By Glenda Cooper
Reporter, BBC World At One
Diamorphine - the clinical equivalent of heroin used to treat cancer sufferers and drug addicts - is still in limited supply more than two years after the government was warned there were serious shortages, a BBC investigation has found.
Many rely on diamorphine
While Ken Jones, the president of the Association of Chief Police Officers, has called for more of the drug to be prescribed on the NHS.
However, figures obtained under the Freedom of Information Act reveal that the amount being used in the NHS is a fraction of what it was before the current problems with supplies began.
In December 2004 there was a sudden drop in supply after production problems.
The Department of Health issued an alert, warning doctors to conserve the drug for those whose need was the greatest.
This included people like David Childs, a former mayor of Rushden, Northamptonshire, who died of asbestos-related cancer last May at the age of 57.
His family told the BBC World at One programme that when they asked for diamorphine for his pain, they were told there was none available.
"We were told there was no [diamorphine] in the hospital or even in the county," said his daughter Lorraine.
"We even offered to buy some if there was a private supply or somewhere we could source it but we were told that wasn't possible."
Cut in spending
At the beginning of the shortage in December 2004, £328,000 was spent on diamorphine in hospitals.
This dipped to £90,000 in September 2005, according to FOI figures.
There was a similar story for those prescribed diamorphine in the community where the figures dropped by about a third in June - September 2005.
Those affected in the community included 300 of the most difficult to treat heroin addicts like Julie, a 47-year-old receptionist from Cornwall.
She had stayed clean for more than a decade - until her prescription was stopped.
"My life was thrown back into chaos," she said.
"I had savings that I had managed to save over the past 12 years. Without any hesitation that was all spent [on drugs].
"My health deteriorated rapidly, my stability was diamorphine and when that was taken away everything else fell to pieces."
The precise issue of the shortage is complicated though.
The Department of Health said the latest figures show it is now spending almost as much on the drug as it did before the problems.
But the current NHS drugs tariff shows that the price of the drug has gone up from just under £6 for the minimum dose two years ago to just under £9 now - a rise of a half.
Campaigners say that means far less is being prescribed.
"I think there isn't the will at government level to exercise purchasing power over the pharmaceutical companies," said Sally Cook, the co-ordinator for Cornwall's drug users' group.
"I'm not sure that there is even the will in some government circles to treat addiction."
"If there is a national shortage of diamorphine then we should be looking at the alternatives," said Lorraine Childs.
"My father's greatest fear was of dying in a lot of pain. There is no reason for people to die in [that] sort of pain."
Kettering General Hospital, which treated her father, issued a statement which said: "We had supplies of the morphine doses he required and he received those."
But it went on: "On the national supply issues KGH has at times found supplies to be problematic in line with the NHS generally.
"So far we have maintained supplies for all patients who need them."
So will the national situation get any better?
The two companies, Chiron (now owned by Novartis) and Wockhardt UK, involved both say they will boost production by a significant amount this year.
The Department of Health also said it anticipates the situation will improve.
But it concedes two years on from its first alert, demand for the drug is still not being met.
The World at One is broadcast weekdays on BBC Radio 4.