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Choice and conflict about heroin-prescribing in the clinics of the 1970’s
Martin Mitcheson
‘Heroin on trial’ conference, May 2018
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BACKGROUND TO CLINICS
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Sir Humphry Davy Rolleston,(President of Royal College of Physicians, 1922-1936)
Home Office Governmental Committee Report 1926
• The legitimacy and authority of the medical versus law enforcement perspective
• “maintenance” (not termed thus) with injectable morphine (or sometimes diamorphine(heroin) legitimate medical practice
• Sets UK apart from post-1920s US policy
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Sir Russell (subsequently Lord Brain) 1961
• Essentially no change to the small problem
But• Risk of illegal import if
demand not satisfied from legitimate sources
• First addict under age of 20 recorded in 1960
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Sir Russell (subsequently Lord Brain) 1964
• For the first time, seen as a growing problem amongst the young
• A ‘socially transmissable condition’
• Entirely based on prescribed or diverted pharmaceutical injectables(from small number of independent doctors)
• Recommends creation of a network of drug treatment centres (esp around London)
• Implemented 1967 – the new clinics take over all prescribing of heroin to addicts
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Quantity of heroin prescribed annually (London)
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Quantities of heroin and injectablemethadone prescribed annually (London)
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Quantities of heroin, injectable and oral methadone prescribed annually (London)
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notified addictsamount prescribedprice on the streetprice from dealer
Addicts, amount of prescribed heroin, street and dealer prices
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ADDITIONAL SLIDES
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