Abstract
Recent UK guidelines support the prescription of injectable heroin and methadone for opiate dependence, but many doctors disagree. Heroin has been prescribed in England for almost a hundred years, and the “British system” was once the subject of international curiosity. Since 1965, a prescriber licensing system has led to a great reduction in the proportion of opiate addicts treated with heroin. Recent trials in Switzerland and the Netherlands have prompted a review of British practice. It will probably remain somewhat different from continental practice, particularly with respect to long-term supervised injecting, but without adequate funding it may disappear altogether.