NHS HEROIN 'WILL PROTECT WOMEN'

Earlier this week the first funeral took place of one of the five
young women killed in Ipswich while working as prostitutes.

The deaths of Ipswich prostitutes raised concerns over the link
between sex workers and drugs

All had been supposedly working on the streets to help finance an
addiction to heroin and crack cocaine.

Their deaths led to calls for heroin to be widely prescribed on the
NHS as a way of stopping drug addicts becoming prostitutes.

On a cold night in Ipswich's red light district, Janine is working.

She is selling herself in order to buy drugs, specifically heroin and
crack cocaine.

It's the same for all of the other prostitutes she knows. She says:
"I can't name one girl who doesn't have a drug habit who works the streets."

Society will have to think about whether they want this treatment to
be available and whether they are prepared to pay for it Dr Emily
Finch, Maudsley Hospital

Before the killings Janine was making almost UKP200 a night. All of
it would be spent on drugs "apart from a phone credit and a packet of fags".

The heroin also helps her to do the work as, "it just numbs your emotions".

Her friend and fellow heroin user, Paula, the mother of a young baby,
doesn't work as a prostitute but has watched many of her friends end
up on the streets.

"I have seen girls do things for crack (cocaine) they would never
dream of doing otherwise", she says.

'Daily dose'

Ten years ago Erin O'Mara, who lives in north west London, was in the
same position as Janine.

To finance her habit she began working in the sex industry, initially
as an escort. As her addiction developed she couldn't keep to any routine.

Many prostitutes work to get money to pay for drugs such as heroin

"When you have got a habit the drugs come first and if you don't have
them by the time you start your shift you can't do it. That's why a
lot of girls end up working on the street."

Erin no longer works as a prostitute but she does still take heroin.
After 20 years on the drug she has tried every kind of treatment. Now
she is part of a select group of drugs users who get their heroin on the NHS.

At a chemist near her flat there are several other addicts there
collecting methadone prescriptions.

Methadone is synthetic heroin substitute and is the tried and trusted
route for heroin addicts trying to kick the habit.

Erin is getting the real thing. The chemist is expecting her and
hands over a bag containing her daily dose of pharmaceutical heroin.
She has been doing this every few days, week in, week out, for the
last four years.

She says: "You've got a measured dose, you know exactly how much
you're taking and you can function perfectly well on it."

Her speech is a little slurred and she seems a little woozy but
getting heroin on the NHS has given her stability - she now has a job
and a flat.

"I felt like I was trapped on this treatment nightmare. Now that I
get my heroin prescribed, all that anxiety has gone."

Control

Erin is a special case. She is HIV positive and has had Hepatitis C
so it's vital she doesn't share needles.

Currently just over 1% of heroin users in the UK, around 400 people,
get their heroin in this way.

Each one costs the taxpayer around UKP10,000 a year.

In spite of this, some policy makers and police would like to see a
lot more people being prescribed heroin.

Tom Lloyd, the recently retired Chief Constable of Cambridgeshire
says heroin on the NHS could dramatically cut the cost of drug relate
crime and improve the lives of heroin users.

"If they were allowed to have heroin under controlled circumstances
then that chaos would be taken out of their lives, they could get
their lives sorted out."

'Huge improvements'

This is exactly what's currently happening in three areas in Britain
where trials are being conducted into prescribing heroin on the NHS.

Users don't get it at their local chemist like Erin, but have to go
to a centre to take the drug under strict supervision.

The trials have only been running for a year but Professor John
Strang, director of the National Addiction Centre, says the early
results are promising.

"Our strong clinical impression is we are seeing huge improvements
which we would not ordinarily have seen."

The stiffest opposition to wide scale heroin prescribing comes from
Professor Strang's own colleagues within the medical establishment.

Will suit 'a minority'

At his private GP practice in Felixstowe in Suffolk, Dr John McMurray
has been dispensing methadone to heroin users for many years.

He says giving heroin to patients, even heavily addicted users like
Erin O'Mara, could end up killing them.

"What you needed to feel perfectly OK yesterday if you use today
could be sufficient to kill you".

Even those campaigning for heroin on the NHS say it will only be
suitable for a minority of heroin users.

That could still mean up to 25,000 addicts being given free heroin.
The bill for the NHS would be around UKP375m.

Dr Emily Finch is a consultant psychiatrist in addiction at the
Maudsley Hospital, one of the sites conducting trials into heroin prescribing.

She says it won't be up to doctors to decide whether the scheme
should be rolled out: "Society will have to think about whether they
want this treatment to be available and whether they are prepared to
pay for it."

The Investigation: Heroin On The NHS will be broadcast on Radio 4 at
2000 GMT on Thursday 8 February.

You can also listen online for 7 days after that at Radio 4's Listen again page.