SUICIDES, OVERDOSES LINKED TO DETOX DRUG

A CONFIDENTIAL briefing paper on national trials of the heroin
detoxification drug naltrexone has revealed alarming rates of overdose and
suicide among those receiving treatment.

The paper, prepared for Queensland Health Minister Wendy Edmond by senior
health bureaucrat Dr Alun Richards, contains details of a draft report on
the trials.

Queensland participated in the trials of oral naltrexone treatment and
submitted results to the National Drug and Alcohol Research Centre, which
will officially release its findings next month.

Details of the research came yesterday as the Medical Board continued its
investigation into Brisbane doctor Stuart Reece's use of controversial
naltrexone implants.

Premier Peter Beattie issued a veiled attack on federal health authorities
for not probing the unauthorised use of implants before his Government
initiated the Medical Board investigation.

Mr Beattie, who conceded he had not been fully briefed on the
investigation, said there were "difficulties" in the relationship between
state and federal health authorities.

But he said the implants were only approved for trial purposes in Perth,
and had federal health authorities prevented the implants being used in
Queensland the investigation "would never have happened."

"I understand there are emotional issues involved and I understand the role
of the Medical Board," Mr Beattie said.

"But if the Medical Board wasn't moving to protect lives, then everyone . .
. would be belting the Government, and quite rightly."

A Therapeutic Goods Administration spokeswoman yesterday refused to detail
any investigation into the implants, whether importation would be
restricted or whether an application had been made to allow their use in
Australia.

Board president Dr Lloyd Toft said yesterday it was hoped the investigation
into Dr Reece would be completed within two months.

While Dr Reece has been banned from using naltrexone implants, he may still
prescribe oral naltrexone, which has been evaluated in the trials.

The confidential briefing paper shows the trials found naltrexone
detoxification was widely associated with a higher death rate than other
methods of treatment.

However, it did concede that naltrexone showed good results when patients
continued taking the drug, with Dr Richards stating: "Where patients have
died after using naltrexone it is usually because they have stopped taking
the drug and have reverted to using heroin."

The paper stated that national trial results showed naltrexone treatment
was associated with a heroin overdose rate (both fatal and non-fatal) of
46.3 per 1000, against a rate of 2.2 non-fatal overdoses per 1000 for
methadone. Four out of 454 patients on naltrexone died during the study.

It also found the highest rate of "suicide-related events" (6.6 per 1000
patients) with naltrexone.