GPs TO PRESCRIBE HEROIN FOR HARD-CORE USERS

Guidelines to encourage specialist doctors to prescribe injectable
heroin for the most hard-core problem drug users are to be issued
shortly, the home secretary, David Blunkett, confirmed yesterday. The
guidance will be quickly followed by pilot schemes under which doctors
will prescribe heroin according to clinical need in an attempt to help
hard-core users manage their addiction and curb their criminal behaviour.

Mr Blunkett's announcement, at a conference of GPs in Sheffield, is to
be followed next week by the launch of an "innovative" Home Office
advertising campaign aimed at children and parents to drive home the
risks of class A drugs including heroin and cocaine.

The information campaign in England and Wales follows "Know the
Score", launched last year in Scotland, and rejects a "just say no"
message after research showing that such authoritarian campaigns were
not working.

The new campaign is expected to focus on providing reliable, credible
and non-judgmental information which encourages young people and their
parents to seek further advice and help.

Mr Blunkett emphasised yesterday that the main emphasis of the
government's drug policy is now to focus on the "scourge" of class A
drugs and hardened drug takers.

"We need radical thinking about how we engage them in treatment.
Prescribing heroin is all about what is right for the individual. It
is about making it available to all those with a clinical need."

He said prescribing heroin was right for only a small number of
people. The number involved would not dramatically increase beyond the
440 patients currently prescribed heroin.

The majority of addicts will still be treated with
methadone.

The home secretary added that it was important to ensure that addicts
were not able to sell on the heroin they were prescribed as happened
30 years ago when the first experiments were tried.

But the reluctance of most doctors to be involved in treating heroin
addicts was spelled out to Mr Blunkett when one Bedfordshire GP told
him that some doctors feared that police action would follow if one of
their patients died as a result.

The Royal College of General Practitioners said it remained concerned
about the decision: "We caution against any expansion in the
prescribing of heroin in a primary care setting until there is clearer
evidence around its efficacy."

The college's Claire Gerada said heroin was an expensive and dangerous
drug which was rapidly fatal in overdose for a naive user or a user
who had lost his or her tolerance. She warned that once a patient was
placed on prescribed heroin it was likely to be for life.

But Roger Howard of Drugscope said he was cautiously optimistic that
sufficient doctors would become involved in treating such hardcore
drug addicts.

He said the reluctance would remain while there was uncertainty in the
new GPs' contract over the payments for specialist drug treatment.