Dr Peter Carter, of the Royal College of Nursing, has spoken approvingly of heroin prescribing on the NHS. This sounds shocking, perhaps. All I can do is gently point out that every trial ever done on diamorphine prescribing has shown it to work well in restoring previously hopeless addicts to being effective members of society. Their health improves dramatically. They give up crime. They get jobs.
Besides, many opioid addicts can’t stand methadone, the current preferred treatment. It rots teeth and can be generally burdensome. If you give addicts free heroin you remove at a stroke their principle motive for committing theft or going into prostitution.
It has shown excellent outcomes in trials in Europe and recently in Canada , though the Americans are adamantly opposed to heroin and will not even use it in medicine. Very often what happens in practice is that addicts get bored of prescribed medication and give up altogether on a prescription.
So maybe we should think the unthinkable. At the very least policy must be grounded in evidence, not in prejudice. Substitute prescribing is accepted in tobacco addiction. Why not heroin?
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