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Public health activists hailed the state Board of Pharmacy's lifting of the restriction as a way to lessen risky sharing of needles by drug users, but not all pharmacists are happy about it.
"I just don't agree with the rationale behind it: purposeful purchasing for illegal use," said John Hinkle of Hinkle's Pharmacy in Columbia.
"I can't believe our pharmacy board would do something so foolish," said Velinda Pickel, a Royer Pharmacy manager.
But pharmacist Herman Glassman at Queen Pharmacy said deregulating syringe sales makes sense.
"When people are reusing needles, there's an opportunity to spread disease," said Glassman, who added that the change will also make access to needles more convenient for diabetics.
The prescription requirement ended Sept. 12. A customer can now buy as many syringes as he wants, and there's no age restriction. The needles must be kept in a pharmacy's prescription area and be sold under a pharmacist's supervision.
Pharmacists don't have to sell syringes to people lacking prescriptions if they don't want to, said Leslie Amoros of the Pennsylvania Department of State, which oversees regulatory boards.
"This is not a mandate to pharmacists," Amoros said. "But based on scientific study, it's a good step forward to improve the public's health."
In a letter to the Board of Pharmacy in 2007, the Pennsylvania Pharmacists Association endorsed syringe deregulation and called for prompt action.
Before the Board of Pharmacy's action, Pennsylvania was one of only three states that had not deregulated the sale of hypodermic needles.
Connecticut led the way in 1992, resulting in black-market syringe sales falling 74 percent to 28 percent, the Centers for Disease Control and Prevention reported.
Because of positive results of over-the-counter syringe sales in some states, the National Association of Boards of Pharmacy in 2000 encouraged all states to revise their regulations.
The CDC reports that about 20 percent of HIV infections and the majority of hepatitis C infections occur because of the virus being transmitted by addicts sharing needles. The sex partners of those drug users are then put at risk.
In 2002, a group called Pennsylvania Coalition for Responsible Syringe Policy asked the Pennsylvania Pharmacy Board in a letter to consider deregulation.
Then, in 2005, a separate group, Pennsylvanians for the Deregulation of Syringe Sales, hired an attorney and submitted a formal, 9-page petition asking the Pharmacy Board to make the change. That group is headed by Robert E. Field of Lancaster, an apartment industry executive and advocate of drug law reform.
"Our job was to get the ball rolling," the group's attorney, Elizabeth Mullaugh of Harrisburg, said.
Field said he sought the repeal of the prescription requirement after his advocacy for a needle-exchange program for drugs users in Reading met with opposition.
Field said his group met in 2005 with state officials, including a high-ranking member of Gov. Ed Rendell's administration. That meeting was facilitated by Rep. Mike Sturla of Lancaster city, then chair of the House Professional Licensure Committee, facilitated. Field said state officials he met supported the change.
"There's real evidence that this will save people's lives," Sturla said. "I think it needed somebody to give it a little push. I think (Field) deserves a whole lot of credit for pushing."
The Pharmacy Board held hearings and sought written input from interested parties. Almost all of the input the board received supported deregulation.
Dr. Jeffrey Kirchner, a physician who runs an AIDS treatment center at Lancaster General Hospital, supports the regulatory move.
"The data speaks for itself," Kirchner said. Infection rates have been shown to be significantly impacted when people have clean syringes. It's a misconception that it promotes drug use."
Ronda Goldfein of AIDS Law Project of Pennsylvania, one of many groups that urged the Board of Pharmacy to lift the prescription requirement, said research shows that allowing drug users to have easy access to sterile needles reduces the spread of HIV and hepatitis and does not increase the number of drug users.
"People aren't going to say, 'Now that I can get a clean needle at Rite Aid, I'm going to start shooting heroin,' " Goldfein said.
She said having access to needles at pharmacies is especially important to drug users in areas outside of Philadelphia and Pittsburgh. They are the only cities in Pennsylvania with special permission to operate needle exchanges that distribute needles at no cost and encourage addicts to enter treatment.
Beyond those cities, distribution and possession of a syringe for injecting illegal drugs remains a crime under the drug paraphernalia law.
"One of the terrible consequences of heroin addiction is that people hide their disease, they don't get proper medical care and they end up sharing needles," said Adam Kegley, head of Addiction Recovery Systems of Lancaster, a methadone clinic. "And Lancaster, I can tell you, has a very serious heroin problem. Since opening in May 2006, we have seen a steady stream of admissions. The admissions have not slowed down."
Because deregulating needle sales doesn't solve the addiction problem, Kegley said more steps are needed, including the expansion of needle exchanges across the state.
"We need to tear down the paraphernalia law and operate responsible needle exchanges that reach out to the addicts and, ultimately, get them to stop using," he said.
Chris Runkle, program director of Manos House, a drug treatment facility for juveniles, said he has seen teen users who have contracted hepatitis C.
"The percentage is small only because we're catching them early," he said, adding that allowing syringe sales makes sense as a disease-reduction tactic.
"But I don't think it should be, 'Here's a needle. Thanks for shopping,' " Runkle said.
He said community groups need to come together to create an outreach effort, such as a needle exchange, that focuses on disease prevention, education and treatment.
Still, ending the prescription requirement is an important first step, advocates said.
"I think we're going to be saving lives all around Pennsylvania" now that needles are being sold over the counter, said Scott Burris, a specialist in health law at Temple University School of Law. "Pharmacists can now enlist in the fight against AIDS."
E-mail: jhawkes@lnpnews.com
