Developing a Solid System for Denying Insulin Syringe Sales - Georgia

[shaq786]

Hello all,

I am looking for some guidance. In my area, we have a lot of suspicious people trying to buy insulin syringes. I usually just tell them we don't have it but now its getting to a point where some start questioning that. Just last week I told a guy we didn't have it and he peaked outside of our pharmacy window and said we did and I argued with him requiring proof that we need his bottle before we can sell it.

Anyone have any better strategies on proper screening?

I am thinking of just asking them What size needles? What kind of insulin? and how many units?, if the answers don't seem right then say, "thank you, in addition to all that information, we also require proof of insulin need. That means bringing in a bottle or us calling your doctor to verify the need for syringes. We do this to establish a proper pharmacist/patient relationship" and refuse to sell based on that.

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[Sparda29]

So you're denying clean insulin syringes and increasing the likelihood of someone contracting a blood-borne disease? It's not your job to deny sales even if it is being used for illegal drugs.

 

[shaq786]

So you're denying clean insulin syringes and increasing the likelihood of someone contracting a blood-borne disease? It's not your job to deny sales even if it is being used for illegal drugs.

Barriers to access are very common. Some pharmacies sell only to people they know, and many pharmacists here deny people all the time. Here in GA only pharmacists and pharmacy interns are legally allowed to sell syringes.

 

[JoBreeze]

It's the south.

"Getting" bad guys >> Public health

 

[Hirka Tbawa]

The way I understand the law here in Georgia is that I can only sell syringes if I know it is for a "Legitimate medical use". So, when someone unknown to me comes to my counter asking for syringes, this is exactly what I tell them, and that I need an excuse to sell it. If they fill insulin or B-12 at my pharmacy, or somewhere in my chain I can look them up, if they have the number to their pharmacy that I can call and verify, or let me see an insulin bottle. Picking up for your grandmother at home who is visiting and don't have any of that on you? Is there someone there that can take a picture of the bottle and text it to you (everyone has smart phones), no? Don't have a camera / text messaging? Call them, have them read off the NDC number on the insulin bottle.

The people who are legit always understands, and since I give so many options, there is always a way. If they aren't legit, they can't argue with me, they normally say something about coming back, but never do. Either way, no one in need goes without, and keeps me from second guessing myself on a judgement call.

 

[npage148]

I sell syringes to anyone 18+ that asks. Clean needles prevent hep/HIV infections. Morality police need not apply

 

[Old Timer]

Hello all,

I am looking for some guidance. In my area, we have a lot of suspicious people trying to buy insulin syringes. I usually just tell them we don't have it but now its getting to a point where some start questioning that. Just last week I told a guy we didn't have it and he peaked outside of our pharmacy window and said we did and I argued with him requiring proof that we need his bottle before we can sell it.

Anyone have any better strategies on proper screening?

I am thinking of just asking them What size needles? What kind of insulin? and how many units?, if the answers don't seem right then say, "thank you, in addition to all that information, we also require proof of insulin need. That means bringing in a bottle or us calling your doctor to verify the need for syringes. We do this to establish a proper pharmacist/patient relationship" and refuse to sell based on that.

Unless your state has some requirement that you screen, you just sell them If you don't you are killing people and spreading disease. STOP. Just sell it and forget. If you get someone who you know is an IV drug user just tell them you will sell them all they want as long there are no syringes in your parking lot or restroom

 

[confettiflyer]

Picking up for your grandmother at home who is visiting and don't have any of that on you? Is there someone there that can take a picture of the bottle and text it to you (everyone has smart phones), no? Don't have a camera / text messaging? Call them, have them read off the NDC number on the insulin bottle.

You people have time for that?

Ask, get a reason, cover your ass, sell, move on to the next thing. Pat yourself on the back for helping reduce the spread of disease.

Really, syringes should just be available to anyone and everyone who wants it. I'm more worried about the person you DON'T see/hear from.

I keep forgetting there are places with not-so-progressive laws out there, sheesh.

 

[xiphoid2010]

It depends on the state law.

I graduated in ohio, based on ohio jurisprudence CE:

"Under Ohio law, pharmacists can sell syringes to: 1) any person authorized to administer injections, 2) individuals using them for lawful purposes of injecting insulin or other drug prescribed to treat a disease by a licensed health professional authorized to prescriber, 3) a person using the syringe for legal research, clinical, or educational purposes, 4) a farmer using it to administering drugs to animal, and 5) a person using syringes for mechanical, trade or craft purposes".

So strictly speaking, it's illegal to sell it for the purpose for injecting illicit drugs. However, since pharmacists are not required to verify if the person is a farmer or use it for craft, we are basically not liable as long as they deny illegal drug use and aren't high at the moment of sale. But still, it's entirely up to the individual pharmacist how strictly or loosely they want to abide by the letter of the law.

The first prudent thing to do is to know your state's law.

 

[xiphoid2010]

You people have time for that?

Ask, get a reason, cover your ass, sell, move on to the next thing. Pat yourself on the back for helping reduce the spread of disease.

Really, syringes should just be available to anyone and everyone who wants it. I'm more worried about the person you DON'T see/hear from.

I keep forgetting there are places with not-so-progressive laws out there, sheesh.

I can see both sides of the coin. I can see one side arguing from the public health perspective, other side arguing from holding people responsible perspective. Or those countries with harsher legal systems -- laws that result in more dead criminals is a cheaper solution in itself calculus.

I'm neutral on this one, since none of the solutions seems plainly superior. I wish there was a super computer somewhere that can crunch/model the outcomes and give a simply logical/unemotional answer what is the best cost/benefit solution.

 

[BenJammin]

When I was an intern, county law said no syringes to anyone without a valid prescription. Even then I don't like the idea of selling it to them because it brings them into the store. I couldn't care less about a bunch of junkies giving each other HIV when they're going to overdose anyway.

Thank god I'm not in retail.

 

[JoBreeze]

What a childish understanding of public health.

 

[pharmasaur]

That's a shame that you don't want to prevent the spread of communicable diseases. Just tell them to buy it online.

 

[rxlea]

When I was an intern, county law said no syringes to anyone without a valid prescription. Even then I don't like the idea of selling it to them because it brings them into the store. I couldn't care less about a bunch of junkies giving each other HIV when they're going to overdose anyway.

Thank god I'm not in retail.

I've found the people who make these statements are also the ones that complain about their tax dollars funding care for "junkies" with HIV.

If you look at it from a cost perspective or a public health perspective, it makes more sense to sell. Also, more profit for the store??

 

[xiphoid2010]

I've found the people who make these statements are also the ones that complain about their tax dollars funding care for "junkies" with HIV.

If you look at it from a cost perspective or a public health perspective, it makes more sense to sell. Also, more profit for the store??

Actually we don't know for sure. Yes, preventing ID among junkies is likely to decease STD/HIV healthcare cost. But what about the unintended consequences that result from reduced mortality/longer drug use? (e.g number of ODs, drug related crime, cost of law enforcement, etc). It's much more complicated than just reducing cost of infectious diseases alone. That's why I wish we had a super computer than can comprehensively model/predict the overall consequences on the society.

 

[xiphoid2010]

Agreed that most of our models are simplified when you consider indirect health care cost and societal cost. But, junkies with hiv will still be junkies. you're just adding the cost of treating HIV and all the related issues to that on top of whatever OD's, law enforcement, etc. costs.

It's not simple addition. A thought experiment: junkie (a) uses dirty needle get HIV lives for 10 years vs. junkie (b) uses clean needle and lives HIV free for 30 years. Which one cost the society less? With (b) you saved HIV treatment cost for 10 years, but you have an additional 20 years of drug related crimes, the legal expenses, treatment for OD during that time...

I know we should value human lives. But what is a life worth? Some would say it's priceless, but that's unworkable. We use QALY for that purpose. If we use ~$25-$50K/QALY which is what many national health systems use measure the cost effectiveness of a treatment, then does the added life expectancy of a junky meet that criteria? As you can see, we'll need a supercomputer a lot of programing to really crunch that data.

 

[Sparda29]

That's why the next thing should be decriminalization of possession of drugs. Don't go after the users, go after the sellers/distributors/manufacturers. Too many people are in jail because they got caught with a baggie of weed in their pocket.

 

[slimcutt]

If you want to get rid of these people, just sell syringes only by the box of 100 (don't sell 10 packs). 95% of them won't pay the $30 or whatever it is, and just move on.

 

[opinionfree]

Unfortunately, you've made your decision regarding the sales of syringes to 'questionable' people. Your just searching for a polite manner to rid yourself of these lost individuals. If you're going to stand on principle, then directly inform the person of your concerns regarding their purchase of syringes. Professionals shouldn't be encumbered by cowardice.
Remember, new IV drug users need to be taught, from an experienced IV drug user. Let's all keep our fingers crossed, that when someone you love, experiments with drug usage, all the syringes being used are clean.

Isn't sodomy still illegal in most states? Should pharmacists be restricting the sale of adult lubricants in fear for people committing the crime of butt sex?

Please consider many of the thoughts presented on this topic. It's scary that the newer pharmacists would even entertain the notion of restricting syringe sales. Share your concerns for the person buying the syringes with the person, but by all means don't restrict them from making the purchase. Please.

 

[Unchained]

That's why the next thing should be decriminalization of possession of drugs. Don't go after the users, go after the sellers/distributors/manufacturers. Too many people are in jail because they got caught with a baggie of weed in their pocket.

Where exactly has the decriminalization of the possession of drugs worked? The decriminalization of marijuana hasn't even worked. It has resulted in high rates of crime and the infiltration of major narco traffickers. I say we should keep feeding the prison industrial complex with the losers who are unable to control their minds without the use of illegal drugs. Our country's future is threatened by the amount of money wasted on the use of drugs. Other countries are weakening us by flooding our streets.

 

[xiphoid2010]

That's why the next thing should be decriminalization of possession of drugs. Don't go after the users, go after the sellers/distributors/manufacturers. Too many people are in jail because they got caught with a baggie of weed in their pocket.

The root of the drug problem is still the basic economics of supply and demand. If there is only one drug user in 100 square miles, there will be no drug dealers to be found. Put 100 in the same area, there will be enough demand to support a drug dealer. Put 10,000 in the same area, there will be enough to support drug gangs, and a larger user base will lead to drug cartels. As long as enough demand exist, supply side will come.

This also kind of takes the thought experiment further: an increase in life expectancy of drug users also increase the demand side of the equation... How many more areas that wouldn't otherwise be able to support a drug distribution network would become so? Would that relationship be inverse, linear, or exponential? Effect on power of organized crime, cost of law enforcement, US productivity, GDP, debt, ability to fund other social programs? See how the whole thing spreads out and get complicated very quickly? I doubt anyone can be sure that's the net cost/gain of selling vs. not selling needles has on society.

 

[shaq786]

Unfortunately, you've made your decision regarding the sales of syringes to 'questionable' people. Your just searching for a polite manner to rid yourself of these lost individuals. If you're going to stand on principle, then directly inform the person of your concerns regarding their purchase of syringes.

There is no point in trying to share your concerns with these druggies because they don't care, they've heard it all before. I can imagine you sharing your concerns about misuse of syringes before you sell it to them, when all they are thinking about it is their next high.

Remember, new IV drug users need to be taught, from an experienced IV drug user.

I don't think you want an experienced IV drug user to teach a new IV drug user, unless you want them to learn unclean habits.

Isn't sodomy still illegal in most states? Should pharmacists be restricting the sale of adult lubricants in fear for people committing the crime of butt sex?

By that line of reasoning, a pharmacist might as well fill any C-II script they get from anyone if they are giving away needles to anyone. They are both used for an illegitimate purpose.

It's scary that the newer pharmacists would even entertain the notion of restricting syringe sales. Share your concerns for the person buying the syringes with the person, but by all means don't restrict them from making the purchase. Please.

Restriction on sales of syringes isn't a matter how many years someone is practicing but rather based on each pharmacists' judgement of the matter, which is a grey area. Some people deny and others don't. Simple as that.

 

[owlegrad]

By that line of reasoning, a pharmacist might as well fill any C-II script they get from anyone if they are giving away needles to anyone. They are both used for an illegitimate purpose.

Yup, exactly the same! No difference at all!

 

[BenJammin]

What the hell is wrong with you guys? Sodomy was made legal in all 50 states in 2003 with the Lawrence v. Texas ruling.

 

[zelman]

A lack of access to clean needles will not stop anyone from using heroin. Period. End of story. If they had the reasoning skills to avoid dirty needles, they would be avoiding heroin in the first place.

Everyone who says that there is a benefit to more people having HIV should consider the $1500 per month Atripla costs and the fact that people with HIV and no/low income will get all their drugs paid for by you, the taxpayer.

If there was some system wherein people who got hepatitis or HIV via an illegal act would not receive public assistance related to that ailment, there would be a cost/benefit consideration to be made. But that is not the case. The cost of new HIV infections from not selling syringes outweighs any perceived benefit.

Follow your state's law, but don't create unnecessary barriers.

 

[Bubba98]

16 year retail rph currently working nights...there is social theory and then there is the real world. If you are in area where IV drug use is common you most CERTAINLY have to take some basic steps to curb sales. If you don't, you will have managers getting stuck with needles in the garbage and sweeping some up in the parking lots. Nearby business owners will question what is going on. You will require a lock on the bathroom. The police may find someone dead in the parking lot. That just happened in Charlotte Nc.
Small studies have shown that junkies don't give a damn about clean needles.
Just ask for proof of insulin use. Even if someone has to take a pic of the bottle and send it to them. Insulin diabetics take their insulin use VERY seriously and will have access to some sort of proof. Junkies will talk a bunch of gibberish and give you absolutely nothing. No proof of even the slightest kind=no needles.

 

[Rouelle]

Hello all,

I am looking for some guidance. In my area, we have a lot of suspicious people trying to buy insulin syringes. I usually just tell them we don't have it but now its getting to a point where some start questioning that. Just last week I told a guy we didn't have it and he peaked outside of our pharmacy window and said we did and I argued with him requiring proof that we need his bottle before we can sell it.

Anyone have any better strategies on proper screening?

I am thinking of just asking them What size needles? What kind of insulin? and how many units?, if the answers don't seem right then say, "thank you, in addition to all that information, we also require proof of insulin need. That means bringing in a bottle or us calling your doctor to verify the need for syringes. We do this to establish a proper pharmacist/patient relationship" and refuse to sell based on that.

With all morality arguments put aside, what you ask is very simple: If you work at an independent, you can establish a pharmacy policy that the only people you will sell syringes to are those who possess a valid prescription for an injectable drug (insulin, B12, testosterone, etc) that they fill at your pharmacy. Enforce this policy uniformly to both "suspicious" looking people and non-suspicious looking alike. Be open with your policy and don't lie about being out of stock. Obviously if your work at a chain you are pretty much required to follow company policy and this whole discussion is moot.

 

[xiphoid2010]

Everyone who says that there is a benefit to more people having HIV should consider the $1500 per month Atripla costs and the fact that people with HIV and no/low income will get all their drugs paid for by you, the taxpayer.

If there was some system wherein people who got hepatitis or HIV via an illegal act would not receive public assistance related to that ailment, there would be a cost/benefit consideration to be made. But that is not the case. The cost of new HIV infections from not selling syringes outweighs any perceived benefit.

Follow your state's law, but don't create unnecessary barriers.

I alreday mention the potential HIV drug cost saving. The fact remains that someone with HIV will have shorter life expectancy than without, especially people who most likely will be diagosed late and be treatment non-compliant. The calculus is then remains one of drug saving vs total cost to society.

But I agree with your last sentence. Without conclusive data for or against, its probably best to abide by law and company policy first. After that, if there is wiggle room, make a judgment call, do what you think is best for the society.

 

[zelman]

I alreday mention the potential HIV drug cost saving. The fact remains that someone with HIV will have shorter life expectancy than without, especially people who most likely will be diagosed late and be treatment non-compliant. The calculus is then remains one of drug saving vs total cost to society.

But I agree with your last sentence. Without conclusive data for or against, its probably best to abide by law and company policy first. After that, if there is wiggle room, make a judgment call, do what you think is best for the society.

You did mention drug cost, but add into your mental calculation the ICU stays of those who make it to the hospital before dying sooner. The cost of dying is astronomical when doctors get their hands on someone.

 

[xiphoid2010]

You did mention drug cost, but add into your mental calculation the ICU stays of those who make it to the hospital before dying sooner. The cost of dying is astronomical when doctors get their hands on someone.

That applies equally. Mortality in the end is always 100% whether you use clean or dirty needles, making end of life cost awash. The is then is who has the higher ICU cost totaled? A junkie with HIV over a shorter span or a junket without HIV over a longer span? What about the ER cost of due to number of OD episodes? Ambulence cost? And thats just barely scratching the surface of the healthcare portion of the equation. I honestly don't know, and cant see anyone here can be sure how the complex model on overall societal cost would compute out.

 

[gtpederson]

My city has the cheapest/purest heroin in the country.
I follow my store's policy - proof of legitimate use or no bueno.
Prior to this policy, we had one person overdose in the bathroom, and another in the parking lot.
That said, I will direct them to the nearest store that sells them no questions asked.

 

[Ackj]

That applies equally. Mortality in the end is always 100% whether you use clean or dirty needles, making end of life cost awash. The is then is who has the higher ICU cost totaled? A junkie with HIV over a shorter span or a junket without HIV over a longer span? What about the ER cost of due to number of OD episodes? Ambulence cost? And thats just barely scratching the surface of the healthcare portion of the equation. I honestly don't know, and cant see anyone here can be sure how the complex model on overall societal cost would compute out.

The problem is that HIV isn't Ebola. You're not talking a decrease in life that will be so much lower that it'd be significant, because you die several years later, not mere days. Life expectancy for an HIV patient is now in the 50s and 60s, which probably outpaces that of your average junkie. IV drug abusers have a shorter life expectancy for a number of reasons besides the transmitted diseases due to financial reasons, psych conditions, overdose, embolism, endocarditis, etc, so I don't think you'll see a major difference here. Granted if you're still using you're probably not compliant with ART, but still. Also you've got the few cases where they finally clean up. If you're cleaned up and still have HIV, you're still paying for those treatments forever, just not the ODs anymore.

 

[opinionfree]

While it's academic to debate all of the post infection costs to society, let's look at it one step removed. If people DON'T catch a disease, by using clean needles, they will be LESS of a financial burden to society. Hypothetical costs and financial models need not apply, if people can use clean needles and not be infected, by a blood borne disease. People are muddying up the argument. Life, as well as this topic are fraught with exceptions. Stop looking for the few and focus on the many. Esoteric arguments of tertiary costs, can be factored down, if people don't become infected from using dirty needles.

Unfortunately on this thread, like so many others, people are lock minded. It's my way, I'm right, Don't challenge my thinking. Why do you even bother to participate in a discussion, if not to broaden your thinking on a topic? Does anyone ever change their mind on anything. I do. Alas, people are desperate to convince themselves they are right and everyone else is wrong. It saddens me to say, but they only way most learn compassion, is when hardship affects their loved ones. Merry F***in' Christmas.

 

[xiphoid2010]

While it's academic to debate all of the post infection costs to society, let's look at it one step removed. If people DON'T catch a disease, by using clean needles, they will be LESS of a financial burden to society. Hypothetical costs and financial models need not apply, if people can use clean needles and not be infected, by a blood borne disease. People are muddying up the argument. Life, as well as this topic are fraught with exceptions. Stop looking for the few and focus on the many. Esoteric arguments of tertiary costs, can be factored down, if people don't become infected from using dirty needles.

This simplified line of thinking works when considering a population that is of net benefit to society. But in this group, saving in healthcare may quite possibly be offset by increased crime/drain on society. That's the big question, is a solution generating more probems than it solves.

I think people should admit that nobody knows the answer, so the logical thing to do is (1) follow the law (2) do what your best guess is the right answer within what is legally permissible and (3) consider the possibility alternative guesses might be right and you might be wrong.

 

[Sparda29]

Where exactly has the decriminalization of the possession of drugs worked? The decriminalization of marijuana hasn't even worked. It has resulted in high rates of crime and the infiltration of major narco traffickers. I say we should keep feeding the prison industrial complex with the losers who are unable to control their minds without the use of illegal drugs. Our country's future is threatened by the amount of money wasted on the use of drugs. Other countries are weakening us by flooding our streets.

How has the criminalization of drug possession helped? In NYC it's the worst, especially with that ******ed stop-and-frisk program. Plenty of people who are productive and good members of society are entered into the criminal system and have a permanent mark on their record just because they liked to indulge in a little weed from time to time.

Why should marijuana be illegal (and alcohol legal)?

 

[xiphoid2010]

Why should marijuana be illegal (and alcohol legal)?

I watched a documentary on alcohol that said in term of addictive/abuse and potential for harm, it should be classified as a C-III had it been a new drug that came out today. However due to the history, and majority of the population as users, it is basically grandfathered in.

 

[Sparda29]

I watched a documentary on alcohol that said in term of addictive/abuse and potential for harm, it should be classified as a C-III had it been a new drug that came out today. However due to the history, and majority of the population as users, it is basically grandfathered in.

So yeah, based on that marijuana should be legal or a C5/C6 or even unregulated. Asides from potentially getting cancer from smoking it, or getting fat due to the increased appetite, where is the harm? Drinking and driving is illegal, making smoking weed and driving illegal and you're good to go.

 

[xiphoid2010]

The problem is that HIV isn't Ebola. You're not talking a decrease in life that will be so much lower that it'd be significant, because you die several years later, not mere days. Life expectancy for an HIV patient is now in the 50s and 60s, which probably outpaces that of your average junkie. IV drug abusers have a shorter life expectancy for a number of reasons besides the transmitted diseases due to financial reasons, psych conditions, overdose, embolism, endocarditis, etc, so I don't think you'll see a major difference here. Granted if you're still using you're probably not compliant with ART, but still. Also you've got the few cases where they finally clean up. If you're cleaned up and still have HIV, you're still paying for those treatments forever, just not the ODs anymore.

Sorry missed your post earlier. Yes, I'm aware of that, and can number all these variables you mentioned and more. eg. how much is actually the life expectancy difference? How much is considered "major"? For each additional year of life expectancy due to clean needles, does a drug user cause an additional $10K or $30K or $100K in crime to feed the habit? If he shot a pharmacist while robbing it, sentenced to life behind bars, how much does it cost to lock somone up forever?

What you and I are both showing is just how extremely complex and beyond individual's ability to analyze the issue really is. I don't see how some are able tell the other side with such confidence that they are right and others got it wrong.

 

[kvl1027]

Would it be unethical to only sell 3ml syringes? That would be a problem taking care of itself, right?

Seriouslt, just sell the syringes and move on. Hell I even give them a sharps container and tell them not to throw their $h!t in the trash. Please be a responsible junkie!

 

[xiphoid2010]

So yeah, based on that marijuana should be legal or a C5/C6 or even unregulated. Asides from potentially getting cancer from smoking it, or getting fat due to the increased appetite, where is the harm? Drinking and driving is illegal, making smoking weed and driving illegal and you're good to go.

I agree with you on this. From a pharmacological point of view, pot is a lesser drug than alcohol. The only thing I would point out is your conclusion is not entirely sound. Just because alcohol is incorrectly classified, it doesn't mean marijuana should also get an incorrect classification.

Since it's effect is similar to sedative/hypnotics such as benzos, it should be classified as C-IV same these other drugs. If you really want to generous, maybe C-V like some of the OTC codeine products, a limited quantity over the counter may not be unreasonable.

 

[swiftjuan]

Hello all,

I am looking for some guidance. In my area, we have a lot of suspicious people trying to buy insulin syringes. I usually just tell them we don't have it but now its getting to a point where some start questioning that. Just last week I told a guy we didn't have it and he peaked outside of our pharmacy window and said we did and I argued with him requiring proof that we need his bottle before we can sell it.

Anyone have any better strategies on proper screening?

I am thinking of just asking them What size needles? What kind of insulin? and how many units?, if the answers don't seem right then say, "thank you, in addition to all that information, we also require proof of insulin need. That means bringing in a bottle or us calling your doctor to verify the need for syringes. We do this to establish a proper pharmacist/patient relationship" and refuse to sell based on that.

I am diabetic. Walmart has the cheapest OTC insulin. I went in to buy needles and was denied by the pharmacist unless I bought the insulin as well. Thank god i had the money for both. The problem is that POOOOR people buy over the counter insulin because they can't afford doctors or prescription insulin. WHAT IF I HAD NOT HAD THE MONEY. STOP BEING THE MORALITY POLICE BECAUSE YOU ARE GOING TO KILL SOMEONE.

 

[farmadiazepine]

Honestly, why do you want to deny the sale of clean syringes? These laws that permit the sale of clean syringes were made so that people can have access to clean needles no matter what they are using them for. The laws in NY and NJ were made with the intention that clean needles are being provided for IV drug users as well as diabetics and anyone who needs a clean needle.

Saying no to an IV drug user asking for syringes is the same as saying yes to "I want you to have HIV, and I want to take on the burden of providing you with HIV medication for the rest of your life through deductions from my paycheck." The person who loses when a pharmacist denies syringes to people who want to inject drugs IV is the pharmacist him or herself and the community.

 

[IlDestriero]

I'm not sure why you want to deny anyone access to clean needles. That strikes me as stupid as not selling condoms or birth control pills.

 

[crossurfingers]

I'm in Texas and called the state board of pharmacy once for clarification. Although they do not have any laws regulating the sale of hypodermic needles here, they told me that there is some statement in the laws where the pharmacist can be held liable if someone dies from shooting up with a syringe they bought at the pharmacy. At the chain that I work at it is their policy that they establish a link between the person picking up and insulin use, but that could just mean they could tell you some random person who is in our system that fills for insulin. The state board didn't have any suggestions of how to go about vetting people.

 

[zelman]

I am diabetic. Walmart has the cheapest OTC insulin. I went in to buy needles and was denied by the pharmacist unless I bought the insulin as well. Thank god i had the money for both. The problem is that POOOOR people buy over the counter insulin because they can't afford doctors or prescription insulin. WHAT IF I HAD NOT HAD THE MONEY. STOP BEING THE MORALITY POLICE BECAUSE YOU ARE GOING TO KILL SOMEONE.

We will not kill anyone. We'll happily phone an ambulance to take you to the emergency room for your medical treatment.

I've been working in pharmacy for 15 years and sold less than one person per year syringes OTC for a legitimate medical purpose. I'd put the OTC purchasing at 500 to 1 at illegal/non-medical intent (injecting flavored liquid into meats and whatnot) to legitimate medical use. POOOOOOOR people have MEEEEEEDICAAAAAAID and use that coverage to have their syringes paid for. If you are paying out of pocket for syringes because you're a poor diabetic, you are an extreme rarity, and our decision-making processes are unlikely to take you into account.

 

[type b pharmD]

Personally I am kind of proud to sell approximately 50,000-60,000 clean needles per month to my community .. not only is it PROVEN to decrease disease spread and mortality , it also provides an opportunity to interact with and serve an underserved population. Not all junkies are crazy some of them want to quit or maybe want to learn more about their health and how to get help ... Even if it's 1/100 there is a great opportunity there, there is a decent margin on the needles, and honestly if I was a junkie, nothing would be more depressing (besides obviously running out of drug) than being turned away by the corner healthcare dude in contempt. If you're selling clean needles to an abuser, you just may be the only interaction they have with legitimate society , let alone healthcare. There's something respectable and important about that .. even if the tiny shred of respect is enough to help a couple of people realize that care is out there, that's a couple individual lives saved... Let alone all the statistical lives saved.


Nobody has ever OD'd in my bathroom or left dirty needles sitting around. Stores in my district that deny needles somehow seem to have more of that.. I wonder if it's a coincidence ?

 

[maria1oh]

If you start selling syringes you'll have junkies passed out in the bathrooms, increase in shoplifting, and needles found in the parking lot. Best to just get rid of these customers and send them elsewhere. That's like saying "just fill the fake oxycodone scripts because it's best they get their illegal drug fix safely rather than having to hit the streets for drug"

 

[type b pharmD]

If you start selling syringes you'll have junkies passed out in the bathrooms, increase in shoplifting, and needles found in the parking lot. Best to just get rid of these customers and send them elsewhere. That's like saying "just fill the fake oxycodone scripts because it's best they get their illegal drug fix safely rather than having to hit the streets for drug"

False. I've been at my store a long time and have never heard this happening from any of the store staff. Maybe the drug users respect us since we respect their legal rights to purchase a healthcare commodity ? Maybe this is more of a problem at urban stores or places with a substantial indigent population ? If they leave needles you could put out a container ... The profits on the needles would more than pay for it ... Plus, tell me one junkie on Medicaid who doesn't need their pneumonia and tetanus shots. That is a good sale, and selling them syringes opens the door to healthcare conversation that could save their life

Filling fake scripts is not even comparable .. one is legal and a life saving intervention , one is illegal and causes harm to health ... Yeah they're the same

 

[BenJammin]

I'm not sure why you want to deny anyone access to clean needles. That strikes me as stupid as not selling condoms or birth control pills.

Apples and oranges. What a ridiculous comment. Some of us are sick and tired of seeing used needles lying everywhere, poking out of trash bags, putting people at risk for contracting diseases. People love using the phrase "the morality police", well how about this morality: take your druggie ass out of my pharmacy and go shoot up somewhere else.

 

[Digsbe]

I've worked with pharmacists that denied the sale of syringes unless the patient had a script on file or could show us their medication that required injections if it was filled somewhere else. They had friends that sold syringes to anyone and they had used them in the bathroom, outside the store and in the parking lot leaving used syringes on their property. Not only that, but their pharmacy became known among the illicit drug community as being an "easy" place to obtain what they wanted so they received many more questionable scripts for control drugs compared to others.

There are some common sense reasons behind not wanting to sell syringes to everyone, and many wouldn't want to use their store, license or business to promote someone's illicit drug use. People play the "moral police" when they try and tell someone else how they have to act in areas where they have room to make such personal choices for themselves and how they want to conduct themselves in a professional setting. My own opinion is that I'd sell them, I think it's safer because denying the sale won't stop them from shooting up in most instances, but if problems developed as a direct result of those sales I'd reconsider. If it was illegal in my state to do so then I wouldn't sell them and would try to direct them somewhere where they may receive help. Personally for me I think it's an aspect of providing compassionate patient care to make sure people have adequate access to clean needles regardless of how they are used as a form of promoting public health. Someone may make mistakes and knowingly break drug laws but using illicit drugs doesn't mean I wish to deny them clean needles and indirectly promoting the contracting of diseases that are easily preventable.

As far as being polite, just have a standard policy put in place. You can say "we don't sell syringes to patients that don't have an active prescription for an injectable med on file" and just use that for every patient that asks. Tell them that's your store's policy and then direct them somewhere else where they may buy them. If you are in a state with legal consequences behind selling them just quote the law and say it's a liability issue.