Australia’s leading medical journal will run a tough editorial this Monday, calling for an inquiry into the dangers of an unproven treatment for heroin addicts.
Crikey understands that a group of leading figures in the health world want the Federal Government to hold an independent review of the safety of Naltrexone implants, controversial devices which have been implanted into thousands of heroin addicts to help them try and quit.
The editorial in the April 21 issue of the Medical Journal of Australia is understood to raise serious questions about the safety of the still-experimental implants.
Last year Crikey ran a series of stories on the implants, which have not yet been properly assessed in good quality clinical trials. The implants are being used under an exemption in the Australian law, called the Special Access Scheme, which allows the use of unproven drugs in special circumstances.
Unlike other standard treatments like methadone, Naltrexone acts strongly against the effects of heroin, but one of the side effects is that people may be more likely to overdose if they go back to using heroin again. The implants have already been linked to a number of deaths, and a second article in next week’s Medical Journal of Australia discusses a series of new cases involving serious harm associated with use of the implants.
The chief promoter of the implants is the Perth-based Dr George O’Neil, who told Crikey he has implanted more than 2000 of these devices. O’Neil, who thanks God on his website and prays regularly, received strong political support from the Howard government, including taxpayer-funded grants to help assess and develop the implants. The grants were in excess of $150,000, and rumoured to be as much as $1 million.
In particular, former Health Minister Tony Abbott was seen as a big supporter of this controversial drug therapy. Last year O’Neil said of Abbott: “He’s been sympathetic and he’s onside.” Another strong supporter of the unproven treatment, Brisbane Dr Stuart Reece, said senior people in the Howard government had supported those advocating the treatment “at an ideological level.”
It will be fascinating to see whether the Medical Journal of Australia’s editorial has any impact on the new crowd, or whether Canberra simply continues to support the use of an experimental, unproven and potentially harmful drug therapy.
Naltexone certainly holds promise. However, this will be a function of it’s ability to modulate neurodynamics in the nucleus accumbens, specific to influencing higher cognitive functions. It is this poorly understood pharmacokinetic activity that sees smoking, alcoholism, gambling, non-opiate med’ addiction, sex, etc related behaivour alter, as the established negative feedback loop is “inhibited” neurodynamically. It’s role as an opiate blocker is an unfortunate side-effect assumed the answer to immediately stopping immoral behaviour by moral conservatives: the most vocal/active proponents also committed to discrediting Harm Minimisation in favour of zero tolerance. Addiction is a function of deep brain structures, nerodynamically/anatomically changed by opiates. As the same areas are vital to mood and respond to endogenous opiates one can see it is vital to prescribe patient-specific doses. Proponents are unprofessional: http://dfaw.typepad.com/dfawatch/dfa-rebuke-mja-on-naltrex.html
By all the standards applying to the quality of medical practice in this country O’Neil’s treatment is proven. ‘Proven’ in medicine is more a political term than a scientific term as you have to have talent to endow it with the qualities of the latter.
In medicine there is a list of the ‘proven’ where the proving facts are more like unsophisticated gestures of consensus with a spattering of little provable facts purporting to be relevant and promoted as tying up the consensus while proven and so fundamental, elementary and totally accepted facts of medical science are totally ignored to death (of our patients).
The anally retentive find when they manage to shove a large implement of ‘proven fact’ up there it helps them to HUFF and PUFF.
In almost your words ..
Canberra simply should continue to support the use of a not so experimental, looking provable but potentially harmful drug therapy for a horrible condition.
There are totally safe ways if Govt will do the work and pay
Naltrexone is a reasonably well know drug in the treatment of drug and alcohol addiction. The implant is somewhat novel way of delivering it. The Special Access Scheme is used frequently and is not at all unusual. ‘Unproven’ is a meaningless term scientifically and especially in the treatment of drug and alcohol abuse. I deplore the politicisation of health care of which this article is a classical example with a sprinkling of ‘Howard’ , ‘Abbot” and , no doubt the “group of leading figures in the health world”. This article is in short, petty left vs right bs!. It contibutes precisely zero to patient care