Physician Prescribing of Sterile Injection Equipment To Prevent HIV Infection: Time for Action

1 August 2000 | Volume 133 Issue 3 | Pages 218-226

Injection drug users, their sex partners, and their children are at high risk for acquiring HIV infection and other bloodborne diseases. The risk for disease transmission in the United States is partly the result of restricted access to sterile injection equipment. Physicians and pharmacists can play an important role in providing syringe access by prescribing and dispensing syringes to patients who use injection drugs and cannot or will not enter drug treatment. Prescribing and dispensing injection equipment are ethical, clinically appropriate, and fully consistent with current public health guidelines on disease prevention. An analysis of the laws of the 50 U.S. states, the District of Columbia, and Puerto Rico finds that physicians in nearly all these jurisdictions may legally prescribe sterile injection equipment to prevent disease transmission among drug-using patients and that pharmacists in most states have a clear or reasonable legal basis for filling the prescriptions. Given these medical and legal findings, physicians may wish to take a larger role in improving access to sterile injection equipment by prescribing this equipment for their patients where this practice is legal, and by joining efforts to change the law where it poses a barrier.

Author and Article Information

From Temple University School of Law, Philadelphia, Pennsylvania; Public Citizen's Health Research Group, Washington, DC; Lindesmith Center West, San Francisco, California; and the Miriam Hospital/Brown University School of Medicine, Providence, Rhode Island.

Acknowledgments: The authors thank Temple University law students Lisa Kane, Salli Ortiz, Ryan Silverman, and Ronald Webster for essential research assistance; Jane Silver and T. Steven Jones for inspiration and comments; and Gloria Magnano for secretarial support. The authors also thank the anonymous peer reviewers for their constructive suggestions and the members of the expert panel that reviewed the legal research project (Terje Anderson, Arthur Caplan, Zita Lazzarini, Frank McClellan, Maxwell Mehlman, Sharon Stancliff, Robert Swenson, and Donald Williams).

Grant Support: By grant 037162 from the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation (Scott Burris); grant DA 09712 from the National Institute on Drug Abuse (Peter Lurie); grant K20 DA00268 from the National Institute on Drug Abuse, grant 1 KD1 TI12037-01 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration, grant P30-AI-42853 from the National Institutes of Health (partial support), grant 282941581 from the Open Society Institute, grant 10630-26-EG from the American Foundation for AIDS Research (Josiah Rich).

Requests for Single Reprints: Scott Burris, JD, Temple University School of Law, 1719 North Broad Street, Philadelphia, PA 19122; e-mail, burris{at}vm.temple.edu.

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Current Author Addresses: Mr. Burris: Temple University School of Law, 1719 North Broad Street, Philadelphia, PA 19122.

Dr. Lurie: Public Citizen's Health Research Group, 1600 20th Street NW, Washington, DC 20009.

Mr. Abrahamson: The Lindesmith Center West, 1095 Market Street, Suite 505, San Francisco, CA 94103.

Dr. Rich: The Miriam Hospital/Brown University School of Medicine, 164 Summit Avenue, Providence, RI 02906.