Jane Ellison MP

Parliamentary Under- Secretary of State (Public Health)

Department of Health

Richmond House

79 Whitehall

London SW1A 2NS

Ref: ML.N0080.CM.30.01.14

Date: 30^th January 2014

Dear Jane,

During Business Questions earlier today, I put the following to the Leader of the House of Commons:

Naloxone reverses the effects of opiate overdose but it currently needs to be prescribed. The Advisory Council on the Misuse of Drugs has recommended that it be made more widely available to trained people such as hostel staff so that they can more effectively intervene in an overdose case. May we therefore have a debate, please, on the limitations created by the Medicines Act, which contains rules that are preventing this ground-breaking work from going further and more lives from being saved?

He kindly responded:

As the hon. Lady asks about the Medicines Act, I will ask my hon. Friends at the Department of Health about how that is applied in the circumstances she describes and whether anything can be done to help in the way she seeks.

The ground breaking work to which I was referring is that being undertaken in my constituency, and across Brighton and Hove, to roll out training to administer Naloxone. It’s already saving lives and is credited as one of the reasons that the drug related deaths figures in the city have declined over the last couple of years.

You’ll know that the Medicines Act 1968 establishes that no one except individuals with a prescription or medical health professionals can administer an injectable drug. 

Section 7 of this act does allow for a list of injectable drugs that can be given by anyone in an emergency with the purpose of saving someone’s life.  In 2005, naloxone was added to this list. 

This currently means that:

i.    naloxone is an injectable, and therefore prescription-only, medicine that may be used by anyone for the purpose of saving life in an emergency;

ii.    naloxone can be prescribed directly to a patient, or supplied via a Patient Group Direction (PGD) or Patient Specific Direction (PSD);

iii.    prescribers should only prescribe and supply naloxone to a known patient with a medical condition that requires the medication, and with the patient’s informed consent; and,

iv.    naloxone cannot currently be prescribed (or supplied using a PGD/PSD) to a carer, peer, or member of staff on behalf of a drug user, and cannot be given to anyone without the drug user’s informed consent.

These regulations are currently acting as an obstacle to wider use of naloxone by eg trained individuals in hostels and I’d like to urge the Department of Health to review its current prescription only status.

You’ll know that in Scotland the Take Home Naloxone programme has been very effective and was backed up by a letter of comfort from the Lord Advocate that granted immunity to any pharmacists/health professionals who wished to provide these services with a supply of the drug. This approach is not dissimilar to the way in which the first needle exchanges, for example, got off the ground and indicates that flexibility and a commitment to evidence led policy making can have a significant and positive impact on reducing drug related harms and deaths.

Would the Government consider supporting the principle of a letter of comfort for trained individuals for whom it would be beneficial to be able to administer naloxone to counter the immediate effects of an opiate overdose?

I’d welcome the opportunity to discuss this with you further and look forward to your response.

Yours sincerely,

Caroline Lucas MP, Brighton Pavilion