BILL ANALYSIS
AB 1701
Page 1
Date of Hearing: March 23, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 1701 (Chesbro) - As Introduced: February 1, 2010
SUBJECT : Hypodermic needles and syringes.
SUMMARY : Establishes, indefinitely, the Disease Prevention
Demonstration Project (DPDP), which permits cities or counties
to authorize licensed pharmacists to sell or furnish 10 or fewer
hypodermic needles or syringes to a person for use without a
prescription, as specified. Specifically, this bill :
1)Deletes the December 31, 2010 sunset date for the DPDP, under
which a city or county is permitted to authorize a licensed
pharmacist to sell or furnish 10 or fewer hypodermic needles
or syringes to a person for use without a prescription if the
pharmacy is registered with a local health department (LHD).
2)Deletes the December 31, 2010 sunset date in current law that
permits a person, with authorization by a city or county, to
possess 10 or fewer hypodermic needles or syringes if acquired
through an authorized source.
EXISTING LAW :
1)Regulates the sale, possession, and disposal of hypodermic
needles and syringes; and requires a prescription to purchase
a hypodermic needle or syringe for human use, except to
administer adrenaline or insulin.
2)Permits a city or county to authorize a licensed pharmacist to
sell or furnish 10 or fewer hypodermic needles or syringes to
a person for human use without a prescription if the pharmacy
is registered with a LHD in the DPDP until December 31, 2010.
3)Prohibits the possession and sale of drug paraphernalia; but
until December 31, 2010, allows a person, if authorized by a
city or county, to possess 10 or fewer hypodermic needles or
syringes if acquired through an authorized source.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
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COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, in response to
the growing epidemic of AIDS and other infection related
diseases in 2004 California launched a new pilot program, the
DPDP, which has allowed over 650 pharmacies the ability to
provide the opportunity of syringe sale while providing
injection drug users with health materials, important
information, and links to care. The author states that the
implementation of the program was successful. Participants
remain positive and enthusiastic and research has shown that
there is no evidence of negative effects such as increased
syringe litter.
2)BACKGROUND . Injection drug use (IDU) is the second leading
cause of HIV transmission and the leading cause of the
hepatitis C virus (HCV) in California. According to the
California Department of Public Health's (DPH) Office of AIDS,
in 2009 IDU was associated with 19% of the 190,000 reported
HIV/AIDS cases, and it is estimated that approximately 750 new
HIV infections may be attributed to IDU each year. The link
between IDU and HIV transmission is particularly strong for
women and minorities. It is also estimated that at least 60%
of prevalent cases of HCV infection are associated with IDU.
In 2008, 36 acute HCV infections and 69,519 unique chronic HCV
cases were reported in California, and HCV-related deaths in
the state more than doubled from 503 in 1995 to 1,195 in 2004.
Public health experts, including the Centers for Disease Control
and Prevention, have identified access to sterile syringes as
one component of a comprehensive HIV prevention strategy
designed to reduce HIV transmission among IDUs. In the last
ten years, a number of national organizations have endorsed
deregulation to allow IDUs to purchase and posses syringes and
needles without a prescription, including the American Medical
Association, the American Pharmaceutical Association, the
National Association of Boards of Pharmacy, the National
Alliance of State and Territorial AIDS Directors, and the
Association of State and Territorial Health Officials.
3)DPDP . SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004,
established a five-year pilot program to allow California
pharmacies, when authorized by a local government, to sell up
to 10 syringes to adults without a prescription. According to
the DPH Office of AIDS, 15 counties and four cities in
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California have authorized a DPDP. Two other counties are
currently considering or planning to implement the program,
and four County Boards of Supervisors have rejected
authorization of a DPDP.
According to DPH, implementation of SB 1159 has rolled out
smoothly in most participating local health jurisdictions.
Participating counties and cities have been positive about the
opportunities to form new collaborations, to address the issue
of syringe disposal, to provide syringe purchasers with
essential health information, and to enlist pharmacies in
public health efforts. To date, research conducted on the
program has found no evidence of negative effects, such as
increased crime or syringe litter, associated with the
program.
A report based on DPH's evaluation of the pilot project and the
impact of syringe sales on rates of disease, rates of crime,
rates of drug use, rates of needle-stick injury to law
enforcement officers, and rates of unsafe discard of syringes
is currently under review by the department.
4)RELATED LEGISLATION . AB 1858 (Blumenfield) deletes the
prohibition against any person possessing hypodermic needles
or syringes, deletes the December 31, 2010 sunset date for
DPDP, and increases the number of hypodermic needles and
syringes permitted to be obtained or possessed without a
prescription from 10 needles to 30 needles. AB 1858 also
permits DPH to authorize entities to provide hypodermic needle
and syringe exchange services in any location where it
determines that the conditions exist for the rapid spread of
HIV, viral hepatitis, or any other potentially deadly or
disabling infections that are spread through sharing needles
and syringes. AB 1858 is set to be heard in the Assembly
Health Committee on April 6, 2010.
SB 1029 (Yee) eliminates most provisions of the DPDP, including
requirement that LHDs register pharmacies and provide
pharmacies with educational material for distribution, and
instead allow pharmacists statewide the discretion to sell 30
or fewer syringes to an adult without the requirement of a
local authorization vote and eliminates other elements of the
demonstration project including state requirements regarding
advisory board and evaluation. SB 1029 also deletes the
prohibition against possession of hypodermic needles and
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syringes, and permits adults to possess 30 or fewer syringes
solely for personal use. SB 1029 would also require the
Office of AIDS to develop and maintain information on its Web
site to educate consumers at risk of blood-borne infections of
opportunities to improve and protect the consumer's health,
and to protect the public health. SB 1029 would require
pharmacies that provide non-prescription syringes to promote
safe syringe disposal, and to store syringes securely. This
bill is pending in the Senate Health Committee.
5)PREVIOUS LEGISLATION . AB 110 (Laird), Chapter 707, Statutes
of 2007, permits a public entity that receives General Fund
money from the Department of Health Services (now DPH) for HIV
prevention and education to use that money to support needle
exchange programs. AB 1597 (Laird) of 2005 contained
substantially similar provisions to AB 110, but was vetoed by
Governor Schwarzenegger.
AB 547 (Berg), Chapter 692, Statutes of 2005 creates the Clean
Needle and Syringe Exchange Program to permit needle exchange
programs without a local declaration of emergency. AB 946
(Berg) of 2003 and AB 2871 (Berg) of 2004 would also have
repealed the requirement that a city or county authorize its
needle exchange program through a declaration of a local
emergency. Both bills were vetoed by Governor Davis and
Governor Schwarzenegger, respectively.
Prior to SB 1159 in 2004, SB 1785 (Vasconcellos) of 2002 and SB
774 of 2003 would have permitted the furnishing of syringes
without a prescription. Both measures were vetoed by Governor
Davis.
AB 136 (Mazzoni), Chapter 762, Statutes of 1999, exempts public
entities and their agents and employees who distribute
hypodermic needles or syringes to participants in clean needle
and syringe exchange projects authorized by the public entity
pursuant to a declaration of a local emergency from criminal
prosecution.
6)SUPPORT . The Health Officers Association of California, the
sponsor of this bill, writes that this bill will protect
public health without sacrificing public safety as numerous
scientific studies have found that safe access to syringes
does not lead to increased drug use. The County Health
Executives Association of California states that allowing DPDP
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to continue will likely continue to reduce the number of new
infections across the state. AIDS Project Los Angeles writes
that a 2001 study of 96 U.S. cities found that the rate of HIV
among IDUs was twice as high in the cities that prohibited the
sale of syringes without a prescription compared to cities
that did not have such a prohibition. The Santa Clara County
Board of Supervisors states that this bill is an appropriate
response to a genuine public health threat and would
complement existing harm reduction programs that seek to
reduce the use of dirty needles, such as their County's needle
exchange program. The Drug Policy Alliance writes that
allowing adults to purchase sterile syringes without a
prescription at community pharmacies is a sound public health
strategy endorsed by virtually every major health
organization, including the American Medical Association,
Institute of Medicine, American Pharmacists Association, and
the National Alliance of State and Territorial AIDS Directors.
7)OPPOSITION . The California Narcotic Officers Association
writes that an indefinite lifting of the sunset on DPDP does
not take sufficient account of some of the incidents that have
occurred in connection with non-prescription needle
furnishing, including irresponsible disposal of needles and a
"magnet effect," in which some retail outlets that furnish
needles without a prescription have become magnets for drug
addicts and dealers. California Correctional Supervisors
Organization states that DPDP is directed at illegal drug
users and how they have not demonstrated care and concern for
their own bodies, thus we are ill advised to think they will
properly dispose of dangerous needles and syringes.
REGISTERED SUPPORT / OPPOSITION :
Support
Health Officers Association of California (sponsor)
AIDS Project Los Angeles
California Psychiatric Association
County Health Executives Association of California
Drug Policy Alliance
San Luis Obispo County Health Officer
Santa Clara County Health Officer
Santa Clara County Board of Supervisors
Santa Cruz County Health Services Agency
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Opposition
California Correctional Supervisors Organization
California Narcotic Officers Association
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097