Heroin prescribing in the “British System” of the mid 1990s: data from the 1995 national survey of community pharmacies in England and Wales

Abstract

Prescribing heroin in the treatment of addiction has been, until recently, an exclusively UK practice. However, despite international fascination with such prescribing, no recent report exists on the extent or nature of the practice. Furthermore, no data have ever previously been available on dispensing arrangements and geographical localization of heroin-prescribing to addicts. Data are presented on heroin prescriptions being dispensed to addicts in 1995, collected through the national survey of a 1 in 4 sample of the 10 616 community pharmacies in England and Wales. The 64 heroin prescriptions constituted only 1.7% of the 3846 prescriptions for opiates being issued to addicts by regarding community pharmacists, while methadone accounted for 96.0%. Heroin daily doses were more than three times higher than for methadone. Heroin was mainly prescribed in injectable form and, in contrast to methadone prescriptions, was mainly dispensed on a daily basis. Major regional variations in the extent of heroin-prescribing in the United Kingdom have been identified, with these variations appearing to relate to the practice of individual doctors rather than the nature of the local problem.