Pharmacies as providers of expanded health services for people who inject drugs

A review of laws, policies, and barriers in six countries

Theodore M. Hammett, Son Phan, Julia Gaggin, Patricia Case, Nicholas Zaller, Alexandra Lutnick, Alex H. Kral, Ekaterina V. Fedorova, Robert Heimer, Will Small, Robin Pollini, Leo Beletsky, Carl Latkin, Don Des Jarlais

Research output: Contribution to journalReview article

Abstract

Background: People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Methods. Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Results: Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Discussion. Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.

Original languageEnglish (US)
Article number261
JournalBMC Health Services Research
Volume14
Issue number1
DOIs
StatePublished - Jun 17 2014

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Pharmacies
Health Services
Police
Pharmaceutical Preparations
Health Knowledge, Attitudes, Practice
Syringes
Needles
Opiate Substitution Treatment
Drug Overdose
Stereotyping
Pharmaceutical Services
Vietnam
Russia
Naloxone
Mexico
Drug Users
Pharmacists
Abscess
Hepatitis
Canada

ASJC Scopus subject areas

  • Health Policy

Cite this

Pharmacies as providers of expanded health services for people who inject drugs : A review of laws, policies, and barriers in six countries. / Hammett, Theodore M.; Phan, Son; Gaggin, Julia; Case, Patricia; Zaller, Nicholas; Lutnick, Alexandra; Kral, Alex H.; Fedorova, Ekaterina V.; Heimer, Robert; Small, Will; Pollini, Robin; Beletsky, Leo; Latkin, Carl; Des Jarlais, Don.

In: BMC Health Services Research, Vol. 14, No. 1, 261, 17.06.2014.

Research output: Contribution to journalReview article

Hammett, TM, Phan, S, Gaggin, J, Case, P, Zaller, N, Lutnick, A, Kral, AH, Fedorova, EV, Heimer, R, Small, W, Pollini, R, Beletsky, L, Latkin, C & Des Jarlais, D 2014, 'Pharmacies as providers of expanded health services for people who inject drugs: A review of laws, policies, and barriers in six countries', BMC Health Services Research, vol. 14, no. 1, 261. https://doi.org/10.1186/1472-6963-14-261
Hammett, Theodore M. ; Phan, Son ; Gaggin, Julia ; Case, Patricia ; Zaller, Nicholas ; Lutnick, Alexandra ; Kral, Alex H. ; Fedorova, Ekaterina V. ; Heimer, Robert ; Small, Will ; Pollini, Robin ; Beletsky, Leo ; Latkin, Carl ; Des Jarlais, Don. / Pharmacies as providers of expanded health services for people who inject drugs : A review of laws, policies, and barriers in six countries. In: BMC Health Services Research. 2014 ; Vol. 14, No. 1.
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