STUDY DEBUNKS HEROIN CURE DRUG

Anti-heroin wonder drug naltrexone usually fails to end addiction and
may increase the risk of overdose, the first serious Australian study
of the treatment has found.

The study, published in this month's Medical Journal of Australia and
accompanied by an editorial highly sceptical of the many claims made
for naltrexone, comes at a sensitive time for the drug and its
licensee, Orphan Australia.

The anti-craving drug is being fast-tracked in its bid for huge
subsidisation under the Pharmaceutical Benefits Scheme. A decision is
due by August 1.

In the survey of 30 people, most had returned to heroin or methadone
91 days after beginning naltrexone treatment. Three overdosed on
heroin, one of them fatally.

"Patients were repeatedly warned of the risk of overdose as a result
of diminished opioid tolerance while taking naltrexone," the study
says.

"The patient who died had discontinued naltrexone use after five
weeks.

"Two other patients who relapsed to heroin use reported overdosing and
being revived with naloxone after misjudging their level of
tolerance." The study conducted by James Bell, of the Langton Centre,
with the National Drug and Alcohol Research Centre and the National
Centre for Epidemiology and Population Health at the Australian
National University finds naltrexone ineffective in most cases.

"Attrition was high," it says.

"Three months later, only six patients were still taking naltrexone
(four of whom occasionally used heroin), and only seven were abstinent
from opioids."

The MJA editorial warns against short-cut solutions to drug problems,
and underlines safety concerns raised in Dr Bell's study: "No good
evidence has yet been presented to challenge the assumption that
naltrexone, however packaged, is at best modestly effective and at
worst unsafe."

It blames aggressive marketing, political intervention and an
uncritical media for the hype and unreasonable hopes surrounding the
drug.

"What we have found in the study, and what the MJA editorial is
saying, is that naltrexone is not a magic cure for heroin addicts," Dr
Bell said yesterday.

"In fact, there is some cause to suspect the opposite.

"The reason it's being over-hyped is that everyone is so desperate for
a solution to the heroin problem.

"It's a bit like cancer in a way. You won't find many long-term cancer
sufferers who have not tried a fringe cure at one point or another."

Orphan Australia wants naltrexone subsidised under the PBS for
alcoholics and heroin addicts so that a monthly course worth about
$300 would cost patients about $20.

Federal Health Minister Michael Wooldridge, who fast-tracked
naltrexone's entry into Australia earlier this year, was not available
for comment.