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.
