40 addicts to receive heroin legally
By MARION DOWNEY, Health Writer

Australia's controversial heroin trial is to go ahead after being
approved by a majority of health and law enforcement ministers
yesterday. A small trial to treat 40 addicts using pharmaceutical heroin
(diacetylmorphine) will start in the ACT and be one of a number of
trials in some States using heroin substitutes.

The Ministerial Council on Drugs Trafficking, meeting in Cairns,
approved the first stage of the heroin trials and agreed to a twoday
extraordinary meeting to review the national drug and illicit drugs
strategies.

The ACT Chief Minister, Mrs Carnell, said the resolution "was the most
dramatic breakthrough in drug treatment in 25 years". The ACT trial's
effectiveness will be compared with those in Victoria, South Australia
and NSW.

The heroin substitutes are LAAM, which maintains addicts; Buprenorphine,
used during withdrawal; Naltrexone, for relapse prevention; and
slowrelease oral morphine, used for maintenance.

A modification of the original trial designed in 1991 by academics at
the Australian National University and the Australian Institute of
Criminology was agreed to as part of the decision.

The heroin will not be free patients will have to pay the same as for
methadone maintenance. The trial's objectives have also been modified to
include withdrawal and abstinence from the drug, rather than simply
maintaining them on it.

Yesterday's meeting agreed only to stage one of the trials. Stage two
(250 people) and stage three (1,000 in three cities) will not proceed
until stage one has been completed and assessed.

At this stage there is no obligation for NSW to take part in stage
three. The refusal of the Premier, Mr Carr, to commit NSW to stage three
was at one point thought to have put even stage one in jeopardy.

The Federal Minister for Health, Dr Wooldridge, said pharmaceutical
heroin might not be the most effective substitute. "It would be very
dangerous to look on heroin as if it were some sort of magic cure," he
said. "It may be totally ineffective. It is quite possible that the
other trials will be more effective." The Commonwealth will provide
financial support.

The heroin trial was supported by NSW, Victoria, South Australia and
Tasmania but opposed by Western Australia, the Northern Territory and
Queensland. Queensland's Health Minister, Mr Mike Horan, said: "It sends
out the very worst message to the populace it maintains the addicts on
heroin with a taxpayerfunded dose of heroin injected into their veins
four times a day."

The NSW Minister for Health, Dr Refshauge, said: "I am delighted there
is recognition at a national level that there are a number of treatment
options that need to be explored."

But he said it was crucial to evaluate the trials before making further
decisions.

"We are not all of a sudden going to tell the community that a program
which has been misrepresented by a whole bunch of the community is all
of a sudden going to be in your backyard."

In a communique', the ministers "expressed their concerns at the
indications of the increasing use of illicit drugs, particularly the
increase in opiaterelated deaths in recent years".

A study by the National Drug and Alcohol Centre presented by the meeting
said fatal heroin overdoses increased from 70 in 1979 to 550 in 1995.