒者和无处方销售注射器的负面事件报告。尽管报告了无处方销售注射器的情况,但销售数量低于缅因州注射吸毒者每次注射使用新注射器所需的估计数量。尽管处方法有所改变,旨在增加注射器的可及性,但数据表明,诸如毒品用具法和药房政策等障碍可能会阻止注射吸毒者购买注射器,并导致艾滋病毒的持续传播。修订毒品用具和注射器持有法、澄清注射吸毒者获取无菌注射器的合法医疗目的,以及为药剂师提供预防血源疾病的继续教育,似乎是减少缅因州注射吸毒者中艾滋病毒传播努力中必要的步骤。