Limited Access to Syringes for Injection Drug Users in Pharmacies in Denver, Colorado

Abstract

Objective

To determine the availability of syringes for injection drug users (IDUs) from pharmacies in Denver.

Design

Single-group, uncontrolled, noncomparative study.

Setting

Denver, Colorado.

Patients or Other Participants

23 randomly selected pharmacies in the Denver metropolitan area and 3 additional pharmacies located near drug-buying locations.

Intervention

Attempt by eight trained IDU “research assistants” to purchase packages of 10 U-100 insulin syringes without a prescription from pharmacies.

Main Outcome Measures

Successful purchase of syringes; reasons for refusal.

Results

Of 26 pharmacies, 4 reported not stocking syringes, 3 did not sell syringes to any research assistants, 10 sold to some research assistants but not to others, and 9 sold to all research assistants. Of 206 purchase attempts, 54% were successful. In 37.9% of 95 refusals, the pharmacist reported that syringes were not sold at the store, and in 28.4% the pharmacist refused to sell because the research assistant did not produce diabetic identification or answer insulin-related questions. No differences in pharmacy response were found with respect to the racial or ethnic characteristics of the research assistant. Price varied substantially within and among stores. No pharmacies that sold syringes to research assistants were open 24 hours per day.

Conclusion

While IDUs who live near a pharmacy that regularly sells syringes and IDUs with a convincing diabetes story may have adequate access to syringes, others face inconsistent availability. Price fluctuations and limited hours of those pharmacies that sell syringes may be additional barriers to access to sterile syringes for IDUs in Denver.