Pubdate: Wed, 18 Nov 1998 Source: Advertiser, The (Australia) Page: 14 Contact: http://www.advertiser.com.au/ Author: Rob Kelly HEROIN "CURE" SHOWS PROMISE THE South Australian trial of the drug naltrexone - the rapid withdrawal antidote for heroin addicts - has passed its first test. The trial's initial results were "encouraging", the director of clinical policy and research at the Drug and Alcohol Services Council, Dr Robert Ali, said. Known as the "eight-hour heroin cure", naltrexone closes down the receptors in the brain that promote heroin craving. For the purposes of the trial program, seven addicts were detoxified under anaesthetic in a few hours. A further seven, were given conventional - three to five-day - detoxification at an Adelaide clinic. Dr Ali said that while he did not yet want to go into figures the results were encouraging enough for the trials to continue. He said 100 addicts were now required - 50 for conventional treatment and 50 for detoxification under anaesthetic. All of them would be given a daily dose of naltrexone for at least a year. Few thorough trials or naltrexone have been conducted anywhere in the world and, where they have taken place, the trials have been marred by a high drop-out rate among street heroin addicts. As few as 4 per cent of the patients get through the opiate detoxification stage, pass a naltrexone challenge and continue to take the drug for six months. Dr Ali said the problem now was to find enough volunteers for the trial among the State's 5000 dependent heroin users - of whom 1800 are already on methadone. Two people had already registered but, with the conventional withdrawal treatment taking up to five days - and dependent on bed availability - it would take up to a year to recruit enough addicts for the trial, Dr Ali said. Studies have shown one of the problems faced in getting enough addicts to enter a naltrexone trial is that it is considered a "neutral" drug - - meaning addicts do not get the, rush - or high - they did from methadone. A lot of addicts have dropped out early and went back to methadone. Studies have shown that patients with the greatest material and psychological assets tend to have the best results with naltrexone. Patients with a history of recent employment, and a good educational background, are thought to be better suited to naltrexone. Many of them preferred it to methadone as it did not tie them to regular clinic visits. But even patients who drop out of naltrexone trials early show improvement. Trials in the United States showed 30 per cent to 40 per cent of those who took naltrexone for just three months were still opiate-free six months after stopping treatment. - --- Checked-by: Patrick Henry