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Nonprescription Sale of Syringes in Pharmacies

Licensed pharmacists may sell hypodermic needles and syringes to adults aged 18 and older without a prescription to reduce the spread of blood-borne diseases. Lack of access to new, sterile injection equipment is one of the primary risk factors that leads to syringe sharing, which puts people who inject drugs at high risk for HIV and HCV, as well as for hepatitis B infections.

Nonprescription Syringe Sale (NPSS) Toolkit: Materials for Pharmacists, Health Departments and Customers

The NPSS Toolkit is a compilation of resources designed to help public health agencies expand NPSS in their jurisdictions. The toolkit includes the information pharmacies need to start offering syringes for sale without a prescription. The toolkit's documents may be used in training, academic detailing, and planning activities, and serve as quick reference resources for public health and pharmacy staff.

 Fact Sheets - Short documents addressing fundamentals

  • The Pharmacist Fact Sheet (PDF) outlines the benefits and the key requirements for nonprescription sale of syringes.

  • The Patient Information Sheet is designed for pharmacists to provide to their customers. It provides information on how to properly dispose of sharps waste and gives resources to help customers find drug treatment programs, HIV and viral hepatitis testing, and related medical services. The flyer is available in an English version (PDF) and a Spanish version (PDF).

Tools for Educators – Briefing documents for provider detailing, as well as for pharmacists and pharmacy staff

 Additional Toolkits and Resources

  • Toolkit from the College of Psychiatric and Neurologic Pharmacists - Harm Reduction Strategies for People Who Inject Drugs: Considerations for Pharmacists provides quick tips and guideline summaries, along with resources and references on harm reduction services, professional and policy support, and other topics for pharmacists serving people who inject drugs.

  • List of pharmacy schools in California – Many health departments in the U.S. have worked closely schools of pharmacy to broaden local participation in non-prescription syringe sale, as well as other public health interventions such as naloxone prescription and HIV and HCV medication adherence.

Key Provisions of California Law

California law allows individuals to possess needles and syringes for personal use. There is no limit on the number of needles and syringes that pharmacies may sell to a customer age 18 and older, and no limit on the number an adult can purchase and possess.

Pharmacies that sell syringes without a prescription must store needles and syringes behind counter and must:

  • Provide for safe disposal of needles and syringes by choosing one or more of the following options:

    • selling or furnishing sharps containers, and/or

    • selling or furnishing mail-back sharps containers, and/or

    • providing on-site sharps collection and disposal

  • Provide written information or verbal counseling to customers at the time of sale on how to:

    • access treatment for substance use disorder,

    • access testing and treatment for HIV and HCV, and

    • safely dispose of sharps waste. The CDPH Patient Information Sheet provides this information in English (PDF) and in Spanish (PDF) .

Needle and Syringe Disposal

Used needles, syringes and lancets ("sharps") from individuals are termed "home-generated" waste by California law. Home-generated sharps waste is not regulated in the same way as "medical waste," which is generated on site by medical providers.

Businesses and facilities that accept home-generated sharps waste can be found through:

California Law Related to Sharps Waste Disposal

Business and Professions (B&P) Code Section 4146 permits pharmacies to accept the return of needles and syringes from the public if contained in a sharps container, which is defined in H&S Code Section 117750 as "a rigid puncture-resistant container that, when sealed, is leak resistant and cannot be reopened without great difficulty."

B&P Code 4145.5 requires pharmacies that sell or provide nonprescription syringes to also provide consumers with one or more of three disposal options: 1) onsite disposal, 2) provision of sharps containers that meet applicable state and federal standards, and/or 3) provision of mail-back sharps containers.

Health and Safety (H&S) Code Section 118286 prohibits individuals from discarding home-generated sharps waste in home or business recycling or waste containers.

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