Results revealed that the test-buy success rate increased from 48 percent in 1996 to 65 percent in 2003. In 1996, 49 percent of pharmacists agreed that syringes should be available to injection drug users through pharmacy purchase compared to 71 percent of pharmacists who agreed in 2003. The policies and attitudes of pharmacists were significantly related to syringe access. Similar results have been achieved in other cities. The findings suggest that targeting pharmacists for outreach, education, and recruitment has had an influence on pharmacists’ attitudes, practices, and policies. Structural changes, such as legal and regulatory reforms, have also presumably contributed to increased syringe access in Seattle. The current study methodology replicated a 1996 Seattle study of pharmacists’ attitudes and practices related to syringe sales to injection drug users. Participants in the current study were 227 full-time pharmacists in practice at retail pharmacies across 6 regions of King County. There were two phases to the study. In the first phase, pharmacist participants answered a 20-question telephone survey regarding their awareness of State policy changes, their participant in the syringe sales partnership, and their attitudes, practices, and policies regarding syringe sales to injection drug users. The second phase of the study involved test-buys with 15 pharmacies randomly selected from 5 regions in Seattle. A scripted protocol was used for the test-buys in which a casually attired buyer would ask the employee at the pharmacy counter if they could buy 10 syringes without a prescription or other restrictions. Data analysis included the use of repeated-measures analysis of variance and the Fisher exact test. Future research should focus on the effectiveness of interventions designed to increase pharmacists’ willingness to counsel and provide education for injection drug users. Tables, references