San Francisco Citizen

Our Senator Leland Yee, Ph.D. is today calling for support for his Clean Needle Bill, SB 1029. It would permit all California pharmacists to sell up to 30 sterile syringes to drug users aged 18 and over. Why? To prevent the spread of HIV, hepatitis B, hepatitis C and other blood-borne diseases that live in used syringes.

All the deets of today’s presser with Mark Cloutier, CEO of the San Francisco AIDS Foundation and Barry Zevin, MD, a San Francisco primary care and HIV clinician, below.

Senator Yee, PhD:

Yee Introduces Clean Needle Bill. Legislation would allow pharmacies to sell sterile syringes to prevent spread of HIV & Hepatitis C
 
Today, State Senator Leland Yee (D-San Francisco/San Mateo) was joined by doctors, pharmacists, and AIDS prevention advocates to introduce legislation that would allow pharmacies throughout California the discretion to sell up to 30 sterile syringes to an adult without a prescription. 
 
California is one of only three states that still prohibit pharmacists from selling a syringe without a prescription.  Most states amended their laws in light of evidence that criminalized access to sterile syringes led drug users to share used ones, and that sharing syringes spread HIV, hepatitis B, hepatitis C and other blood-borne diseases that can live in a used syringe.
 
“This is an effective public health measure which is proven to reduce health care costs to taxpayers,” said Yee.  “It’s a moral, as well as fiscal imperative.”
 
“Access to sterile syringes is a vital component of a comprehensive strategy to combat HIV and hepatitis,” said Yee.  “This approach has been evaluated extensively throughout the world and has been found to significantly reduce rates of HIV and hepatitis without contributing to any increase in drug use, drug injection, crime or unsafe discard of syringes.”
 
Governor Arnold Schwarzenegger (R-Los Angeles) signed legislation in 2004 to create a five-year pilot to evaluate the safety and efficacy of allowing adults to purchase and possess a limited number of syringes for personal use.  Under the pilot program pharmacies in Los Angeles County, the Bay Area and some other parts of the state have been allowed to sell syringes.
 
Yee’s SB 1029 would remove the sunset and allow all pharmacists throughout the state with the discretion to sell sterile syringes without a prescription.
 
Sharing of used syringes is the most common cause of new hepatitis C infections in California and the second most common cause of HIV infections.  The state Department of Public Health estimates that approximately 3,000 California residents contract hepatitis C through syringe sharing every year and another 750 cases of HIV are caused by syringe sharing.
 
These diseases are costly and potentially deadly. Hospitalizations for hepatitis B and hepatitis C cost the state $2 billion in 2007, according to a report by the California Research Bureau.  The lifetime cost of treating hepatitis C is approximately $100,000, unless a liver transplant is required, and then the cost exceeds $300,000 per surgery.  The lifetime cost of treating HIV/AIDS is now estimated to exceed $600,000 per patient.
 
By comparison, a syringe costs about ten to fifteen cents retail.  The bill requires no appropriation of state funds, because it allows adults to buy syringes at their own expense.
 
Among health policy researchers speaking in favor of SB 1029, Alex Kral, an epidemiologist who has supervised several studies of HIV prevention said, “In light of over 200 studies worldwide that establish improved syringe access means less disease with no downside, to continue a policy of making syringe sales illegal would amount to health policy malpractice.”
 
The 200 studies Kral referred to were reviewed by the World Health Organization (WHO) in 2008.  WHO concluded that the overwhelming scientific consensus showed improved syringe access reduced rates of HIV and hepatitis without contributing to drug use, crime or unsafe discard of syringes. 
 
“There is not one credible study from anywhere in the world that refutes these findings,” Kral said.
 
Among the numerous studies cited was one published in the American Journal of Public Health from 2001 that compared US cities that allowed pharmacists to sell syringes to adults without a prescription and those that did not.  The study found that the rate of HIV among drug injectors was twice as high in cities that forbid sale without a prescription than those cities that allowed pharmacists greater flexibility to provide syringes.
 
“This approach has been overwhelmingly supported by the health professions,” said Yee. “I look forward to working with my colleagues in the Legislature, the Governor and the California Department of Public Health to craft the most efficient and cost-effective means of saving lives and public dollars by preventing HIV and hepatitis C.”
 
SB 1029 will be considered in committee in March.