Individual and Structural Influences Shaping Pharmacists’ Decisions to Sell Syringes to Injection Drug Users in Atlanta, Georgia

Abstract

Objective

To better understand the individual (e.g., attitudes and beliefs) and structural (e.g., laws and regulations) factors that influence and shape pharmacists’ decisions about selling syringes to injection drug users (IDUs).

Design

Qualitative research.

Setting

Metropolitan Atlanta.

Participants

20 practicing pharmacists who work in or near areas of high drug use in Atlanta, and nine pharmacists who are considered leaders in their profession in Georgia.

Interventions

Semistructured, in-depth interviews.

Main Outcome Measures

Individual and structural factors that influence pharmacists’ decisions about selling syringes to IDUs.

Results

Pharmacists reported that they use their professional discretion in making syringe sale decisions and that these decisions are influenced by individuals factors such as their personal attitudes and beliefs about the nature and causes of drug use, and by structural factors such as the Georgia Board of Pharmacy regulation stating that syringes cannot be sold if they will be used for an “unlawful purpose.”

Conclusions

IDUs’ access to sterile syringes from pharmacies in Atlanta, would likely be increased by (1) providing practicing pharmacists with professional education programs that describe the broad professional support for IDU access to sterile syringes and why blood-borne infection prevention is a legitimate medical purpose for selling syringes and (2) removing or modifying the restrictive Board of Pharmacy regulation governing syringe sales.