Prescription heroin

Prescription future for heroin drug treatment

Doctors will be encouraged to prescribe pharmaceutical heroin to addicts in order to slash drug-related crime, the Liberal Democrats have said.

At a conference on Drugs, Race and Discrimination held by drugs charity Release on Thursday, Liberal Democrat Home Affairs spokesman Chris Huhne MP said that it was time addiction was seen as a public health issue.

Arriving directly from the Liberal Democrat Party conference in Brighton, he said: “We must treat addicts as a matter of public health not as a matter for punishment. They are people who have no option but to try to feed their addiction, and there is nothing to gain from threatening them with prison.

“GPs and clinics should be given the right to prescribe heroin in cases of addiction. The principle is clear.”

The Liberal Democrats’ policy is informed by trials in Switzerland and the Netherlands where around 1,000 addicts were prescribed diamorphine – pharmaceutical heroin, in injectable or pill form. The results were a sharp fall in crime, improvement in the addicts’ health and a better rate of beating the addiction than those using methadone, an alternative heroin treatment. The results also showed after three years on the programme they had more friends who were not addicts, stable housing, and jobs.

The MP and former economist was fiercely critical of the current attitude towards drugs and crime, adding: “If we ran economic policy the same way we ran criminal justice policy we’d be in a perpetual recession. There is an enormous gap between the clear evidence that exists and practice.”

Prison sentences only serve to disrupt the treatment of addicts, the UK Drug Policy Commission has said, and, with drugs available in prison, cannot even act as a period of ‘cold turkey.’

Though doctors can prescribe diamorphine doing so requires meeting stringent regulations and obtaining a Home Office licence, which the Lib Dems would relax. The introduction of methadone in the 1960s and 1970s means that now only a handful of doctors do so – of the UK’s population of 300,000 ‘problem drug users’ and 40,000 registered heroin addicts, only around 300 to 400 addicts deemed as ‘treatment-resistant’ are offered diamorphine as a last resort from 128 licensed clinics.

Steve Rolles, head of research for drug policy reform group Transform, said that, uniquely, it was possible with heroin to compare both legal and illegal use.

He said: “It’s as if there are two alternate realities running in parallel; one where drug users are buying street heroin on the corner, robbing people to fund their habit, catching diseases from dirty needles and dying. At the same time you have medical facilities prescribing safe diamorphine in a controlled environment to addicts who are drawn towards the support services, aren’t committing crime and are living more stable lives.

“One works very well and the other is a complete disaster.”

A growing number of voices are advocating a less punitive approach towards addicts. Parliament’s Home Affairs Committee stated in 2003: “If diamorphine treatment could be offered to all problematic users who do not successfully access other treatments, we believe it could play a useful part in managing the social problems generated by this group of people.” On the committee was a Conservative MP, one David Cameron.

The Chief Constable of North Wales Richard Brunstrom in 2004 suggested legalising heroin to undermine drug-related crime, and Scottish police chief Clive Fairweather and the president of the Association of Chief Police Officers, Ken Jones, recommended prescribing diamorphine as a more “realistic” approach to long-term drug abuse, pointing to overcrowded prisons choked with drug users.

HM Prison Service figures show that in July there were 12,814 inmates sentenced or held on remand for drugs offences. An estimated 60 per cent of acquisitive crimes are drug-related, costing the taxpayer around £12 billion a year. If those on theft, robbery or burglary charges were included the total prison population held because of drug use, and their prohibition, could be as high as 27,524.

However, many doctors have strong ethical reservations about supplying addictive drugs, and baulk at describing it as a ‘treatment.’ There are also concerns over the extra cost of supervised ‘shooting galleries’ where users can inject or take their diamorphine, and fears that prescription drugs given to be taken away may end up sold on the black market, as happened in the 1960s.

In 2006, the Addiction Research Unit based in London’s Maudsley Hospital started trials similar to those in Switzerland, and the Home Office plans a future review in the light of its results.

 

[This article originally appeared in The Big Issue, September 2008]