Selling Syringes

       Does it bother you to sell syringes over the counter to anyone that walks up and asks for them?  It bothers me sometimes. 

       I don’t even want to think about all of the syringes I’ve sold over the years that have inevitably ended up helping a drug addict achieve their next high.  The last thing I want to do as a pharmacist is fuel the drug addiction flame or help someone get high. 

       Syringe sales are a touchy subject for pharmacy staff members.  The question of access to clean needles has been debated over and over again.  Should pharmacies indiscriminately sell such products? 

       Basically, selling or even giving away clean needles to drug addicts is a strategy to try and minimize the spread of infectious disease.  The idea is that the person in question is already addicted and will find a way to shoot up regardless of whether they receive clean needles from your pharmacy or not.  So why not sell them clean needles to try and prevent disease spread? 

       Having said that, IV drug use can spread diseases.  Contaminated drugs can cause adverse effects and diseases that are at least as bad as the risk of using dirty needles.  Then there is the whole issue of overdose.  People tend to forget that these drugs can kill. 

        But getting back to the issue of syringe sales, typically they are considered over the counter products.  That means that pharmacists can sell these items without a prescription. 

        But there is also discretion left to the pharmacist regarding the sale of syringes.  Should we deny a customer access to syringes simply because we think they might be using those needles to inject illegal substances? 

        I can remember instances where I knew with a good degree of certainty that a customer requesting the purchase of syringes over the counter was in fact a drug addict.  Diabetics don’t typically ask for a single syringe at a time.  They also know how many units they are injecting (or the fact that insulin is measured in units for that matter). 

        I know of times where the pharmacy I’ve worked sold syringes to a customer only to have them immediately use the store’s bathroom to inject themselves with drugs.  Is this good for a business to sell a product that enables illegal drug use? 

         For me, it is difficult to separate the public health issue of preventing communicable diseases by selling syringes  with the issue of drug abuse and enabling addicts.  And the fact that addicts are using me to get to their next fix really bothers me. 

         Some countries experiment with programs where the government actually administers drugs directly to addicts.  The idea is that they can control the environment.  This means clean needles, pure products, and controlled dosing to minimize the risk of overdose. 

         But it is a hard sell to get a population to grasp the idea of allowing their government to control the administration of drugs that are supposed to be outlawed.  Just like it’s a difficult concept for me to consider OTC syringe sales to be disease prevention measures in the case of drug addicts.    

         Is this a time for pharmacists and technicians everywhere to separate their personal beliefs from their professional obligations?  Or should pharmacists block the sale of syringes to people known to be drug abusers? 

         I think drug abuse and addiction is consuming the United States along with many other countries around the world.  And as someone that works in a community pharmacy, I see the fall out of rampant drug abuse and addiction everyday at work. 

         So how do we handle those people that are already physically and psychologically addicted to drugs?  Helping them prevent the spread of diseases by allowing access to clean syringes is one potential way.  But that doesn’t mean I have to like it. 

        So in the end, drug abuse is something that needs to be addressed in the U.S. and around the world.  And access to clean needles is something that can help prevent the spread of diseases among IV drug users.  But it also provides an outlet for the continued use of drugs by addicts. 

        So the next time someone who may be a drug abuser comes up to my pharmacy counter and asks to buy syringes, I will probably sell them.  But that doesn’t mean I have to like it.  It will always bother me knowing where those needles will go and what they will be used for after they leave my pharmacy.

        It’s a frustrating dilemma that we find ourselves behind the counter at the pharmacy.  One of many these days it seems.  To sell syringes or not to sell.  In modern community pharmacy, that is the question. 

The Redheaded Pharmacist

17 Comments to “Selling Syringes”

  1. By Wrong Aid, July 19, 2012 @ 9:18 am

    I’m a bit of a Liberal when it comes to drugs. I don’t really care what people do with their lives. Smoke, snort, eat, inject whatever you want. However, I also follow the “not in my backyard” policy. I don’t want my store to be the go-to place for these addicts. I don’t sell syringes unless they actively get insulin at our store. I don’t stock oxycodone 15 or 30 (the pill mill drugs of choice in our area). I’ve told more than 1 Sudafed buyer to get out. I wish I never would have started stocking Suboxone. What a pain that is. “I only want 3 today” after I’ve completed the script. Every damn time!

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  2. By Pharmgirll, July 19, 2012 @ 3:05 pm

    Try to think of it this way.

    Are you causing any harm? Any immediate harm? Are you prepared for the consequences of such harm?

    For example: You sell syringes for suspected illegal drug use. That person has a clean needle and less risk for future harm from Hep-C, HIV, bacteria, etc. Now, agreed that person will probably share that needle and the next person will not have that benefit. But not because they were forced to share because the pharmacist wouldn’t sell a fresh needle. The harm comes from their own actions, not yours.

    For another example: You refuse to sell. The user is going to use. You cannot control that. You are not in the business of, nor eqipped to handle, detox. If you refuse to sell,, you force harm by either forcing sharing or forcing detox. The harm comes from your actions.

    Now I may have just cajoled myself into this over 20+ years of pharmacy practice. Patients are not always going to do what is best for them healthwise. It’s my job to help them be as healthy as they can be. It’s not my job to pass judgement on their choices.

    Hope that gives you another viewpoint.

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  3. By JS, July 19, 2012 @ 3:14 pm

    I am not going to lie and tell you I read this multiple times, I really kind of skimmed it. Please correct me if I am wrong, syringes do NOT require a prescription anywhere in the US? If I read that correctly when did they start being OTC? Or were they always OTC? And if they are OTC, then why do I need a script to get them (I give myself B12 shots 1-2 times per week)? I know one might say in an effort to bill insurance? In my case it’s cheaper to pay cash and get a larger quantity so that wouldn’t apply in my situation? So, please tell me why, why, oh why do they NOT require a script from an MD? If I missed something I apologize……and that will teach me for doing ten things @ once! But really, whose idea was it to allow them to be sold OTC (at your discretion, hopefully). Speaking of syringes…..I LOVE the Vanishing Point Syringes. Take care!

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  4. By Pharmaciststeve, July 19, 2012 @ 5:56 pm

    Consider this.. nearly 100% of those people that are abusing some substances.. that includes tobacco & alcohol… have some underlying mental/emotional issues that they are dealing with.. the so called “monkey on their back”

    basically we are “looking down on” these people because they didn’t get some sort of mental health therapy – for whatever reason – before they started down the path that they are now on.

    as righteous as it might sound/feel.. and how it might give us a “good feeling”… by selling or not selling.. is probably not going to change the path that they are on…

    Obviously, you don’t want to cultivate a following/customer based on selling one syringe at a time…

    Until we start questioning the sale of certain product(s) to people who appear to be over weight… or start limiting/refuse the sale of “sugary ” products to people that we know are diabetics… I think that we will be able to judge who should buy syringes or who should not.

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  5. By Pharmacy Thoughts, July 19, 2012 @ 10:19 pm

    To answer JS’s question, “And if they are OTC, then why do I need a script to get them (I give myself B12 shots 1-2 times per week)?”, you need a prescription for the B-12 syringes. It’s just the insulin syringes that are sold OTC. Also, it’s a relatively new decision to have them go OTC.

    At my pharmacy, we don’t sell single syringes. We just don’t. They have to buy them in packs of 10, and they’re only allowed one pack per purchase. The pharmacy down the street from us, though, refuses the sale of them. So, we get hit up a lot for needles. The way I see it, I’d rather sell the clean needles and prevent some of the spread of communicable diseases than to refuse the sale and have them reuse and share what they have. Addicts will find a way to get high, regardless of who does and does not sell needles. That’s just my thoughts on it, though. Everyone is entitled to their own opinions, and no one should feel forced to sell needles if they don’t feel comfortable with it.

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  6. By PharmacyTechPOV, July 20, 2012 @ 7:49 am

    Our store does not sell syringes unless there is an active script on file for an injectable medicine.

    My personal opinion is not to sell. In this day and age of lawsuits gone wild, I don’t want to be the defendant in a wrongful death suit. If it hasn’t happened already, one day the family of an addict that OD’d will sue the pharmacy, the pharmacist and the tech that sold them the needle saying we should have known better.

    Addicts are going to shoot up regardless if they have a clean needle or not. But I don’t want to be a party to it and I don’t want to be liable.

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  7. By Pharmaciststeve, July 20, 2012 @ 3:49 pm

    @PharmacyTechPOV
    That has got to be one of most lame statements that I have every read/heard as a reason not to sell syringes to something that might be a addict… actually it gave me a good laugh Smile

    Unless you sold the person a private label syringe only sold my your store… or the person in question paid for it with a charge card or debit card – unlikely

    or they still had the receipt in their pocket from the purchase…

    tracking down who sold it them.. is nearly IMPOSSIBLE… besides… it was the DRUG/substance that killed them .. not the syringe..

    It is amazing how our “Puritanical roots” have granted us the authority to be so judgmental over our fellow man’s actions.

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  8. By Oldrphbs, July 21, 2012 @ 9:12 am

    A few years ago, Illinois changed to allow us to sell OTC. They were previously Rx by state law. The entire purpose of this change was to allow drug users the chance to have a clean needle. That was the OPENLY stated reason and I support it completely. Availability of a clean needle or not is not going to change a person’s drug use. Too many of us get mad and look for reasons NOT to do something perhaps out of frustration for being powerless in some things. Incidentally, you can go into any Rural King, Big R, Tractor Supply, Farm and Fleet etc and pick up sterile syringes and needles, “for veterinary use”. You just check them out at the register.

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  9. By pharmacy chick, July 21, 2012 @ 10:57 pm

    here’s my take on it. If it was my own policy to make, I wouldn’t sell syringes without a rx and I would sell them by the box only. no singles..no 10 packs.

    prevention of disease? really, do you think the junkie cares if he is spreading or preventing disease by using clean needles? NO he/she does not. they only care about their next fix. He is already injecting s**t into his veins..he is hardly caring about his overall health.

    Ive been called to the bathroom to fish needles out of the garbage ( over my dead body by the way!!) Ive had a construction guy (during a remodel) ask me to remove a syringe that was wedged in the toilet drain ( also over my dead body). Ive had customers come in and tell me there was a syringe in the parking lot.

    do I need to tell you where they likely came from ? yup. my counter…because my company made it a policy to sell syringes to anybody with money in their hands. no questions asked.

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  10. By PharmacyJim, July 22, 2012 @ 4:28 pm

    As simple as I can make it, I sell them some of the time without a Rx, but not always. That does not mean I like it….but I do see both sides.

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  11. By PharmtechL, July 24, 2012 @ 2:21 pm

    Im my store, we dont sell syringes, unless you fill scripts with us. I think every store is different. Ive floated in pharmacies that dont care. I had a young woman a few days ago that came in asking for syringes, and i asked her what she uses them for and she said insulin. I asked her what size needle she needed and she couldnt tell me what gauge or anything. I asked her how many units does she take and she said 1. I asked her what type of insulin does she take and she said “oh its for a friend.” um sorry. We use to sell syringes in my store no problem till we had someone OD in our parking lot with our needle stuck in their arm. After that, no more. We know pretty much all our patients that get needles, and wont sell to anyone else.

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  12. By The Killa, August 12, 2012 @ 6:03 pm

    As an addict, (oxy was my number one drug of choice), I was always dumbfounded by how the pharmacist would fill a script for 240 Roxi 30’s for me NO PROBLEM!!! But, give me hell the second I tried to buy a box of needles. Most of them time, I would be able to get a few from the pharmacist as “my mail order compounding pharmacy for my cortisone” forgot to send them with my injectible cortisone”. However, I would frequent the Wal-Mart pharmacy on my breaks and buy 3 boxes of 100 needles at a time. NO QUESTIONS ASKED!!!! Its funny, I would come in obviously WD’ing DEMANDING needles.
    Now that I am in recovery, I still have the position that it is a pubic health issue and a basic human right! While I never shared needles (nor shot up in front of anyone…it was my secret that I kept for THREE LONG YEARS!!!!), I have contracted infections to the point of having to be hospitalized due to me reusing needles. These are only designed to be used once, not the 10-30 times that they really are used. I am not a bad person, you look at me…I don’t scream JUNKIE…I scream success!!! I came from a wealthy family, best schools, always employed (till I quit my most recent job as one of the girls was selling heroin at work and I didn’t trust myself to say no), I don’t fit the stereotype. But…I made the decision to shoot up. I drove to pharmacy to pharmacy till I got my first needles. Do I wish I never did it? What good is that going to do? I have tracks on my hands/arms and I honestly look at them with a sense of pride. I know where I was, where I was going, and they are a constant reminder that I am ONE PILL AWAY from going back to my old life!

    Please…sell the needles to ANYONE who asks for them! I promise you that there will come a time (hopefully) where this man/woman in front of you will look at their arms and think..am I even getting high anymore? Why am I doing this? I ended up in detox/rehab after refusing to sleep with someone for heroin. The mere fact I was considering it MADE ME STOP!!!

    If you want to make a real difference…STOP filling crazy scripts written by “Well respected doctors/clinics” who would never overprescribe. I’m in my 20’s…Do I really need 160 Roxi 30’s 90 OxyContin 80’s, 90 Xanax 2’s to treat back pain/nerves??? That if you ask me is the real problem. My generation is generation RX…we reach for a pill for EVERYTHING!!!

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  13. By michael glass, January 7, 2013 @ 12:43 pm

    wow some of you people are disgusting. people can do what they want and why would you want to help spread aids and hepatitis by not providing clean needles. they walk in buy the needle and leave, and if someone goes in the bathroom, so what, you dont know for sure what they’re doing. just mind your own goddamn business you self righteous sanctimonious pricks!

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  14. By michael glass, January 7, 2013 @ 12:46 pm

    you’re asking what they’re using the syringes for????? its NONE OF YOUR GODDAMN BUSINESS. do cashiers ask you what youre using those bullets for that youre buying? NO, they dont. god i hate all the moral majority assholes who think they can legislate their morality on the whole goddamn country.

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  15. By Ryan McGroarty, January 11, 2013 @ 1:59 pm

    Michael Glass based on your comments I can clearly tell you NOT a pharmacist. This is a very difficult situation that we pharmacists must deal with. I have not actually had anyone ask about purchasing syringes without a prescription, but I am of the mind that if you are not one of our regular customers I will not sell them to you. Try going to a doctor’s office or clinic with which you have no relationship and say “gimme some syringes and don’t ask me any questions” and see what happens.

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  16. By Dick, March 30, 2013 @ 10:06 pm

    When a doctor examine’s your body, I would bet to say he hates it too.

    Also, when you have a drink, I bet the waiter hates serving you. I bet he hates watching you shovel down that disgusting filth.

    But really, I hate you. Because I am trying to get my antibiotics filled and you are wondering what they are for. How dare you.

    I am going to find out where you are lisencned. I hope it gets revoked. And, God forbid, you ever break your foot or have surgery, I hope the pharmacist hates filling your rx for painkillers. I hope he makes you feel uncomfortable. I hope you are ashamed.

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  17. By Lauren, April 22, 2014 @ 1:32 am

    I am a full time caretaker – as well as a registered nurse – for my mother who suffers from both diabetes and stage 4 cancer. Needless to say, I am the one who has to pick up her syringes at the pharmacy as she is unable to leave the house in her condition. Recently she had to go to the ER because she used her last syringe and multiple pharmacists refused to sell them to me where I know State Law allows the sale of up to 30 without a prescription. All I requested was one package. At the time, her blood sugar was over 200 and she is still in the hospital because of their unwarranted prejudice. It is my unfortunate experience that when regarding the sale of insulin syringes (we live in CA where it is legal to purchase then OTC) pharmacists do not often consider people like my dying 60 year old mother who has never done drugs in her life. I had to go to 10 pharmacies before I could acquire what my severely ill mother needed. I hope you take this into consideration next time you sell syringes OTC.

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