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The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for Health, who is responsible for deciding which heroin addicts are provided with heroin in line with his Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by his predecessor in March 2016.

Nicola Blackwood

The prescribing of injectable opioids, such as methadone or diamorphine (pharmaceutical heroin) as substitutes for illicit heroin, as outlined in the Government’s Modern Crime Prevention Strategy, published in March by the then Home Secretary, has been an option for many years but since the late 1960s, prescribing of diamorphine for the management of addiction has been restricted to licensed addiction specialists.

The decision to prescribe injectable diamorphine for the treatment of dependence is a clinical matter, for a clinician to take in conjunction with the patient. Advice to guide these decisions is contained in Chapter 5 and Annex 8 of the 2007 UK Guidelines on the Clinical Management of Drug Misuse and Dependence. The guidelines advise that:

– “injectable opioid treatment may be suitable for a small minority of patients who have failed in optimised oral treatment.”;

– “clinicians providing injectable opioid treatment should encourage patients not to regard it as a lifelong treatment option and should regularly review their patients and the continuing necessity for this unusual and expensive treatment”; and

– The use of diamorphine “alone does not constitute drug treatment…it should be seen as on element or pathway within wider packages of planned and integrated drug treatment”.

The guidelines are currently being reviewed by an Expert Working Group, to take into account developments in the evidence base. In July 2016, the Expert Working Group published their draft update for consultation. The consultation has closed and the responses are being considered by the Expert Working Group.

Diamorphine is licensed as a medicine by the Medicines and Healthcare products Regulatory Agency. Clinicians wishing to legally prescribe it for the treatment of dependence need to obtain a licence for that purpose from the Home Office and to comply with all other legislation relevant to the safe management, use and supply of medicines which are controlled drugs.

The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for the Home Department, what discussions she has had with police forces and police and crime commissioners on heroin distributed in their areas in line with her Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by her predecessor in March 2016.

Brandon Lewis

The Modern Crime Prevention Strategy, which highlighted the value of supervised injectable diamorphine/heroin in reducing crime, was launched by Home Office Ministers at the International Crime and Policing Conference on 23 March whose attendance included a large number of representatives from the criminal justice system. Police and Crime Commissioners and police forces wishing to explore issues relating to heroin assisted treatment are encouraged to engage with the relevant local authorities which commission drug and alcohol treatment in their areas.

The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for Health, how much his Department has spent on providing heroin to heroin addicts in line with his Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by his predecessor in March 2016.

Nicola Blackwood

As outlined in the Government’s Modern Crime Prevention Strategy, the use of injectable diamorphine as part of treatment for a small cohort of entrenched, long-term opiate users can be effective.

On behalf of the Department, Public Health England managed a pilot programme of supervised injectable diamorphine prescribing at a cost of £2 million per annum. The pilot ran from 2012 to 2015 at: South London and Maudsley NHS Foundation Trust in Southwark, London; Sussex Partnership NHS Foundation Trust in Brighton; and Tees, Esk and Wear Valleys NHS Foundation Trust in Easington, County Durham.

Information about expenditure on diamorphine prescribing for the treatment of dependence, sites where it is available outside this pilot, and how much diamorphine has been prescribed to heroin addicts is not collected centrally. The decision to commission and fund the local provision of diamorphine prescribing is for local authorities.

The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for Health, what criteria are used when deciding to give heroin to heroin addicts in line with his Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by his predecessor in March 2016.

Nicola Blackwood

The prescribing of injectable opioids, such as methadone or diamorphine (pharmaceutical heroin) as substitutes for illicit heroin, as outlined in the Government’s Modern Crime Prevention Strategy, published in March by the then Home Secretary, has been an option for many years but since the late 1960s, prescribing of diamorphine for the management of addiction has been restricted to licensed addiction specialists.

The decision to prescribe injectable diamorphine for the treatment of dependence is a clinical matter, for a clinician to take in conjunction with the patient. Advice to guide these decisions is contained in Chapter 5 and Annex 8 of the 2007 UK Guidelines on the Clinical Management of Drug Misuse and Dependence. The guidelines advise that:

– “injectable opioid treatment may be suitable for a small minority of patients who have failed in optimised oral treatment.”;

– “clinicians providing injectable opioid treatment should encourage patients not to regard it as a lifelong treatment option and should regularly review their patients and the continuing necessity for this unusual and expensive treatment”; and

– The use of diamorphine “alone does not constitute drug treatment…it should be seen as on element or pathway within wider packages of planned and integrated drug treatment”.

The guidelines are currently being reviewed by an Expert Working Group, to take into account developments in the evidence base. In July 2016, the Expert Working Group published their draft update for consultation. The consultation has closed and the responses are being considered by the Expert Working Group.

Diamorphine is licensed as a medicine by the Medicines and Healthcare products Regulatory Agency. Clinicians wishing to legally prescribe it for the treatment of dependence need to obtain a licence for that purpose from the Home Office and to comply with all other legislation relevant to the safe management, use and supply of medicines which are controlled drugs.

The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for Health, if he will publish a list of the areas in which heroin has been given to heroin addicts in line with his Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by his predecessor in March 2016.

Nicola Blackwood

As outlined in the Government’s Modern Crime Prevention Strategy, the use of injectable diamorphine as part of treatment for a small cohort of entrenched, long-term opiate users can be effective.

On behalf of the Department, Public Health England managed a pilot programme of supervised injectable diamorphine prescribing at a cost of £2 million per annum. The pilot ran from 2012 to 2015 at: South London and Maudsley NHS Foundation Trust in Southwark, London; Sussex Partnership NHS Foundation Trust in Brighton; and Tees, Esk and Wear Valleys NHS Foundation Trust in Easington, County Durham.

Information about expenditure on diamorphine prescribing for the treatment of dependence, sites where it is available outside this pilot, and how much diamorphine has been prescribed to heroin addicts is not collected centrally. The decision to commission and fund the local provision of diamorphine prescribing is for local authorities.

The below Parliamentary question was asked by Ian Austin on 2016-10-07.

To ask the Secretary of State for Health, how much heroin has been given to heroin addicts in line with his Department’s policy set out on page 31 of the Modern Crime Prevention Strategy, published by his predecessor in March 2016.

Nicola Blackwood

As outlined in the Government’s Modern Crime Prevention Strategy, the use of injectable diamorphine as part of treatment for a small cohort of entrenched, long-term opiate users can be effective.

On behalf of the Department, Public Health England managed a pilot programme of supervised injectable diamorphine prescribing at a cost of £2 million per annum. The pilot ran from 2012 to 2015 at: South London and Maudsley NHS Foundation Trust in Southwark, London; Sussex Partnership NHS Foundation Trust in Brighton; and Tees, Esk and Wear Valleys NHS Foundation Trust in Easington, County Durham.

Information about expenditure on diamorphine prescribing for the treatment of dependence, sites where it is available outside this pilot, and how much diamorphine has been prescribed to heroin addicts is not collected centrally. The decision to commission and fund the local provision of diamorphine prescribing is for local authorities.