Diamorphine assisted treatment in Middlesbrough: a UK drug treatment case study

Introduction: Diamorphine Assisted Treatment (DAT) is a treatment offer for individuals with Opioid Dependency (OD), who have failed to benefit from standard treatment model (Opioid Substitution Therapy [OST]). In the Middlesbrough DAT service, self-administered injectable synthetic heroin (diacetylmorphine) is offered to participants, twice daily under the supervision of medical staff in a controlled and safe environment. This case report evidences outcomes from the first operational DAT service in England outside of a research trial. Method: Descriptive quantitative data from participants who engaged within the first year of operation of DAT (n=14) is presented detailing engagement, harm reduction, and psychosocial outcomes, and criminality of the cohort. Results: The DAT service was associated with high engagement, a large reduction in positive toxicology screens for street heroin, reduced homelessness, increased engagement with psychosocial interventions and a substantial reduction of criminal offences. Poly-drug use (specifically the consumption of street tablets) impacted treatment engagement for a proportion of the sample. Conclusions: We present this work as an example of bottom-up policy making within the context of UK drug treatment and implications for practice discussed