Table 3 Corporate pharmacy policies (chain pharmacies)
Sites/interventions | US (Boston) | US (Providence) | US (SF) | Canada (Vancouver) | Russia (St P) |
|---|---|---|---|---|---|
Needle/syringe sales/distribution | Corporate policy either specifically allows for or is silent on non-prescription sales of syringes. Most pharmacies sell needles/syringes but the law provides that sales of syringes is at the discretion of the pharmacist. | Sales may be at the discretion of the on-site pharmacy manager | Chains can enroll in Disease Prevention Demonstration Programs so individual stores can sell needles/syringes, but implementation within chains has been inconsistent.a | Most chains sell needles/syringes but individual stores can set policies; many stores will not sell | Chains have no objection to selling needles/syringes but would probably oppose free distribution |
Needle/syringe disposal | Pharmacies generally will not accept used syringes for disposal. | Pharmacies generally will not accept used syringes for disposal. | One chain allows; another prohibits | Most chain pharmacies have sharps containers and accept full containers; individual store policies may differ | Requires additional license for collecting and storage of epidemiologically hazardous waste |
HIV testing | HIV testing is not available in pharmacies. | HIV testing is not available in pharmacies. | Some pharmacies in one chain offered free HIV testing as part of National HIV testing month | Not currently available | Only at medically-licensed facility |
HBV/other vaccination | A recent change in pharmacy policy (MDPH, Drug Control Program and Immunization Program, Joint Policy 2012–2) permits administration of the hepatitis B vaccine in pharmacies to adults by a qualified pharmacist. Two major corporate chains have opened walk in clinics for adult vaccination including hepatitis B vaccines. | Pharmacies may offer any vaccine including hepatitis B, pneumonia, shingles, pertussis, tetanus, meningitis and human papillomavirus. | Most chains offer vaccinations | Could be offered if staff are properly trained | Only at medically-licensed facility |
MMT/OST | Federal Law prohibits dispensing methadone at retail pharmacies. | Federal Law prohibits dispensing methadone at retail pharmacies. | Prescriptions could be filled but DOT requires corporate approval | Regularly dispensed by prescription | Methadone is a prohibited psychoactive agent |
Naloxone/overdose prevention/rescue | Prescriptions for naloxone may be filled. | Also see collaborative practice agreement comments above (Table 2). | Prescriptions could be filled | Individuals cannot obtain by prescription; pharmacies fill orders for clinics and other authorized organizations | Not generally stocked by pharmacies |
Abscess treatment | Corporate policies support provision of information | Corporate policies support provision of information | Information about wound care can be provided | Pharmacies refer customers to health clinic | Pharmacies could offer information; requires display space |
Brief counseling/materials | Corporate policies support the provision of information. | Corporate policies support the provision of information. | Information about medications and health concerns can be provided | Some pharmacies may have informational materials, but most do not | Pharmacies could offer information; requires display space |
Referrals | Corporate policies support the provision of information. | Corporate policies support the provision of information. | Referrals can be made | Pharmacies make referrals | Pharmacies could offer |