SUICIDES, OVERDOSES LINKED TO DETOX DRUG

Catriona Mathewson, Sean Parnell

Wed, 06 Jun 2001 Source: Courier-Mail, The (Australia) Copyright: 2001 News Limited

A CONFIDENTIAL briefing paper on national trials of the heroin
detoxification drug naltrexone has revealed alarming rates of overdose
and suicide among those receiving treatment.

The paper, prepared for Queensland Health Minister Wendy Edmond by
senior health bureaucrat Dr Alun Richards, contains details of a draft
report on the trials.

Queensland participated in the trials of oral naltrexone treatment and
submitted results to the National Drug and Alcohol Research Centre,
which will officially release its findings next month.

Details of the research came yesterday as the Medical Board continued
its investigation into Brisbane doctor Stuart Reece's use of
controversial naltrexone implants.

Premier Peter Beattie issued a veiled attack on federal health
authorities for not probing the unauthorized use of implants before
his Government initiated the Medical Board investigation.

Mr Beattie, who conceded he had not been fully briefed on the
investigation, said there were "difficulties" in the relationship
between state and federal health authorities.

But he said the implants were only approved for trial purposes in
Perth, and had federal health authorities prevented the implants being
used in Queensland the investigation "would never have happened."

"I understand there are emotional issues involved and I understand the
role of the Medical Board," Mr Beattie said.

"But if the Medical Board wasn't moving to protect lives, then
everyone . .. would be belting the Government, and quite rightly."

A Therapeutic Goods Administration spokeswoman yesterday refused to
detail any investigation into the implants, whether importation would
be restricted or whether an application had been made to allow their
use in Australia.

Board president Dr Lloyd Toft said yesterday it was hoped the
investigation into Dr Reece would be completed within two months.

While Dr Reece has been banned from using naltrexone implants, he may
still prescribe oral naltrexone, which has been evaluated in the
trials.

The confidential briefing paper shows the trials found naltrexone
detoxification was widely associated with a higher death rate than
other methods of treatment.

However, it did concede that naltrexone showed good results when
patients continued taking the drug, with Dr Richards stating: "Where
patients have died after using naltrexone it is usually because they
have stopped taking the drug and have reverted to using heroin."

The paper stated that national trial results showed naltrexone
treatment was associated with a heroin overdose rate (both fatal and
non-fatal) of 46.3 per 1000, against a rate of 2.2 non-fatal overdoses
per 1000 for methadone. Four out of 454 patients on naltrexone died
during the study.

It also found the highest rate of "suicide-related events" (6.6 per
1000 patients) with naltrexone.

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Dr Michael Dawson Senior Lecturer Department of Chemistry, Materials and Forensic
Science University of Technology, Sydney Tel:
(61)(2)9514 1717 PO Box 123,
Fax: (61)(2)9514 1460 Broadway, NSW. 2007
mailto:Michael.Dawson@uts.edu.au