BMJ  2008;336:68-69 (12 January), doi:10.1136/bmj.39434.460694.AD

Feature

Substance misuse

More than a quick fix

¹ Utrecht

doi: 10.1136/bmj.39422.503241.ADdoi: 10.1136/bmj.39421.593692.94

Despiteits long use in the UK, prescribing heroin to misusers remains controversial. Tony Sheldon looks at the history and the evidence behind the increased prescribing in Europe

The first 150 words of the full text of this article appear below.

"The past is a foreign country: they do things differently there." The famous line from L P Hartley’s The Go-Between seems to sum up the medical prescribing of heroin to addicts. British medicine has a history of prescribing heroin, and the practice is now also largely accepted in Switzerland and the Netherlands. But use of the British system, as it was known abroad, in the United Kingdom has declined in favour of methadone maintenance—although not vanished completely.

It was 1926 when a government committee chaired by Humphry Rolleston, president of the Royal College of Physicians, advised it was legitimate medical practice to supply heroin to addicts for their maintenance. Only later was the practice restricted to doctors licensed by the Home Office. Past UK examples include the drug dependency clinic of London’s University College Hospital, which prescribed injectable heroin during the 1970s.¹ Later, a team led by psychiatrist John Marks . . . [Full text of this article]

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