HC Deb 14 October 2002 vol 390 cc524-6W
Mr. Stinchcombe

To ask the Secretary of State for Health what(a) studies and (b) pilots have been undertaken since 1972 into the impact on (i) crime levels and (ii) health indicators of prescribing heroin. [66662]

Ms Blears

There is very limited United Kingdom research in the area of heroin prescribing. Given the current use of injectable methadone in the UK and also a smaller number of opiate addicted individuals currently receiving injectable heroin, potentially there are difficulties in recruitment to suitably sized and rigorous research studies. Those studies that have been reported from the UK since 1972 do not give definitive results as to the effect of heroin treatment on health and crime but indicate potential benefits and risks.

Hartnoll et al (1980) reported a London study carried out in the early 1970's comprising injectable heroin and oral methadone treatment in patients assessed as dependent on heroin. There were no differences between the two groups in health outcomes at 12 months and no consistent differences in levels of crime identified though there were methodological problems in comparing the two groups appropriately.

McCusker et al (1996) reported the introduction of heroin prescribing to one of three English community drug teams but no conclusions could be drawn about the impact of the heroin treatment and outcomes due to the methodology used.

Battersby et al (1992) in a descriptive study of injectable opiates are reported to have shown reductions in illicit drug use and criminality with little improvementshown in health, also raising some concerns about continued unsafe injecting practice.

Metrebian et al (1998) studied the use of either injectable heroin or injectable methadone for those doing badly on oral methadone. This suggested that the use of injectable methadone could be a viable alternative to injectable heroin in some and that the use of injectable opiate treatment in those who had failed oral treatments could lead to improvement in those who remained in treatment, in health and levels of criminal activity. They concluded that injectable heroin is not necessarily the drug of choice given the availability of injectable methadone.

The more recently reported Swiss and Dutch studies are not directly applicable to the UK context, the Swiss study being in effect a feasibility study. However, both have produced results indicating the possibility of benefits for health and crime, for a minority of patients who are carefully selected long term opiate addicts who have failed in other treatments including oral methadone treatment.

No pilots have been identified that contribute to assessing the impact of injectable heroin on health and crime.