Pubdate: Sun, 17 Sep 2000
Source: Age, The (Australia)
Copyright: 2000 David Syme & Co Ltd
Contact:  250 Spencer Street, Melbourne, 3000, Australia
Website: http://www.theage.com.au/
Author: Peter Ellingsen

HEROIN TOLL TO HIT NEW HIGH

The war on heroin has stalled, now little more than a skirmish with fatal
overdoses on track to match or pass last year's total of about 370.

The high toll comes despite police claims that they have cleaned up drug
precincts, with drug deals taking a lower profile on many streets. Behind
the scenes, more people are overdosing: and they are younger. Access to
methadone, the most popular heroin treatment, is still limited.

The failure to reduce the death toll comes as the Victorian Government's
drugs adviser, Professor David Penington, has conceded that there will be no
supervised heroin injecting rooms, and that the heroin blocker, naltrexone,
has hit the streets of Melbourne disguised and sold as heroin.

Most of the deaths, now running at nearly 220, occur in Melbourne's central
city, a fact that has prompted the Melbourne City Council to consider a new
drugs strategy, including syringe vending machines and kits to test the
purity of heroin.

The controversial draft measures follow political inaction sparked by the
failure to agree on supervised injecting rooms. According to Professor
Penington, the Liberal Party's opposition to the rooms means they will not
go ahead. "Parliament will give up on injecting rooms because of the State
Opposition," he said.

He backs the thrust of the council's strategy, but worries that its plan for
a drug overdose treatment centre may not work.

"I support the plan for improved primary health care in the CBD," he said.
"But I don't know if I support talk of drug overdose treatment centres." The
council plan envisages a mobile "recovery service" to combat overdoses, and
vending machines for some of the more than 100,000 needles distributed in
the city each year. "There is also a need to consider strategies to increase
safer injecting by people who use drugs, and the feasibility of heroin
purity testing kits," it says.

Professor Penington and the drug agency Turning Point say the treatment of
addicts is being hampered by a shortage of GPs and pharmacists willing to
prescribe methadone.

About 7000 of the estimated 19,500 opiate-dependent users in Victoria are on
methadone.

"There is a shortage of doctors willing to be part of the program,"
Professor Penington says.

"We are trying to remedy this with training. I urge the government to
support this because it's vastly important. Every dollar spent on treatment
saves $7 spent on drug addict costs."

According to the Melbourne City Council's draft drug action plan, heroin is
now cheaper and more potent, a fact that may be contributing to the
spiralling rate of overdoses.

Users "dropping" and being treated before it is too late in Melbourne - the
so-called "non-fatal overdoses" - topped 400 in March. This was nearly 20
higher than for the same month last year.

Fatal overdoses - now at 219 - are slightly down on last year, but,
according to the Victorian Institute of Forensic Medicine, they will
probably match or pass last year's figures, once the tests required to
establish the cause of death are completed.

Professor Penington says police claims to have cleaned up the streets did
not tell the whole story.

"They believe if they clean up the streets there is no problem, but it is
not that simple," he says.

"Their actions have only displaced the activity to other areas."

Detective Superintendent Frank Byrne, who heads Operation Reform, disagrees.
He says that overdose deaths in Footscray have fallen since the crackdown
there.

"It is our part of harm minimisation," he said, recalling the $11 million
seizure of 11kilograms of heroin last month.

"We aim to reduce supply and cut down overdose deaths," he said.

"It has been very effective."

All sides concur that the heroin on the streets is more potent than it was
last year.

Head of emergency at StVincent's Hospital Andrew Dent, says naltrexone is
being substituted for heroin in a number of deals, almost certainly by
addicts given the drug to help them get off heroin. "It is very distressing
for those taking it," he says, "they suffer loss of bowel control, severe
pain all over the body, and vomiting."

The head of Turning Point, Professor Margaret Hamilton, who is on the
government's drug policy committee, denies that the drugs strategy is in
tatters. "I would say it is in transition," she says, although she
recognises the shortage of methadone providers among GPs.
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