The lesser of 2 evils

Selling syringes is a sore spot for many pharmacy personnel, both technicians and pharmacists alike. I’ve heard technicians say that they wish that they (the drug abusers) would “just die.” I used to have moral qualms about it, too. Why sell something to drug addicts which only facilitates their habit? Why make it easier to abuse illegal substances?

I had an epiphany one day. It occurred to me that selling needles was the lesser of two evils.

Option 1: Withhold clean needles.
Outcome: Person still injects drug of choice, potentially using an unclean needle.

Option 2: Sell clean needles.
Outcome: Person still shoots up, but may avoid infecting or becoming infected with a blood-borne pathogen.

Option 2 is the better option, if for no other reason than it’s more economical. By possibly reducing the spread of infectious disease, we’re possibly saving taxpayer money. Drug abusers are typically uninsured, and wind up in the ER where tax money will pay for the cost of their care. It should go without saying that withholding clean needles isn’t going to stop an addict from getting their fix. Of course drug abuse leads to other medical complications, so there’s no guarantee that they won’t end up there anyway…

Naturally, I play the “Gee I wonder if they’re using it for insulin… or maybe their cat?” game all the time, even though I know it’s unlikely. When they haven’t showered in about a week, look as though they’ve been living in a box under a bridge somewhere, and complain that you’re not snappy enough about selling them their $2.10 bag of syringes, it’s probably a good sign that you’re not using said needles for healthy reasons.

But it’s a comfortable delusion nonetheless.

[tags]Medicine, pharmacy, needles, syringes, drug abuse[/tags]

7 thoughts on “The lesser of 2 evils

  1. Sort of on the same topic: how do you deal with forgeries? I had a lady come in one night (after the doctor’s office closed of course), with a man’s driver’s license from Hawaii (we’re in Oklahoma), wanting to fill a script for 360cc of promethazine/codeine syrup. These scripts are almost always fake. I just told her I’d have to call the doctor to confirm. I tried the doctor, but the office was closed (duh), and told her I wouldn’t fill it.

    Also, we had a copy of a forgery with the exact same handwriting on a different doctor’s Rx pad.

    Just curious how you handle this.

  2. just found out today that she got the damn thing filled at another one of our chain stores. I knew I should have warned other pharmacies in the area…. sheesh, whatever.

  3. Not at total delusion.
    I once cared for a guy with a hx of >10 years doing IV drugs.
    He was Hep C and HIV negative. I was surprised and asked him about his habits. He ALWAYS used clean needles and did not share. I congratulated him on having the insight to do so.

    OTOH, had another pt who didn’t understand why he kept getting infections from using his femoral vein to shoot up his lemon juice and cocaine cocktail.

  4. I’ve heard reports they want to make Naloxone more accessible so when people overdose they won’t die. Though they say when they almost die is when they “wake” up and attempt to sober up.

    It’s a two way street, I think. On one hand, I think since death can be rather rapid on an over dosage a way of treating maybe a not bad idea in home first-aid kits… Yet having that, people would be more willing to do heroine to begin with since now they know they won’t get seriously hurt.

    I don’t know what to make of it let them die is one way of fixing the problem, though if them dying on smack will cause others to die then obviously they should be treated immediately.

    Do you have any takes on this? I read this in the paper, but heard nothing since.

  5. The cynic in me wishes we’d just let natural selection run its course. Cheaper, and the problem is self-limiting. Being a medical professional, however, I’m expected to be a bleeding heart and think the opposite, otherwise I’m a terrible human being.

    But yes, I’ve heard talk of Narcan being added to first aid kits and whatnot. I’m not against the idea, but I’ve not got a fire in my belly to git ‘er done, either.

    It’s important to note that Narcan would only be temporary, since while you can sober someone up nigh instantaneously, they don’t stay sober very long. It basically amounts to an opioid Epipen: a stopgap before emergency treatment, otherwise it’s just a futile gesture.

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