Wednesday, 5 January 2011

Reply From The Government About Diamorphine Prescribing

Heres the reply I just got from the department of health from the letter I sent last month... pretty vague if you ask me...

Heres the original letter I sent of: Plese feel fee to edit:

Dear (Insert MP’s name here),
                 I am writing with regards to the current treatment modality of heroin addiction in the UK.
After personally using heroin for 15 years and having utilising the various treatment options currently available believe I have a fair understanding of the issues surrounding opiate addiction and treatment.
In my experience, and invariably of many others, maintenance treatments like methadone and subutex, have their place, but for the majority of addicts just don’t work, one report suggests a success rate of just 4% with methadone!

There are numerous government reports supporting the prescribing of diamorphine for heroin addicts, and the studies and trials that have been done all have much better results regarding health problems and a marked reduction in crimes committed to support habits.

The UK is also in a better position legally than most other countries as doctors here are allowed to prescribe diamorphine for addiction (alebeit with a home office license) this should be exploited as there are hundreds of thousands of heroin addicts in the UK that can see no way out of their situation.

After a recent heroin ‘drought’ in the UK, a lot of addicts are questioning the range of treatments available to us.
Not only is the situation regarding getting into a treatment programme different all over the country, the choices on offer (methadone or subutex maintenance are not suitable for everyone)
For example, some GP’s will prescribe on the same day, but in other areas users will have to join a drug dependency unit and be co-prescribed with a GP, this on average can take six to eight weeks which is just too long, typically when an addict asks for help, they are at ‘rock bottom’ and need it immediately.
In our class culture, if a user can afford it, a lot of private doctors will prescribe morphine, diamorphine or benzodiazepines with no questions asked. How is this fair to the average addict?

I feel (along with many others) we are made to jump through so many hoops it almost isn’t worthwhile. Even if we do what is asked of us we are only going to get a drug which is more addictive than heroin, has more side effects, is a lot harder to detox from and in most cases doesn’t even alleviate 100% withdrawal symptoms and cravings!
I believe it is time the government looks at other options. Methadone and subutex do not work for the majority of addicts. There are plenty of other options out there and we need to stop looking at addiction with a ‘one size fits all’ attitude.
Addiction is obviously a very complex, difficult issue to treat, many of us have deep psychological issues, whether it be from childhood abuse, or pre-existing depression that we discovered was manageable through opiates.
It is proven that opiates alleviate depression. It’s time we were treated with dignity and respect, like any ‘normal’ patient would get.
Currently, your average heroin user is forced to buy on the streets from unscrupulous criminal gangs that will, as standard ‘cut’ heroin with all kinds of adulterants, putting users at risk from poisoning.

Not only would being treated properly with appropriate medication put a stop to health problems associated with injecting/smoking adulterated heroin, there would be a marked drop in drug related crime, prostitution, gang affiliated violence and profiteering.
I believe we need to re-asses the way we currently treat addicts, if users want to use methadone it should be made easier and faster to access, injectable ampoules should be made available to those who want it as needle fixation is a big part of many addicts’ problem.
Injectable diamorphine should be the standards treatment for addicts that inject and for smokers, in tablet form.
A clean supply of these drugs would massively reduce the problems classically associated with heroin addiction.
It would also mean users would be able to lead a relatively ‘normal’ life, get back into employment and attain some level of dignity as the daily routine of getting money, buying drugs would no longer be an issue!
I realise this is a highly controversial issue and will not change overnight but I believe we need to move out of the stone age when it comes to the treatment of addiction

Yours Sincerely

(Name/Or I guess it could be anonymous?)

Send one off yourself too!

Theresa May's email address (current person responsible for drugs policy/strategy) -

Dear Mr ********,

Thank you for your email of 6 December to Anne Milton about the prescribing of diamorphine to those dependent on drugs.  I have been asked to reply.

The Department is grateful for your email outlining your experiences of drug dependency and treatment.   
Although treatment is not a ‘one size fits all’ system, it is important to understand that high quality treatment is the most effective way to address drug dependency.  Having independently evaluated methadone and buprenorphine, the National Institute for Health and Clinical Excellence has recommended that substitute prescribing with either methadone or buprenorphine, delivered in tandem with psychosocial treatments (such as talking therapies), should be the frontline treatment for opioid dependency in the UK.  However, the Department shares your concern that in the past methadone may not have been used appropriately or to the full benefit of patients.  The Department wants to see treatment helping those who are dependent on drugs to full recovery, reducing the harmful effects that drugs have on both individuals and the wider society and enabling them to contribute productively to society.

On 8 December 2010 , the Department published a new Drugs Strategy, ‘Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life’.  This puts a greater emphasis on supporting those who are drug dependent to achieve recovery and on enabling local community providers to help those who are drug dependent to achieve better outcomes.

An electronic copy of the strategy can be found on the Home Office website at:

and by entering the title of the publication in the search bar and following the links.

You may also be interested to know that the National Treatment Agency for Substance Misuse has recently set up an expert group, chaired by Professor John Strang of the National Addiction Centre, to develop a clinical consensus and protocols for substitute prescribing.  This will focus practitioners and clients on abstinence and long-term recovery, and prevent unplanned drift into long-term maintenance.

Yours sincerely,

Edward Corbett
Customer Service Centre
Department of Health'


Gledwood said...

Wow, it's quite something that you even got a reply!

Would you post up the email you sent them, or did you post it up before? Whenever I look back in people's blogs I tend to get waylaid by all the interesting old stuff... if you ddi post up the letter, could you add the link to this post? I'd be most interested to read it.

For one thing I'm thinking of writing a letter of my own. I want to be forceful and uncompromising without being rude. I wanted to mention my "mental health phenomena" which I do think are pertinent re the "one size doesn't fit all" malarky to which they now (at long long last) pay lip service.

If we were being treated for anything else we'd have a full range of prescribing options. Why only methadone and bupe? Pathetic!

Nice one on geting it together to send that off. That's more than nearly any of the rest of us have done, so Congratulations.

PS Melody Lee is back. She is one of the best junkie bloggers out there

Gledwood said...

Trust them to give half a link:

I think this, from the plethora that emerged, is the full one...

Anonymous said...

a really excellent letter to the government.Every injecting heroin addict & the understanding few know that prescribing diamorphine would solve the crime & shame that addiction to heroin gives. I will send a copy of this letter to my MP too. Thankyou very much.

Sid said...

Thanks Anon... yes, please spread the word, post the link to the letter on forums or to people you know will be interested, I guess the problem is that junkies can't be bothered! Plus now the drought is getting better people are spending more time using and not online on places like BlueLight etc...

Theresa May is responsible for the 2011 drugs strategy so shes a good one to send it too, as well as your local MP. We need a hell of a lot more support to even make them think about it, but I guess out of 300,000 estimated heroin addicts I'd be lucky to get 100 to send the bloody letter off.... sad eh..

Heres the petition link too to post wherever you want!

Cheers, Sids

Anonymous said...

An excellent letter you wrote, but I am afraid the government reply is yet more of the weasel words we can expect from this shower of useless turds who claim to be our representatives.

Examine closely the language they use, in the context of what we already know about the Condem coalition:

Firstly they never once mention diamorphine - even though it is briefly mentioned in the drug's strategy.

Then they tell us that NICE have said that methadone & subutex + "talking bullshit" should be the frontline therapies for addiction.

The following sentence says that "The Department shares your concern that in the past methadone may not have been used appropriately or to the full benefit of patients."

But our concern Theresa-fucking-May is that METHADONE DOESN"T WORK AND WE HATE YOUR RANK GREEN GLOOP. Her concern is not that we aren't being offered effective medications, but, as we all know, that far TOO MUCH METHADONE is being prescribed, which is a whole other issue, and not what we came here to discuss.

Then they finish off by telling you that their puppet consultant John Strang, is coordinating a new set of guidelines on how to prescribe EVEN LESS methadone while making it look like they care.

In other words, a serious inquiry into why diamorphine prescribing, which has been shown over and again to be the most effective intervention for chaotic heroin addiction, is not being expanded, has been turned into a statement on how much this government hates all forms of maintenance prescribing, and can't wait to do away with it.

If I were you I would write back, and demand specific information on diamorphine, like you asked in the first place, cos this reply is a typical Tory con-job mate.

timtrash said...

i've just recently sent a letter to my local m.p. asking why it should be that there are those in this country under the care of certain home office liscenced consultants that are getting diamophine scripts whilst i cannot recieve it. to my knowledge there are no dr's in my area (i moved out of london and to my home county of herefordshire) that hold one of these liscences. the dr i do have is really for diamorphine prescribing but obviously his hands are tied. i did get a reply from the m.p. saying he's about to write to the head of the local primary care trust and the bods at the home office. i doubt doing any of this will get me anywhere but i felt ishould atleast try, have my say as it were. i know he'll get replies quoting the governments new drug stategy which is an absolute joke! but i'm not going to let it go that easly!

Sid said...

Well the more letters that are sent, and the more pressure put on the better.. there was a piece on the news last night about the RIOTT trials in Kings College London, they reported 6% of people on diamorph got clean. the same as the people on methadone.. then they wheeled out Ann bloody Widdicoombe saying why should we give junkies a free hit on the state.. and this was the bloody BBC!

Anonymous said...

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Anonymous said...

Why should the taxpayer front your laziness to put some effort into your recovery. The sooner you're all on over 12mb of subutex the better.

Sid said...

Because for a lot of people that have tried everything else diamorphine maintenance is a good treatment. It has been proven over and over to reduce drug related crime, illicit drug use on the side, giving people a chance to become productive members of society because they no longer have to worry about finding heroin, it's clean, cheap and highly effective.

In zurich, new addict numbers have been cut hugely, drug use on the streets has all but dissapeared.

I have been on subutex, up to 16mg at the highest, it didnt work for me as maintenance but i used it very succesfully to taper and get clean.

Just because it works for you does not mean it will for everyone. Your attitutude is the reason were in this mess, addiction treatment is not a 'one size fits all' issue.

Besides, as Iv'e already said, im more than happy to apy for my prescription.

I would'nt expect 'the tax payer' to foot the bill, I've worked my whole life and paid my way.

For us functioning addict's a diamorphine prescription would be lifechanging.

Anonymous said...

Not just DM though,I'm not bothered about shooting up now,give me some MSTs and I could be an efficient,functioning human being.I've had to start on the 'green gloop' and it is horrible,both mentally and phsyically.I now feel trapped on the stuff,don't think I've got another detox in me to get off,they talk about the half life of it,what about the half life it puts you in?

Sid said...

Well I guess I'm one of the lucky one with an MST script, although it really isn't all that for maintenance if I'm really honest. Wears off quick and the 600mg daily i get really barely holds me. I'm doing another ibogaine detox in a month to get off the stuff altogether. I have to make it work this time I'm so sick of it all!

Anonymous said...

Well I have to be quite FRANK with regards to the current policy. 20 years Ive been a heroin user/addict and I have had to to trade away my dignity, self respect and morals all for a drug which if prescribed would cost me no more than the typical smoker. Yes I have burgled, mugged, shoplifted, stole I.Ds, Dealt, been to prison and all the usual for a life long addict like myself and here I am without doubt a Criminal. Strange thing though, I have never stole for anything other than fear and desperation of withdrawel, yes in that state with no stash I am a danger to anyone, frail or strong with a wallet or purse on their person. Fact is once I had a few grand left to me through a death of a relative. I DID NOT COMMIT A SINGLE CRIME THE WHOLE TIME I HAD MONEY !! I mean why would I as I had my stash and cash for more, the people Ive hurt, the things I have done, more a bi- product ofcurrent drug policy than of my criminality, so Mr Government would you rather this madness go on with no telling who gets hurt or robbed next, maybe it will be your aunti, cousin, sister, lover, dad, mom, daughter, son, and sure Il get caught and do my jail time where by the way the cycle of robbing and using will just continue. The obvious answer would be to prescribe, yes that "First do no harm" oath does have some perspective in view of people in my predicament. Prescribe diamorphine so I can just get on with my life please, or if not then all I can I guess I will be bumbing in to you or someone you know soon, see ya !!

Anonymous said...

Yeah this is a good post cause I was on subutex (8mg) for 6 months but got sick of the morning sneeze fits so decided to go cold turkey one day, which, was a bad move. I then after six weeks of sleepless nights decided to buy street heroin and smoke it for a week or so and then stopped and after that I didn't suffer at all. I know for a fact that diamorphine is easier to wean than any substitute.

Blake Fielder said...

I've only just come across your fascinating blog, I admire your tenacity and draw inspiration from it. I've researched a little about prescribing diamorphine as a ten year plus user of methadone and unfortunately in tandem pretty much, heroin and crack. What I found interesting is actually reading John Strang's report which I found through a kings college link where he works or at least was in 2010. He seems to actively encourage the prescribing of diamorphine! Thought it interesting in light of the rather tepid reply that didn't allude to his findings nor that they reiterate your comments in the well constructed letter.

Helen said...

That's a great letter, I sent a copy to my MP. I would expect a reply; that is their job. I don't think Theresa May actually addressed the issue really; she didn't give any reasons why the government don't encourage diamorphine treatment.
I'll post you the reply :-)

Helen said...

Ps. I was on methadone for 3 years and i felt like it was impossible to stop using. Then I changed to 14mg Subutex and since then I've felt so much better. I don't get cravings like I used to; it's like a switch has gone off in my brain and suddenly I feel different about heroin. I wish I'd gone on Subutex to start off with instead of methadone, but maybe there was a subconscious part of me that wasn't really ready to stop using. However, I'm aware Subutex doesn't work for a lot of people and I think everyone should get the opportunity for treatment that works for them - methadone doesn't seem to work for hardly anyone! All it did for me was helped me to be well enough to get out and make money. Not that positive.
Thanks for a thought provoking post; I'll send you whatever response I get.