Pubdate: Wed,  5 Jan 2005
Source: San Jose Mercury News (CA)
Copyright: 2005 San Jose Mercury News
Author: Barbara Feder Ostrov, Mercury News


A new law that took effect Saturday will allow California pharmacies
to sell needles without a prescription to help prevent HIV/AIDS and
hepatitis C, but addicts can't head to their local drugstore for a
clean fix just yet.

Local governments must approve such sales and, so far, only Contra
Costa County has given the go-ahead. Most Bay Area public health
departments are still studying the issue.

The legislation, introduced by state Sen. John Vasconcellos, D-San
Jose, and signed into law last year by Gov. Arnold Schwarzenegger,
permits pharmacists to sell up to 10 sterile syringes and needles at a
time to people older than 18. Pharmacists must sign up to participate
in a "demonstration" program that will be tracked by state health
authorities for its usefulness in preventing disease.

Pharmacists' participation is voluntary, and life won't change for
diabetics and other patients who routinely get prescriptions to
purchase syringes to inject insulin or other medications.

Because previous laws have made it illegal to purchase or possess a
syringe without a prescription, drug addicts have found themselves in
a precarious position if they wanted clean syringes to protect
themselves against disease. Some rely on California's 23 legally
authorized needle exchange programs, while others buy them
underground. Still others use dirty, blunt needles, known among drug
users as "nails," said Joey Tranchina, who runs an authorized needle
exchange program based in Redwood City.

Although some law enforcement groups opposed the legislation, it has
been hailed by public health advocates as a welcome addition to their
arsenal of methods to combat HIV/AIDS and hepatitis C transmission.
Despite concerns that providing syringes on demand could encourage
drug use, numerous studies of needle exchange programs have shown no
evidence of that, Tranchina said.

More than a third of AIDS cases in the United States occurred in
injection drug users or their partners or children, according to the
Kaiser Family Foundation, a non-partisan think tank based in Menlo
Park. In California, injection drug use accounts for 20 percent of all
reported AIDS cases, making it the second-largest risk factor for the
deadly disease.

"It's not a panacea, just like needle exchange is not a panacea, but
we think it will help some," said Dr. Wendel Brunner, director of
public health for Contra Costa County, whose supervisors approved
pharmacy syringe sales in mid-December.

In Santa Clara County, public health experts will soon meet with law
enforcement groups and pharmacists to develop a program to take to
county supervisors, said county health spokeswoman Joy Alexiou.

San Jose Police Chief Rob Davis said he's keeping an open mind about
the new law but has concerns that the extra source of syringes could
mean more used needles on the street, potentially endangering the
public and his officers.

"There are a lot of question marks," he said.

In San Mateo County, supervisors have been asked to reconvene a needle
exchange task force to consider whether to allow non-prescription
syringe sales in pharmacies, but a final recommendation is not
expected until the spring, said Dr. Scott Morrow, the county's health

In Santa Cruz County, "we haven't gotten too far yet," said Leslie
Goodfriend, health services manager for the county's health services
agency. But prospects for approval look promising, with Goodfriend
noting that the county has always supported needle exchange programs
- -- "anything that can help reduce HIV/AIDS or hepatitis C."

Pharmacies are also waiting for more information. Walgreens
spokeswoman Phyllis Proffer said the chain had not made a decision on
whether it would participate in the program.

Tranchina, executive director of the AIDS Prevention Action Network in
Redwood City, says it's unclear how many of the estimated 15,000 to
20,000 injection drug users in the county would visit a pharmacy to
purchase clean needles, even if those needles were sold for pennies.
But someone who might be intimidated by a needle exchange program in a
grim neighborhood might feel more comfortable going to a pharmacy, he

"We welcome all avenues," Tranchina said. "This is a battle of
survival. Every uptick in HIV increases the chance that one of our
kids is going to have to live with it, and so much of it is
unnecessary. This is low-hanging fruit. Why not pick it?"
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