Pubdate: Sat, 02 Jun 2001
Source: Courier-Mail, The (Australia)
Copyright: 2001 News Limited
Contact:  http://www.thecouriermail.com.au/
Details: http://www.mapinc.org/media/98
Author: Tony Koch, NALTREXONE TESTS MUST BE DONE SWIFTLY

THE decision last week by the Medical Board of Queensland to prohibit 
Brisbane doctor Stuart Reece from using naltrexone implants to treat heroin 
addicts has serious consequences.

Reece has hundreds of patients, most of whom are desperate to be cured. The 
board ruled that Reece ``poses an imminent threat to the wellbeing of 
vulnerable persons and immediate action is necessary to protect the 
vulnerable persons''.

The point in contention was that naltrexone implants have not yet been 
certified to be used in human beings. The West Australian manufacturers of 
the implants have stopped production after publication of concerns about 
Reece's large practice.

A woman well-known to me -- the mother of a heroin-addicted girl -- 
yesterday wrote: ``We as parents knew that the implants were not for human 
use. However, given that our kids have been injecting poison -- heroin -- 
of varying quantity and quality for years, the implants provided us with a 
means to keep our loved ones alive.

``My daughter has been clean of heroin for four months now and in two 
months when the implant runs out -- what then? Where are our kids to go 
now? Interstate, obviously. So once again, it is recovery and treatment for 
the rich.''

Another letter from a similarly desperate mother: ``My son has an implant 
which is five months old and will run out in the next two or three weeks. 
Others are in need of implants now and cannot get them. We are extremely 
concerned that our sons and daughters who have sought to cure their 
addiction and live drug-free will be prevented from completing their 
treatment. We sought assurance that these implants would be available and 
not withheld -- via MP David Jull -- who wrote to the Prime Minister on 
behalf of myself and Mothers Against Drugs.

``We can understand the need for protection of the public from harmful and 
dangerous drugs. Here we have the opposite, and those seeking to live a 
heroin-free life are being used in a battle which has nothing to do with 
recovery. It is ludicrous that the one treatment which is not addictive is 
subjected to such intervention.'' The women's anguish is understandable. 
The Health Department must step in immediately with continued treatment of 
Reece's patients, who should not be made to suffer any more than they are 
already. Neither should the torment of their families be further fuelled.

THE Medical Board had, on the facts available, little option but to act as 
it did. Reece, as well-intentioned and expert as he is, is clearly unable 
to effectively cater for the workload he has attracted. Perhaps that 
highlights the real problem -- the dearth of real options for 
drug-dependent young people. There is a dreadful shortage of facilities for 
the detoxification and subsequent rehabilitation of such people once they 
avail themselves of treatment, with the effect that many fail for the want 
of basic post-treatment care. Very few addicts have the genuine, loving 
support typified by the letter-writers quoted above. Many have to depend on 
professional services and facilities provided by government -- and with 
very little personal, friendly support.

The Medical Board acted correctly in taking the action it did. It would be 
wrong, and totally irresponsible in this day and age, to allow drugs to be 
used on people when those products have not been through the appropriate 
laboratory tests. There is also the matter of legal liability should there 
be unforeseen longer-term consequences. There is already evidence -- or 
assertions at least -- that deaths have occurred among naltrexone implant 
patients that could or should have been avoided.

The onus lies with the state and federal governments to ensure naltrexone 
is tested to the required standards, and if it is found to have the safe 
qualities attributed to it, the product should be released with the 
appropriate warnings and safeguards. Naltrexone has been around now for 
some years, and it is reasonable to expect that final evaluation should not 
takes years more.
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MAP posted-by: Keith Brilhart