Abstract
BACKGROUND: Pharmacies often restrict access to over the counter (OTC) syringes. The objective of this study was to quantify the frequency that patients experience barriers when seeking to purchase a 10-pack of OTC syringes from community pharmacies in Oregon. METHODS: To ascertain the availability of a 10-pack of OTC syringes, we conducted a telephone audit ("secret shopper") study of Oregon community pharmacies. Descriptive statistics and binomial logistic regressions were then performed to identify factors associated with willingness to sell a syringe 10-pack OTC. Factors included in the analysis were related to pharmacy type (chain vs. independent) and county characteristics (rurality, syringe service program presence, overdose rate). RESULTS: We contacted 425 pharmacies (361 chain, 64 independent) between December 2023 and March 2024; of those, 62.8% were in urban counties. Staff at 184 (43.3%) pharmacies reported that they would not sell a syringe 10-pack OTC. Urban pharmacies were more likely to restrict OTC syringe sales compared to rural pharmacies (adjusted odds ratio [2.11]; 95% CI [1.22-3.65]). No significant differences existed between chain and independent pharmacies. CONCLUSIONS: Community pharmacies are well positioned to ensure access to sterile syringes, but our findings show that they are unreliable access points as nearly half of Oregon community pharmacies restrict patient access to OTC syringes. Unwillingness to sell OTC syringes was most pronounced in urban counties. Pharmacy-directed efforts are needed to ensure access to sterile syringes and address unmet health needs for people who inject drugs.