LIVING HOPE IN ST KILDA

Simon Rose has no doubt it's true. After all, the printed warning they
issue patients at his clinic, The First Step, in Carlisle Street, St Kilda,
spells out the danger in capital letters:

"THIS IS NOT A THEORETICAL SITUATION. PEOPLE DIE WHEN THEY CEASE NALTREXONE
AND USE HEROIN."

While he says the Perth study provides the evidence, he and others have
always known that Naltrexone has made the relapser more susceptible to an
overdose.

Yet Dr Rose knows of only two people who have died in these circumstances
after coming off his Naltrexone treatment.

Dr Rose believes he may have avoided some deaths through his precautions in
screening out addicts whom he sees have little prognosis of success.
Without carers, they cannot undergo the treatment, and he rejects about
10-15 per cent of addicts wanting the treatment.

His clinic is unreservedly about saving lives, not putting them in jeopardy.

More than half the 234 people he treated in the first five months remain
clean of heroin today.

Dr Rose's technique involves rapid, controlled flushing of the heroin from
the body in one day and its replacement by Naltrexone, which blocks any
craving for the drug or any high it might give.

The clinic's treatment is popular because it costs only $200, although the
Naltrexone pills are extra. Many addicts are now opting to get Dr Rose to
implant a slow-release dosage, giving protection for 280 days for about $1000.

Heroin addicts have flocked to the clinic over this summer, and the place
is an astonishing scene on a detox day, Tuesday or Friday. With their
carers, they throng the corridors of the old brick house, and many are
flopped on mattresses in an old extension out the back.

The clinic was set up mid-last year after road transport businessman Peter
White poured in almost $500,000 of his own money to buy the property in St
Kilda, right in the sex/drugs zone.

Modelled on George O'Neil's practice in Perth, it differs in being less
overtly Christian and much more non-judgmental, developing almost into a
therapeutic community of reformed addicts, a happy place where there is a
strong sense that people are reclaiming their lives.

For instance, Dr Rose's first patient, Becky Moore, works as a general
factotum in the clinic. She says one of the clinic's successful strategies
is having so-called "secondary carers", people organised by the clinic
outside the addict's immediate circle, keep in touch by telephone and
become a sounding board.

"You've got no self-esteem at all," she said. "You think the whole straight
world hates you, that they're scum and they think you're scum, and all of a
sudden, it renews your faith in humanity and your faith in yourself."