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The Guild of Healthcare Pharmacists (GHP) has told The Pharmaceutical Journal that diamorphine stock should be “ring-fenced” for obstetrics, gynaecology and clinical theatres amid ongoing supply issues.
Alerts sent by the Scottish government on 6 January 2026 and Community Pharmacy England on 23 December 2025 said that diamorphine 5mg and 10mg powder for solution in injection ampoules were out of stock, and that the 100mg powder was expected to run out in January 2026.
However, in a statement to The Pharmaceutical Journal, the GHP said that “there are key areas where diamorphine will continue to be required”, despite the drug being subject to periodic supply issues over many years.
“Strong consideration should be given to ring-fencing stock for use in obstetrics and gynaecology, as well as theatres, due to specific clinical requirements for using diamorphine. Other areas should be encouraged to switch to morphine where suitable to preserve stock.”
“Medicines shortages are a constant pan-hospital issue. The GHP recognises the hard work that pharmacy teams do on a daily basis to mitigate the impact of medicines shortages on patient care,” it added.
The medicine supply alerts asked healthcare professionals who prescribe, administer or dispense diamorphine hydrochloride to make a permanent switch to morphine sulphate 10mg/1mL injections where possible, as there is no confirmed date for diamorphine resupply.
The switch should be “expedited as a permanent change in practice given the continuing unpredictable supply of diamorphine”, the alerts said.
“Morphine and diamorphine are not equipotent, and care should be taken when switching patients or amending guidelines to ensure equipotent dosage.”
Diamorphine hydrochloride, an opioid used to manage severe pain, first faced supply problems in February 2020, when the Department of Health and Social Care (DHSC) announced that the two manufacturers of 5mg and 10mg strengths — Accord and Wockhardt — were out of stock.
In the latest alerts, teams were asked to ensure new patients are not started on diamorphine unless they cannot use other opioids and to reserve the remaining stock of diamorphine ampoules for patients who are unsuitable for morphine sulphate injections.
Hospital teams were asked to centralise any diamorphine in the hospital pharmacy, reserving the remaining stock for use in patients who cannot be treated with morphine.
“Patients in drug addiction treatment programmes may experience difficulties switching to alternatives and the community drug and alcohol team should be contacted for advice,” the alerts said.
During a previous diamorphine shortage in 2022, UK drug and drug law charity Release warned that some patients who used the medicine as a heroin substitute were relapsing, owing to a lack of suitable alternatives.
