L.A. County to Allow Sales of Needles

Los Angeles County joined a growing list of California counties and cities on Tuesday that have embraced a controversial effort to reduce the spread of HIV/AIDS and other serious infections by legalizing over-the-counter sales of syringes.

The Board of Supervisors voted 3 to 2 to allow pharmacies that register with the county’s Department of Health Services to sell customers up to 10 syringes without a prescription.

The new policy is backed by a coalition of pharmacies, health officials and AIDS-awareness advocates who argue that providing clean needles to illegal intravenous drug users is a vital step in the fight against AIDS.

Until recently, California was one of only five states that outlawed over-the-counter sales. But a law that took effect in January allows cities and counties to authorize registered drugstores to sell needles without fear of prosecution.

“The cost of a syringe is infinitesimal compared to the cost of treating an AIDS patient who has contracted AIDS through a dirty needle,” said Supervisor Zev Yaroslavsky, who voted for the measure along with Supervisors Gloria Molina and Yvonne Brathwaite Burke.

Critics complain the policy amounts to a government endorsement of illegal drug use and say county health officials should focus on encouraging users to seek treatment.

“There’s no way you can be a healthy drug user,” said Supervisor Mike Antonovich, who voted against the measure with Supervisor Don Knabe.

The vote applies to pharmacies throughout the county, excluding Pasadena and Long Beach, which have their own health departments. The cities of Los Angeles and West Hollywood voted to support the effort earlier this year.

The vote comes five years after the supervisors narrowly approved a similarly divisive plan that would have certified needle-exchange programs and given providers immunity from prosecution.

That program, however, languished in the county’s Department of Health Services, prompting Yaroslavsky to criticize county health officials over what he described as an “inexcusable” lack of progress.

“If there was a smallpox epidemic, do you think it would take you five years to figure out what to do about it?” Yaroslavsky asked the agency’s director, Dr. Jonathan Fielding. “I’ve been here 10 years, and half of that time nothing has been done.”

Fielding apologized and said his department would redouble its efforts to create a certification program.

“We will fix this,” he assured the board.

The city of Los Angeles has helped fund needle-exchange programs for a decade. Last year, seven programs served 11,000 drug users.

County health officials blamed the certification program’s delay partly on conflicts with the community organizations that would run the exchanges, over such issues as whether to restrict drug users to no more needles than they hand in. They hope to have a program started by October.

There are no reliable figures for how many AIDS patients contract the disease through dirty needles. But in Los Angeles County, an estimated 14% of the 49,000 residents living with AIDS or who have died from the disease were either intravenous drug users or had sexual contact with such users.

At the same time, the county is home to 120,000 to 190,000 illegal intravenous drug users. County health officials said about 45% of those share syringes, which increases the likelihood of spreading HIV, hepatitis and other blood-borne diseases.

Fielding said studies of needle exchanges and over-the-counter sales have shown a dramatic decline in needle sharing and transmission of HIV.

“Both are important,” he said. “We feel that they may reach different segments of the intravenous drug-using population.”

Pharmacies that register will be required to give syringe buyers information about drug treatment and testing for HIV and hepatitis.

One major drugstore chain has already expressed support for the policy.

“From my opinion, it’s a no-brainer,” said Philip Burgess, national director of pharmacy affairs for Walgreens, based in Deerfield, Ill. “Access to clean needles reduces the spread of HIV and AIDS.”

But some public-safety organizations oppose the syringe sales, faulting California’s new law for failing to ensure that customers receive drug treatment and to monitor who is purchasing the needles.

“This amounts to a virtually unfettered, unregulated distribution of needles,” said John Lovell, a lobbyist for the California Narcotic Officers’ Assn. “You’ll just be promoting more and more of a street drug culture.”

In March, Riverside County voted against adopting the same sales policy, citing concerns about improper disposal of needles and increased crime in neighborhoods where drugstores would sell syringes.

But other counties have approved the over-the-counter sales, including Alameda, Marin, San Francisco, Contra Costa, Santa Cruz, Yuba and Yolo.

Los Angeles County officials said they hoped pharmacies would be selling syringes by October.

That would leave just Pasadena and Long Beach without programs. Pasadena health officials could not be reached for comment, but Long Beach health officials have discussed adopting a needle-sale policy.

“Maybe now that L.A. County is doing this,” said Dr. Felix Aguilar, the city’s acting health officer, “that will spur us to recognize this.”