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Impact of Deregulation of Syringes in New York State on the Number of Syringes Discarded on the Street & the Willingness of Pharmacists to Sell Syringes to Injection Drug Users

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Project Summary:

The project is an evaluation of two components of the New York Expanded Syringe Access Program (ESAP) that was passed as law in May 2000 and is to be implemented as early as February 2001. The law permits injection drug users to purchase sterile syringes from pharmacies registered with the AIDS Institute of the NY State Health Department, or to obtain syringes from health care providers registered in a similar manner. The evaluation consists of several components, which follow the basic design of observing differences in knowledge, attitudes and practices of different groups before and after the law change. The overall study involves surveys of pharmacists and health care providers. We have already developed instruments, methods and started to collect information to assess extent of awareness and interest in the law change. In addition, this evaluation will include surveys of street discarded needles before and after the law change in order to address whether wider access to syringes poses a public health threat through an increase in street discarded syringes. These data are crucial to collect especially prior to the law change, which occurred without prior notice in May 2000. The New York Academy of Medicine started to set up data collection elements immediately without waiting for funding, recognizing the unique opportunity for policy evaluation. The focus of this project is to examine changes in knowledge, attitudes and practices of pharmacists and providers pre- and immediately post-implementation of ESAP, as well as street counts of discarded needles for the same interval. The goal is to provide data that will inform the state health department and legislators who enacted the law, about aspects of the effects of the law on key parameters early after the law change. Separate funding is being sought to continue the evaluation to examine longer term aspects as well as other parameters not covered in this project. The significance of this evaluation is that this will be the first opportunity to examine systematically the impact of a law change relating to syringe access for injection drug users in an area of high drug use and HIV prevalence where syringe exchange programs already exist and the law affects both pharmacy and health care provider access. This opportunity is unique in that the study will capture this information as the law change is occurring in real time.

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