Pubdate: Tue, 05 Jun 2001
Source: Courier-Mail, The (Australia)
Copyright: 2001 News Limited
Contact:  http://www.thecouriermail.com.au/
Details: http://www.mapinc.org/media/98

NEED FOR QUICK TESTING OF IMPLANTS

THERE is no other description for it -- heroin addiction is a living hell, 
not just for addicts but for their loved ones. Everything changes from that 
chilling moment when parents realise their son or daughter has been 
ensnared by this most insidious of drugs.

Every dream they entertained of watching their children achieve their full 
potential is stolen.

All that is left is the despair of watching their young lives taken over by 
a poison that is hastening their destruction and leaves them easy prey to 
the despicable people who peddle in death.

Small wonder when a treatment becomes available that seems to present a 
"magic bullet" solution, some addicts and their parents cling to it with a 
ferocity born of desperation.

There is no denying naltrexone offers great hope in the treatment of 
addiction. By blocking the effects of heroin, it dramatically reduces the 
drug's appeal.

Why shoot up when no "hit" results?

The snag is heroin users, who still crave that hit, tend to be irregular in 
taking the naltrexone pills they require for their ongoing treatment -- 
hence the appeal of the naltrexone implants that were being manufactured in 
a Western Australian laboratory. In theory, the implants remove this 
element of choice by releasing regular doses of naltrexone into the 
bloodstream over a three to six-month period, holding at bay the addict's 
cravings. Lives, however, cannot be put at risk on no more than a plausible 
theory, which is all the implants are at present.

The devices have not yet been certified for use in human beings and there 
is a growing body of at least anecdotal evidence that as they approach 
their expiry date, the implants may not be releasing the amount of 
naltrexone required.

When the necessary dosage is released, lapsing addicts appear not to be at 
risk. But with an imprecise dose, the potential of a fatal overdose rises 
dramatically. As it is, being placed on naltrexone increases the risk of 
death two-fold compared with being an injecting junkie receiving no 
treatment, and makes a patient eight times more likely to die than an 
addict undergoing standard methadone treatment.

Under these circumstances, the decision of the Medical Board of Queensland 
to place a ban on Brisbane doctor Stuart Reece fitting his patients with 
these implants, while torturous, was the only reasonable one it could have 
made. Inevitably, this decision has caused an outcry from patients and 
their loved ones -- and the extent of their anguish can only be guessed at. 
When the primary alternative offered by the authorities is for users to 
substitute one addictive drug, heroin, for another, methadone, it is easy 
to understand the despair the ban has generated.

That said, however, The Courier-Mail recently has raised concerns about Dr 
Reece's treatment program, discovering at least 24 patients have died over 
the past three years, a rate that alarms senior clinicians. They are 
concerned, too, he is prescribing naltrexone to virtually all his 
heroin-using patients, yet studies have shown it is applicable to only 
about 10 per cent of addicts. The onus now is on the health authorities to 
expedite the testing of the implants and, in the meantime, to maintain a 
close watch on the health of patients, particularly those due to receive 
another implant.
- ---
MAP posted-by: Jay Bergstrom