Call to expand heroin on NHS plan may expand

THE GOVERNMENT is prepared to consider an expansion of the prescription of heroin to thousands of addicts as part of a package of measures to tackle the growing epidemic.

Deputy drugs tsar Mike Trace said last night that new research had found that a hard-core minority of addicts was not responding to orally taken methadone treatment programmes.

The Government is determined to give all properly qualified doctors the opportunity to prescribe diamorphine - pharmaceutical heroin - to patients, he said.

And the law is to be changed to allow needle-exchange schemes to give addicts spoons, swabs and other drug paraphernalia, the provision of which is currently illegal.

The deputy drugs tsar pointed to new research carried out by the National Addiction Centre which showed that some addicts only responded to needle- based treatment.

"The research ... concluded that there was a certain kind of client who responded to injecting who didn't respond to regular methadone use," he said.

The research findings, which will be revealed on Wednesday at a drugs conference in London called "Heroin, The Ultimate Challenge", will pave the way for more widespread prescription of diamorphine or methadone in injectable form, subject to further research.

Drugs agencies welcomed the development, saying that more people should have access to diamorphine in order to stabilise their lives, reduce levels of crime and stop the spread of HIV and other serious infections.

Mike Goodman, director of the drugs charity Release, which is organising the conference, said that up to 20,000 hard-core heroin addicts would benefit from diamorphine prescriptions.

"We are not talking about open access," he said. "But for a substantial minority of addicts this is the only way to get them into treatment." Many addicts who were given orally taken methadone still felt a need to buy street heroin, he said. "Some people are needle freaks."

The Department of Health now intends to let thousands of properly qualified doctors apply for licences to prescribe heroin if, in their clinical judgement, it is the appropriate thing to do and suitable support services are in place.

Currently, only 120 doctors have such licences and less than 250 addicts are in regular receipt of heroin prescriptions. There are 25,000 people who are prescribed methadone, with 90 per cent of them receiving it in oral form.

A study by the Institute for the Study of Drug Dependency earlier this year found that 387 people fatally overdosed on methadone in 1996 compared to 187 on heroin.

The Government introduced new clinical guidelines in April aimed at ensuring that doctors with insufficient training and expertise were not able to prescribe methadone.