South West England needle exchange pharmacist's knowledge of the updated UK 'paraphernalia laws' (2007)

ENGLISH :
Background: The supply of some injecting paraphernalia was legalized in the UK in 2003 in order to reduce harm, prevent blood born virus transmission and encourage access to services. Pharmacies comprise over three quarters of needle exchange outlets in the UK. The extent to which needle exchange pharmacists are aware of the law change or have embraced the new supply opportunities is unknown. Methods: A survey of pharmacy based needle exchanges (PBNX) in the South West of England (n = 143), undertaken using telephone interviews 6 months after the main law change. Results: Participation rate was 85% (n = 121), 66% (n = 80) of PBNX provided needles and syringes only, 34% (n = 41) supplied one or more items of paraphernalia. The most commonly supplied paraphernalia item was citric acid. Forty-two per cent of pharmacists said they were aware of the law change. However, only 2% of these could fully describe it, 41% could partially describe it, 59% were either out of date, wrong or did not know. Most pharmacists saw themselves as 'middle men', acting on behalf of local healthcare planners or drugs services. Most said they had no influence over equipment choice. Conclusions: Although PBNX is extensive within the UK, in the South West of England, the law change to permit the supply of paraphernalia has not been fully implemented. Pharmacists appear to be little involved in decisions around supply with areas for improvement in knowledge of the new law identified. Involving pharmacists more in local decisions may increase their feelings of accountability for the service they provide to injectors. (Author' s abstract)