BILL ANALYSIS �
AB 1743
Page 1
ASSEMBLY THIRD READING
AB 1743 (Ting)
As Introduced February 14, 2014
Majority vote
HEALTH 13-6
--------------------------------
|Ayes:|Pan, Ammiano, Atkins, |
| |Bonilla, Gordon, Chesbro, |
| |Gomez, Gonzalez, Roger |
| |Hern�ndez, Nazarian, |
| |Ridley-Thomas, |
| |Wieckowski, Skinner |
| | |
|-----+--------------------------|
|Nays:|Maienschein, Ch�vez, |
| |Mansoor, Nestande, |
| |Patterson, Wagner |
| | |
--------------------------------
SUMMARY : Deletes the limit on the number of syringes a
pharmacist or physician can sell to an adult without a
prescription and deletes the sunset date of January 1, 2015,
that would end the statewide authorization to sell syringes
without a prescription, as specified.
FISCAL EFFECT : None
COMMENTS : According to the author, the intent of this bill is
to improve access to syringes and hypodermic needles so as to
remove significant barriers for persons seeking to protect their
health and the health of other persons, and to remove barriers
for programs or businesses to provide sterile injection
equipment and education to adults, thereby reducing the spread
of communicable diseases and protecting public health. The
author notes, without this bill, persons living in many parts of
California will not have safe syringe access. At the end of
this year, the state will revert back to a piecemeal framework
adopted in 2005 in which counties or cities (with their own
departments of health) can decide if pharmacists may sell
syringes over the counter. The author states this would mean
safe, over the counter syringes would only be available through
pharmacists in 15 counties and four cities participating in the
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disease prevention demonstration projects (DPDP), in addition to
needle exchange programs operational in only 19 counties and two
cities. The author concludes that a statewide solution is best
because diseases do not stay confined to local borders - county
lines or city limits.
California is one of only five states having statewide
limitations on the purchase of syringes, according to a 2014
survey by the National Association of Boards of Pharmacy (NABP).
Although statewide sales are currently legal, there is a
restriction as to the number.
California has allowed the sale of hypodermic needles and
syringes for almost 10 years. 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. Within several years there were hundreds of
pharmacies participating, reaching a total of 650 by the
suspension of the pilot. The pilot was suspended when statewide
sales were authorized by SB 41 (Yee), Chapter 738, Statutes of
2011. SB 41 also required the Department of Public Health (DPH)
to evaluate the results of the pilot project.
In July 2010, DPH published an evaluation of the pilot. The
report had a number of findings. Among the most relevant were
that an increased number of intravenous drug users (IDUs)
reported using pharmacies as a source of their syringes. The
availability of these sterile syringes seemed to impact
behavior. A significantly lower portion of IDUs reported
sharing of syringes and there was no evidence of increased
unsafe discarding of used hypodermic needles or syringes
observed in the DPDPs. DPH reported that the rate of injection
of illegal drugs decreased among publicly funded human
immunodeficiency virus (HIV) testing clients. The report also
found that drug-related crime remained stable in the
jurisdictions that authorized DPDPs. Nevertheless, DPH
concluded that the program appeared to be having the desired
effect of augmenting access to sterile syringes.
The most important statistic would be the HIV and acquired
immunodeficiency syndrome (AIDS) incidence rates. DPH states
that between problems of data gathering and the short duration
of the projects made the infection rate impossible to measure
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accurately. However, there are a host of studies both
domestically and internationally that provide evidence that
provision of sterile hypodermic needles and syringes reduces HIV
transmission.
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 10
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 NABP,
the National Alliance of State and Territorial AIDS Directors,
and the Association of State and Territorial Health Officials.
The Drug Policy Alliance and San Francisco AIDS Foundation,
cosponsors of this bill, argue this bill will continue
cost-effective HIV and hepatitis prevention policy in
California. By lifting the current sunset and allowing
pharmacists and physicians the discretion to furnish sterile
syringes, this will be an important part of the state's
comprehensive approach to preventing the spread of HIV,
hepatitis B, and hepatitis C. They note over 200 studies from
the United States and abroad concur that improved syringe access
reduces the rate of syringe sharing and disease transmission
without increasing rates of drug use, drug injection, or crime.
The cosponsors also note that maintaining access to sterile
syringes reduces costs to taxpayers; the cost of treating one
case of HIV can exceed $600,000.
Supporters note that California was one of the last states to
relax restrictions on accessing a sterile syringe, leading to an
unnecessarily high rate of syringe-acquired HIV, hepatitis B,
and hepatitis C. They argue since the enactment of SB 41,
pharmacists have been free to protect the health of individual
patients and the community health at no cost to taxpayers. They
support this bill because it will make the discretion permanent
and allow the pharmacists or physicians to decide on how many
syringes can be provided.
The California Narcotic Officers Association and the California
Police Chiefs Association oppose this bill arguing there is no
evidence to justify an outright lifting of the sunset or a
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removal of the current cap of 30 syringes.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097
FN: 0003090