Australian community pharmacists' comfort, attitudes, beliefs, and barriers regarding needle and syringe programs and correlates of provision: findings from a national study.

OBJECTIVES: To explore needle and syringe program (NSP) service provision and related correlates and comfort, attitudes, beliefs, and barriers to service provision, among a nationally representative sample of Australian community pharmacists. METHODS: A national survey was undertaken between January and April 2025. The survey captured data on pharmacy and pharmacist characteristics, provision of NSP, and pharmacists' comfort, attitudes, beliefs, and barriers to providing NSP. Descriptive statistics and logistic regression models were used to determine the correlates of NSP provision and pharmacists' comfort with providing information about safer injection of heroin and stimulants. KEY FINDINGS: Of the 643 pharmacists included in the analyses, 51.5% (n = 331) provided an NSP, with provision ranging from 35.0% in New South Wales to 82.1% in Western Australia. While most pharmacists providing NSPs believed that NSPs provide an opportunity to provide advice and referral to treatment services (56.2%) and education around the risks associated with illicit drug use/injecting drugs (59.0%), few pharmacists reported being comfortable providing information about safer injection of heroin (12.6%) and stimulants (12.7%). Reasons for not providing an NSP included a perceived lack of demand for the service (62.2%) and not enough monetary incentive (30.9%). CONCLUSIONS: Targeted initiatives are needed to strengthen community pharmacists' capacity to extend beyond needle and syringe provision to delivering harm reduction advice and referral. Addressing barriers, including perceived lack of demand and inadequate financial incentives, requires targeted policy support and sustainable funding to expand pharmacy-based NSPs.