HEROIN TREATMENT OFFERS RELIEF, STUDY FINDS

A new drug to treat heroin users was dramatically more effective in
home detoxification than the current standard treatment, a major
government-funded Australian study has found.

The drug, buprenorphine, could also be used after detoxification as an
alternative to methadone for ongoing treatment - with the advantages
of lower overdose risks and less frequent doses.

Buprenorphine was recently approved in Australia but stocks were not
yet available, said the study's principal researcher, Nick Lintzeris,
of Turning Point Alcohol and Drug Centre.

He said the trial of 114 addicts undergoing an eight-day home
detoxification found those randomly allocated to buprenorphine rather
than the standard cocktail of tranquilisers and symptom relief drugs:

Were dramatically more likely to complete detoxification; 86 per cent
of the drug group finished compared to 57 per cent of the standard
treatment patients.

Rated their cravings as lower, were less unwell and functioned better
during detoxification.

Were almost six times more likely to make it through the
detoxification without using any heroin at all.

Were 1.5 times more likely to still be in some form of treatment a
month after detoxification ended and, consequently, were using heroin
less on average.

Although the study was random, it was not double-blind; both
researchers and participants knew who was taking which medication.

Dr Lintzeris is scheduled to release the full findings of the study at
the Australian Professional Society on Alcohol and Drugs Annual
Conference next week.

Detoxification was popular with users but was well recognised to be
less effective than ongoing maintenance treatment at keeping people
off heroin, he said.

The main value of buprenorphine in the study was that patients were
more likely to still be on some form of treatment a month later than
with the other drugs, he said. "I would be predicting within a decade
a lot of these other medications will stop being the be-all and
end-all (in detoxification)," Dr Linzeris said yesterday.

"I would probably expect buprenorphine becomes one of the main
medications used for detox."

However, he warned it was not a cure-all and would need subsidy to be
affordable.

As a maintenance treatment drug, "bup" was interesting in that, after
a certain point, taking more of the drug did not produce a more
intense effect but instead made the existing effect last longer, he
said. This "ceiling effect" meant it could be taken every second day
instead of daily like methadone. As a result some rural patients would
have to travel less and it made it easier for patients to work.

However, a general practitioner who treats addicts, Andrew Byrne, in
Sydney, said he would not use the new drug as a first-line maintenance
treatment because methadone had a longer safety record.

Buprenorphine would be useful for patients who could not or would not
use methadone, Dr Byrne said.

"It's a wonderful alternative," he said.

The study also found that - regardless of detoxification method -
those who were still in some form of treatment a month later reported
using heroin on fewer days and in smaller quantities.

Another study, published this month in The New England Journal of
Medicine, gave addicts methadone, buprenorphine and another drug,
levomethadyl acetate (LAM). It found that all three, in sufficient
doses, were comparable in reducing illicit drug use when used for
ongoing maintenance treatment.