Review of heroin-blocking implant urged

Use of a controversial stomach implant designed to block the effects of heroin must be urgently reined in, according to drug specialists who say addicts are being harmed. A new report found that naltrexone implants commonly cause severe adverse reactions, including extreme dehydration and acute renal failure in those who are fitted with them.
Nine Sydney specialists writing in the Medical Journal of Australia have called for an urgent review of use of the product, which blocks the effects of heroin and stops cravings for about six months. It has not been registered or rigorously tested in Australia but about 1,500 addicts have obtained it through the Therapeutic Goods Administration’s Special Access Scheme for people with a life-threatening need.
Controversy has surrounded the use of the implants for several years, with advocates arguing they offer addicts the best chance of overcoming their addiction and opponents branding them dangerous and ineffective.
One study published last March linked the implant to five deaths. A new study published has found that of 12 implant patients who were admitted to two Sydney hospitals last year, eight hospitalisations were implant-related. Six were suffering severe dehydration, one had acute renal failure and another had an abscess at the implant site.
“These cases challenge the notion that a naltrexone implant is a safe procedure,” said study leader Nicholas Lintzeris, a senior addiction specialist at the Sydney South West Area Health Service. He called for the widespread and unregulated use of implants to be restricted until they have been properly tested for safety and effectiveness.
Professor Robert Ali, director of the Drug Alcohol Services Council in Adelaide, agreed the product should not be so widely available.
“The disturbing suggestions of mortality and morbidity from unregistered naltrexone implants makes a strong case for an independent review to determine whether this treatment is sufficiently safe for such widespread use,” Prof Ali said.
However, another specialist, University of Western Australia Professor of Addiction Gary Hulse, said a trial he had undertaken had found the implant to be just as safe and effective as the oral form of the drug. He defended its use and said many of the criticisms levelled at naltrexone occurred because people’s withdrawals from heroin were not being managed properly.
Source: April 17th 2008

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