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.