title: Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.
abstract: OBJECTIVE
  To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes.
  
  
  METHODS
  Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales.
  
  
  RESULTS
  More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists.
  
  
  CONCLUSIONS
  Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access and training among pharmacy staff members.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Stopka
authors.forename: Ashley
authors.initials: A
authors.lastname: Donahue
authors.forename: Marguerite
authors.initials: M
authors.lastname: Hutcheson
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000188:drug therapy / Q000453:epidemiology; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008404:Massachusetts; D009270:Naloxone / Q000008:administration & dosage* / Q000600:supply & distribution; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000600:supply & distribution; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000600:supply & distribution; D010595:Pharmacists / Q000458:organization & administration; D024382:Professional Role; D013594:Syringes / Q000600:supply & distribution*
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D004366:Nonprescription Drugs; D009270:Naloxone