ADDICTS INJECTING PRESCRIPTION DRUG

Addicts are shooting up the prescription sleeping capsule temazepam with
their heroin, causing overdoses, gangrenous limbs and collapsed veins,
doctors and pharmacists are saying.

The temazepam abuse has been exacerbated by a temporary national shortage
of heroin on the streets, artificially induced by dealers in a bid to
inflate its street price.

But in most cases heroin users are not substituting the drugs but instead
mixing the two for a more powerful hit, and are "doctor shopping" to obtain
temazepam capsule prescriptions.

Victorian public health officials are gathering evidence on the temazepam
problem to present to the federal Human Services Department's
pharmaceutical advisory committee.

A growing number of doctors and pharmacists are calling for the capsule
form of the sleeping pill to be banned or severely restricted, leaving only
the tablet form on the market.

Federal health experts, while not dismissing the concerns, have called for
more written evidence of the drug's abuse.

The chairman of the Royal Australian College of General Practitioners'
drugs and alcohol committee, Benny Monheit, said he was seeing an
increasing number of heroin users through the Alfred Hospital with
infections in their arms and legs because of temazepam injection.

A small percentage had been forced to have parts of limbs amputated because
of gangrene, he said.

Dr Monheit said the mix of heroin and temazepam increased the risk of
overdose. Veins were also more likely to collapse and clot because the
particles in the capsules were not small enough to effectively inject.

A locum pharmacist, Graham Sweet, said temazepam abuse by heroin users was
"accelerating at a fairly alarming rate". While some doctors were aware of
the problem, some were refusing to specify tablets rather than capsules on
the prescriptions, or were ignorant of the drug's abuse, he said.

Some drug users were intimidating doctors and pharmacists into supplying
them with the capsules, he said. "What really frightens me is some of the
people who take these prescription drugs, you see them as couples. There's
Mum, driving around in the car, chock full of benzodiazepines."

Temazepam, marketed as Normison and generic equivalents, is one of the
benzodiazepine class of drugs. Its sedative effect as a sleeping pill tends
to be short, lasting about three to four hours.

Simon Rose, who runs a heroin detoxification clinic in St Kilda, said he
was uncertain whether banning temazepam was the answer. He claimed addicts
would simply swap one drug for another.

The effect of temazepam in terms of amputations had been exaggerated, Mr
Rose said. But the chance of overdose certainly increased when heroin and
temazepam were combined.