'I GET MY HEROIN ON THE NHS'

Get caught with heroin and you face seven years in prison. But not Erin
O'Mara, one of 440 addicts in the UK to get a regular fix from an NHS
prescription - an arrangement she says has turned her life around.

Erin O'Mara is a bright, bubbly magazine editor - hardly the stereotype of
someone who injects heroin four times a day.

But her habit, now in its 20th year, does not line the pockets of a drug
dealer. The 34-year-old gets her fix from her local chemist in west London.
This "perfect prescription", as she calls it, began two years ago and
rescued her from a life of prostitution, drug dealing and serious illness.

The downward spiral began with Erin's first taste of heroin aged 15 while
in her native Australia, and has included 10 unsuccessful methadone
programmes along the way.

To finance her habit, she began working as a masseuse, which led to escort
work and then street prostitution. That stopped when she discovered she was
HIV positive.

But the prescription has transformed her life. As founder of Black Poppy, a
magazine by and for drug users, she addresses drug conferences and is being
consulted about pilot projects.

Sitting in her office, she says: "My prescription has meant I have money
now, and choices I can make in my life - simple things like what I want for
dinner. I can do things I haven't done for years and can think five years
ahead. Before I was just thinking about my next 'hit'."

Each shot supplied by her chemist is just enough to enable Erin to function
properly and prevent the onset of withdrawal. She only feels the buzz if
she relaxes.

The NHS allows only licensed doctors to prescribe diamorphine, the medical
name for heroin, to addicts if they have failed to respond to methadone
treatment. At present just 0.5% of those in treatment are prescribed
heroin, but new pilot projects are expected to increase that number.

Supporters of this policy, such as the independent research group
DrugScope, say controlled distribution by the state can drastically reduce
crime.

They also argue that clean heroin like diamorphine is not in itself
dangerous, just incredibly addictive. And a pharmaceutical prescription
excludes all the risks associated with unsafe injecting and enables the
user to gradually be weaned off the drug.

Topped up doses

Erin believes this approach can save lives. But prescribing heroin is not
always the answer, as she herself knows from the first programme she took
part in in 1998.

"The whole set-up was really oppressive and heavy-handed, but the doses
were too low so people were using other drugs and too scared to admit it.
No-one was happy and no-one was doing well on it. The carrot and stick
approach doesn't work because you can't punish users enough to make them stop".

One patient, a 45-year-old woman, threw herself off a tower block two days
after being penalised by having her prescription withdrawn, Erin says.

And with strict attendance requirements and supervised injections, it
prevented users from getting full-time employment.

Erin claims she was forced off the course after 18 months when she tried to
start a support group. She then founded Black Poppy to give a voice to drug
users, and address issues missed by treatment programmes.

After leaving the prescription programme, Erin was put on methadone
injections, which she topped up with crack. This period was one of her
lowest and her veins began to collapse.

When she heard about a vacancy on a pioneering prescription course at the
Maudsley Hospital in south London, she cornered the doctor in charge at a
drugs conference.

"I remember my sense of complete and total desperation. I felt I could not
go on any longer, that if they didn't help me, I didn't know where I would
be. I felt that this was my last hope, that I'd tried everything. And I
begged."

Her powers of persuasion paid off and she joined what turned out to be a
more flexible programme. She was able, for instance, to spend a few months
at her mother's in Colchester and pick up her prescription from a local
chemist, so long as she visited the doctor every fortnight.

Her immune system strengthened, and two years on she is on a reduced dosage
and aims to come off heroin completely.

As she looks to the future, there is a trace of anger about the years spent
on and off treatment programmes.

"Why did I have to wait until I'd finished selling my young body to men,
until I'd got sick and deeply depressed, until I'd used every vein in my
body from my neck to my feet, until I'd contracted both HIV and Hep C?"

But she is optimistic that the government has begun to move in the right
direction and listen to what drug users want.

ERIN'S DAILY PRESCRIPTION

4 x 100mg diamorphine (solid)

4 x sterilised water

4 x sterilised needles

4 x swabs

pharmaceutically prepared advice leaflet enclosed

HEROIN & THE NHS

Prescriptions peaked in 1960s The UK is one of the few countries to allow it

Any doctor can prescribe it for medical conditions, but need Home Office
licence to treat addiction

Home Office says every UKP1 spent on drug treatment saves UKP3 in less crime

Source: Drugscope

HEROIN IN THE UK

200,000 heroin users

88,000 in treatment , of which 40,000 on methadone

Heroin is an opiate which depresses the nervous system

It can combat physical and emotional pain

Users can feel warm, relaxed and detached

Purity of street heroin varies, with a risk of fatal overdosing

Unsafe injecting means risk of HIV, hepatitis, abscesses and ulcers

Source: DrugScope, NTA