Office of Senator Leland Yee
SACRAMENTO – On the eve of World AIDS Day, Senator Leland Yee (D-San Francisco) is hoping Governor-elect Jerry Brown (D-Oakland) will heed the advice of doctors, pharmacists, and AIDS prevention advocates, by signing legislation to allow pharmacies to sell sterile syringes to an adult without a prescription.
Governor Arnold Schwarzenegger (R-Los Angeles) recently vetoed Yee's Senate Bill 1029, which would have brought California in line with every other state in the nation (accept two) to no longer prohibit pharmacists from selling a syringe without a prescription.
Today, Senator Yee announced his intention to reintroduce the bill during the upcoming legislative session that begins next week.
Most states amended their laws in light of overwhelming evidence that criminalizing access to sterile syringes led drug users to share used ones, and that sharing syringes spread HIV, hepatitis B, hepatitis C and other blood-borne diseases that can live in a used syringe.
Under an existing pilot program, pharmacies in Los Angeles County, San Francisco, and some other parts of the state have been allowed to sell syringes. While he was mayor of Oakland, Brown's home county of Alameda authorized sterile syringe sales.
Yee's legislation would remove the existing sunset of the pilot program (2018) and would allow all pharmacists throughout the state with the discretion to sell sterile syringes without a prescription.
"AIDS and hepatitis do not recognize county borders and thus our current policy is not nearly as effective as it should be," said Yee. "This legislation will reduce health care costs to taxpayers and save lives. I am hopeful that under Governor Brown's leadership, we will get this bill signed into law."
The approach in Yee's bill has been evaluated extensively throughout the world and has been found to significantly reduce rates of HIV and hepatitis without contributing to any increase in drug use, drug injection, crime or unsafe discard of syringes. In fact, there is not one credible study that refutes these findings.
Alex Kral, an epidemiologist who has supervised several studies of HIV prevention, said, "In light of over 200 studies worldwide that establish improved syringe access means less disease with no downside, to continue a policy of making syringe sales illegal would amount to health policy malpractice."
The 200 studies Kral referred to were reviewed by the World Health Organization (WHO) in 2008. WHO concluded that the overwhelming scientific consensus showed improved syringe access reduced rates of HIV and hepatitis without contributing to drug use, crime or unsafe discard of syringes.
Among the numerous studies cited was one published in the American Journal of Public Health from 2001 that compared US cities that allowed pharmacists to sell syringes to adults without a prescription and those that did not. The study found that the rate of HIV among drug injectors was twice as high in cities that forbid sale without a prescription than those cities that allowed pharmacists greater flexibility to provide syringes.
"Based on a robust body of research, it is clear that Senator Yee's bill will save thousands of lives and hundreds of millions of taxpayer dollars by preventing HIV and hepatitis," said Laura Thomas, MPH, Dep. State Director, Drug Policy Alliance. "We thank Senator Yee for his leadership in promoting effective and affordable HIV and hepatitis prevention efforts."
Sharing of used syringes is the most common cause of new hepatitis C infections in California and the second most common cause of HIV infections. The state Department of Public Health estimates that approximately 3,000 California residents contract hepatitis C through syringe sharing every year and another 750 cases of HIV are caused by syringe sharing.
These diseases are costly and potentially deadly. Hospitalizations for hepatitis B and hepatitis C cost the state $2 billion in 2007, according to a report by the California Research Bureau. The lifetime cost of treating hepatitis C is approximately $100,000, unless a liver transplant is required, and then the cost exceeds $300,000 per surgery. The lifetime cost of treating HIV/AIDS is now estimated to exceed $600,000 per patient.
"Many studies prove that clean syringes can dramatically lower HIV transmission rates," said Courtney Mulhern-Pearson, Director of State & Local Affairs, San Francisco AIDS Foundation. "Sterile syringes not only protect injection drug users, they also protect their sexual partners. Providing broader access to clean syringes is the right thing to do for the health of entire communities across California."