Pubdate: Mon, 05 Jul 1999 Source: Illawarra Mercury (Australia) Copyright: Illawarra Newspapers Contact: http://mercury.illnews.com.au/ HEROIN USERS RELAPSE DESPITE NALTREXONE Rapid detoxification of heroin addicts may not be as effective a treatment as first thought, with many addicts relapsing into drug use, the Australian Medical Association said yesterday. Accelerated detoxification, using the drug naltrexone, has been promoted as a "cure" for heroin addiction since 1997. Naltrexone blocks the effects of heroin withdrawal that occurs about eight to 12 hours after the last heroin use, with the patient under general or light sedation. But a study published yesterday in the latest edition of the Medical Journal of Australia (MJA) found many patients started using heroin again and the retention rate on maintenance programs was low. The study was conducted by Dr James Bell and researchers at the National Drug and Alcohol Research Centre's Langton centre in Sydney and the National Centre for Epidemiology and Population Health in Canberra. The researchers examined the success rate of naltrexone-accelerated withdrawal under light sedation for 15 heroin users and for a similar number seeking withdrawal from methadone at a hospital in Sydney. But three months after treatment, 18 patients had returned to heroin use or methadone maintenance and one had died from a heroin overdose. The researchers said most studies of naltrexone maintenance had shown high drop-out rates and high relapse rates into heroin use. Professor Wayne Hall of the National Drug and Alcohol Research Centre at NSW University and Dr Alex Wodak of the alcohol and drug service at St Vincent's Hospital, said the media's enthusiasm for naltrexone-accelerated heroin withdrawal had not been shared by many addiction specialists. "No evidence has yet been presented to challenge the assumption that naltrexone, however packaged, is at best modestly effective and at worst unsafe, in management of unselected cases of opioid dependence," they said in the MJA. - --- MAP posted-by: Jo-D