Pubdate: Fri, 02 Mar 2001
Source: West Australian (Australia)
Copyright: 2001 West Australian Newspapers Limited
Contact:  +61 8 94823830
Website: http://www.thewest.com.au
Author: Liz Tickner
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

EXPERTS BACK DRUG STUDY

ADDICTION experts, substance users and a welfare group have welcomed the 
release of a medical study which has raised concerns about the 
controversial anti-heroin treatment naltrexone.

The West Australian reported yesterday that a two-year study of 3617 Perth 
heroin addicts by psychiatrist James Fellows-Smith and GP James Edwards 
found that untreated addicts were less likely to die than those who dropped 
out of the naltrexone program.

Perth doctor George O'Neil runs a naltrexone clinic in Subiaco.

The study - which Dr Fellows-Smith has submitted for publication in a 
prominent medical journal but has made public beforehand in an effort to 
stop more preventable deaths - found that addicts on the streets had a one 
in 100 chance of dying.

Addicts prescribed naltrexone had a one in 61 chance of dying and those 
prescribed methadone had a mortality rate of one in 458. James Bell, 
director of the Langton Centre at Sydney's St Vincent's Hospital, warned 
against people being seduced by the short-term success that naltrexone offered.

Dr Bell said naltrexone patients faced real danger if they dropped off the 
program and started using heroin again because of their reduced tolerance 
to opiates.

Patients who took naltrexone orally had a low retention rate on the program 
and naltrexone implants were still at the experimental stage, he said.

On the other hand, most patients were able to function normally in the 
community when they took methadone to control their addiction.

WA Substance Users Association manager Tamara Speed said her agency had had 
concerns about naltrexone for a number of years and had produced 2000 
flyers alerting drug users to the risks of over-dosing after coming off 
naltrexone.

Ms Speed claimed that naltrexone patients were not being adequately told of 
the risks.

"Naltrexone has got a place along with other treatments and I don't want it 
to disappear but it needs to be better prescribed," she said.

Mission Australia regional manager Anne Russell-Brown said the study had 
brought back some reality to the debate about drug treatment and 
underscored the need for a broad approach to combat substance abuse, 
particularly among young users.

Ms Russell-Brown said a proposed drug summit needed to move beyond the 
current debate about naltrexone and safe injecting rooms and focus on the 
issue of prevention and family support.

"Government and community decision-makers need to understand that there is 
no one-stop solution to the issue of substance abuse," she said.
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