NALTREXONE NOT A MIRACLE CURE - EXPERT

CONTROVERSIAL heroin treatment naltrexone is not a wonder drug but it
does provide a useful treatment for some addicts, according to drug
experts.

Clinical psychologist Bill Saunders said it had become clear the
treatment needed to be used with great care because of its association
with increased deaths.

Yesterday, The West Australian reported a confidential report prepared
by the National Drug and Alcohol Research Centre revealed high
incidences of overdoses and suicide among heroin addicts who had been
prescribed naltrexone.

Professor Saunders said the results of the report were consistent with
other research by people such as psychiatrist James Fellows-Smith and as
a result evidence was mounting about the possible dangers of naltrexone.

"I think the data is such that it now has to be used extremely carefully
and with appropriate assessment," he said.

Subiaco drug doctor George O'Neil said he had pleaded for results of his
work with naltrexone to be included in the centre's report. But his
request was denied and as a result the report was not balanced, he said.

He said it was not fair to compare morbidity rates associated with
naltrexone to those of other heroin treatments such as methadone,
buprenorphine and new treatment levo-alpha-acetylmethadol.

"It is like comparing apples and oranges because naltrexone is about
moving to an opiate-free lifestyle where the others are about
maintenance of the addiction," he said. "You can offer people
maintenance programs, which keep them on opiates but allow them to stop
relying on heroin, or you can offer them (naltrexone) a chemical
protection which allows them to withdraw from opiate use."

University of WA drug researcher Gary Hulse said it was not known why
patients being treated with naltrexone were at increased risk of death.
More research was needed. "What we do know is that for the people who
stay on it, the risk of overdose is significantly reduced," he said.

There was no doubt naltrexone was an effective treatment but more
information was needed.

Curtin University drugs expert Ali Marsh said naltrexone was not a magic
bullet for heroin addiction but it was a good option for some people.

Dr Marsh said there had been a lot of uncontrolled use of naltrexone and
more trials were needed.

Health Minister Bob Kucera said he was aware of the report but had not
seen it. He said the report would be presented at the Ministerial
Council on Drugs Strategy at the end of next month.