BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1701
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          ASSEMBLY THIRD READING
          AB 1701 (Chesbro)
          As Amended  February 1, 2010
          Majority vote 

           HEALTH              14-4                                        
           
           -------------------------------- 
          |Ayes:|Monning, Adams, Ammiano,  |
          |     |Carter, De La Torre, De   |
          |     |Leon, Eng, Hayashi,       |
          |     |Hernandez, Jones, Bonnie  |
          |     |Lowenthal, Nava, V.       |
          |     |Manuel Perez, Salas       |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Conway, Emmerson, Gaines, |
          |     |     Audra Strickland     |
          |     |                          |
           -------------------------------- 
           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  deletes the  
          December 31, 2010 sunset date:

          1)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)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.

           FISCAL EFFECT  :  None

           COMMENTS  :  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  








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          with health materials, important information, and links to care.  
           The author states participants remain positive and enthusiastic  
          and research has shown that there is no evidence of negative  
          effects of the program.

          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 possess 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. 

          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  
          Office of AIDS, 15 counties and four cities have authorized a  
          DPDP.  Two other counties are 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  








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          pharmacies in public health efforts.  To date, research  
          conducted on the program has found no evidence of increased  
          crime or syringe litter.  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.

          The Health Officers Association of California 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 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.  The Drug Policy Alliance writes that  
          allowing adults to purchase sterile syringes without a  
          prescription 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.

          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.









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          See the policy committee analysis for further information on  
          this bill.
           
          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097 
                                                                FN: 0003799