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The Department of Health said diamorphine supplies could run out within weeks. The drug, the medical version of heroin, is one of the most powerful painkillers known and is used in the palliative care of cancer patients.
The department urged the NHS to conserve supplies but said patients could suffer.
No figures are available for how much is in stock, but monthly usage is about 640,000 ampoules of varying strengths. Large stocks are not held, so the department knows from experience that it can quickly run out.
Professor Mike Richards, National Cancer Director, said: “We have taken immediate action and are working hard to make sure that this potential shortfall does not, as far as possible, affect the care and quality of life of patients.
“Patients should be reassured that we will do all we can to minimise the effect this disruption to supply may have.”
The department said that the drug company Chiron had told it on December 16 that there would be problems providing diamorphine and that supplies were unlikely to improve before March.
Chiron is already in difficulties because of the closure of its flu vaccine plant on Merseyside, which has disrupted supplies of the vaccine here and in the US. The plant is also used to produce diamorphine, so the assumption is that the forced closure of the plant after contamination of flu vaccine may have also affected production of the pain-killing drug.
No spokesman for Chiron either in Britain or at its US headquarters was available for comment last night.
All NHS supplies of diamorphine come from Chiron or Wockhardt UK. Wockhardt has told the department that it should be able to supply more at the end of January, in some strengths, but the department said in a message sent throughout the NHS yesterday that “stocks may rapidly reach a critical level in the next few weeks”. The message urged doctors to conserve stocks for the use of patients in the greatest need, use alternatives where possible, avoid waste, and not attempt to over-order as this would make matters worse.
Diamorphine is used to control pain after heart attacks, in cancer patients, after operations, in intensive care units, in patients with some chronic diseases such as sickle cell anaemia, and in accident and emergency departments. It is also used in maintenance doses for some heroin addicts.
Professor Richards said that alternative drugs were being sought. “We are in contact with other companies to source extra supplies of morphine and other similar drugs,” he said. “We are also assessing what stocks of these alternative medicines are already within the NHS to ensure that sufficient supplies of these alternatives are available.”
But the Conservative Party reacted sharply. Simon Burns, health spokesman, said: “Many cancer patients will suffer needless pain due to the disorganisation of this shambolic Government. Blair’s Government must bear the responsibility if any patient has to suffer additional pain because of the shortage. This is a fiasco that the Government could have prevented.”
Andrew Lansley, the Shadow Health Secretary, said: “We are disturbed to learn that there is no explanation about the shortfall of supply.”
Cancer Research UK said it understood that cancer patients would have priority for available supplies. If so, it is other categories of patient who could suffer.
The Department of Health said that alternatives to diamorphine were available, and that some countries do not use the drug at all. For accident and heart attack victims, the guidance suggests that morphine may be used, and in acute injuries Entonox, an inhaled anaesthetic, may also be useful.
The department said that patients who are concerned should discuss options with their doctor or phone NHS Direct on 0845 4647.
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