Drug study offers new hope for heroin users

Monday, 19 April 1999

Heroin addicts who want to "kick the habit" are being urged to volunteer for a new study which could improve their chances of suppressing cravings for heroin.

The trial ­ undertaken by the Drug & Alcohol Services Council, University of Adelaide and the Royal Adelaide Hospital ­ aims to compare the effectiveness of standard detoxification practices with a practice known as RODA (rapid opiate detoxification under anaesthetic).

RODA is a relatively new technique which involves anaesthetising the person and administering an antagonist drug to displace heroin from the receptors in the brain. This differs from standard detoxification mainly because of the much shorter time involved ­ less than a day, as opposed to withdrawal over a number of days.

Over the course of the study, 100 heroin-dependent adults will receive either RODA in the Intensive Care Unit of the Royal Adelaide Hospital, or standard detoxification at Adelaide's Warinilla clinic.

For all participants in the study, detoxification is followed by nine months of treatment with the drug naltrexone, with their progress monitored for 12 months. All treatment, including the naltrexone tablets, is provided free of charge to trial participants.

The three-year research project, supported by a $466,000 State Government grant, is already underway with about 40 heroin addicts having entered the trial.

Study coordinator Dr Jason White, from the University of Adelaide's Department of Clinical & Experimental Pharmacology, says the research will help determine the possible effectiveness of RODA in improving the outcome of naltrexone treatment.

"Naltrexone can now be prescribed by all general practitioners, as well as drug and alcohol specialists, to reduce people's craving for alcohol and to prevent heroin users who've undergone detoxification from relapsing to heroin use," Dr White says.

"However, the use of naltrexone in rapid detoxification is not one of the approved applications and is still experimental. This trial of rapid detoxification combined with naltrexone maintenance will play an important role in providing a basis for guiding our use of this drug."

"Previous research, and initial results of the South Australian trial, indicate that naltrexone treatment is beneficial for some people. We're not yet in a position to determine whether the use of RODA improves the outcome of naltrexone treatment," he says.

Dr White says of the 40 people who have already undergone detoxification, most had been successful in establishing a daily pattern of naltrexone use.

While some of those people used naltrexone for days or weeks only, others have continued for several months.

"We know that some people who have dropped out of the trial have remained abstinent from heroin, while others have relapsed. We will continue to follow as many participants as possible for up to 12 months, to determine how many achieve and maintain abstinence through this treatment approach," Dr White says.

Dr White says researchers are now looking to step up the rate of induction into the trial, hence the call for more volunteers.

Current heroin users who are interested in participating in the trial should contact the Alcohol and Drug Information Service, phone 13 13 40. They will be asked to leave their name and contact details. Subsequent phone and face-to-face interviews will determine their eligibility for the trial.

Importantly, heroin users who have participated in a methadone maintenance program in the last three months are to be excluded from the trial, for several reasons.

"Starting naltrexone treatment is more difficult physically and medically for patients who've been taking methadone because of the longer-lasting action of methadone," Dr White says.

"Also, methadone maintenance is known to be effective in terms of reducing heroin use, improving health and reducing death rates. Therefore it would be unethical for us to do anything that would encourage clients to leave methadone maintenance for a treatment of unknown effectiveness.

"I should emphasise that detoxification is only the beginning of any treatment. The post-detoxification recovery period is lengthy and requires commitment and perseverance," he says.

The trial is expected to be completed by July 2000.

 

Contact Details

Dr Jason White
The University of Adelaide
Business: +61 8 8313 5987


Ms Robyn Mills
Email: robyn.mills@adelaide.edu.au
Media and Communications Officer
The University of Adelaide
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Mobile: +61 410 689 084


Mr David Ellis
Email: david.ellis@adelaide.edu.au
Website: http://www.adelaide.edu.au/news/
Deputy Director, Media and Corporate Relations
External Relations
The University of Adelaide
Business: +61 8 8313 5414
Mobile: +61 (0)421 612 762