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(generated from captions) the better the place will be we will be able to put in measures to

counteract that and hopefully stamp

out the H5N1 virus. Nick Grimm with that report. We all know that heroin addiction is destructive but decades of work has failed to stamp it out as a major public health issue. Arguments abound about the most appropriate treatment for addicts and one of the more controversial is the drug Naltrexone. The drug holds the promise of breaking the cycle of addiction and is seen as an alternative to a lifetime of dependency on other drugs such as methadone. The idea has the support of the Health Minister, Tony Abbott,

but the Government's own Drug and Alcohol Research Committee warns that Naltrexone can be a risky option for addicts. Natasha Johnson reports.

You wake up every day, it's like

having chemo. You wake up sick,

throwing up. It's like by the end

throwing up. It's like by the end of the day if you don't get it you're

going to die. And you just keep

getting sicker and sicker and

getting sicker and sicker and sicker and sicker until you get it.

I'd chop me arms off if I knew I

wouldn't use - I'd do anything.

Absolutely anything. 25-year-old

Shaun was once the Australian

Apprentice of the Year. He's now a

heroin addict. For eight years, the

Melbourne plasterer has battled a

$3,000 a week habit that's

$3,000 a week habit that's destroyed his life. He has no job, a criminal

record and strained relationships

with his family. Very devastating.

It's like somebody like your heart

inside is burning, you know.

You can't sleep at night. Sometimes

you're wondering where he is,

whether he's alive. You're waiting

for that knock on the door, for

somebody to come and say he's not

alive anymore. Today, Shaun, who

doesn't want to use his real name,

is undergoing rapid detox at the

First Step Recovery Clinic in

Melbourne. He's previously try add

variety of treatments from

residential rehab to prescribed

methadone and managed to get clean

methadone and managed to get clean a couple of times but relapsed.

Now he and his family are pinning

their hopes on a controversial drug

called naltrexone, which prevents

heroin from working. It blocks the

receptors and if people use opiates

they can't get a high from those

opiates. And so therefore it helps

them to stop using. We've given

them to stop using. We've given you a fair bit. I've got a real high

tolerance. It means they're not

getting high all the time so their

brains actually start working Bert

and they can start thinking more

clearly and start dealing with the

issues in their life. After

undergoing this intense 8-hour drug

induced withdrawal treatment, Shaun

will On naltrexone. I've left the

continuery, I've gone to the bush,

I've done it every way I thought

possible and this time I've got me

mind set. I'm on the urge where I'm

going to end up like this for the

rest of me life or change it now

while I can. First using in the

'70s, naltrexone was once hailed as

a miracle cure but the medical

a miracle cure but the medical world remains divided on its benefits.

Compared to so-called min tennance

#24er7ies like methadone or a similar prescribed drug,

buprenorphine. Naltrexone is the

buprenorphine. Naltrexone is the one form of pharmacotherapy that's

specifically designed to stop the

patient being addicted whereas

methadone and buprenorphine keep

methadone and buprenorphine keep the patient addicted. It's

spectacularly effective when people

take it. The problem is that people

don't take it. And not only does

that make it ineffective but it

that make it ineffective but it also makes it a very dangerous drug to

makes it a very dangerous drug to be used. Potentially dangerous because

naltrexone reduces heroin tolerance

back to zero. So if an addict stops

taking naltrexone and goes back to

using heroin at the dose they were

used to, it's highly likely they

will overdose and die. That

possibility has prompted now

research by the National Drug and

Alcohol Research Centre, which is

funded by the Federal Health

Department. We looked at the

mortality rate for naltrexone and

compared it with methadone and

buprenorphine and we found that the

mortality rate for oral naltrexone

was four times higher than for

methadone and seven times higher

than methadone in the period of

than methadone in the period of high risk. If you don't set up a proper

system you have patients coming off

naltrexone very quickly and you

naltrexone very quickly and you have very bad results. Perth

very bad results. Perth obstetrician George O'Neil operates the biggest

naltrexone clinic in the country.

He's recorded 80 deaths in 3,000 of

his oral naltrexone patients over

four years. He's now developed a

slow release implant he argues

combats the compliance problem and

reduces the overdose risk. A claim

supported by research from the

University of WA. Dr O'Neil says

there have been no deaths among his

there have been no deaths among his 1600 implant patients. With

1600 implant patients. With implants naltrexone you are guaranteed that

the patient gets the medicine and

you are guaranteed the patient gets

the medicine for six or nine months

in a row and that gives you a

in a row and that gives you a window where you can start changing your

lifestyle and as I said we're

lifestyle and as I said we're seeing 50% or more - in the order of 50%

come back for a second implant.

Dr O'Neil's family company Go

Medical has patented the implant

Medical has patented the implant and last year received $2 million from

the Federal Government for research

and development. In addition, Dr

O'Neil's Fresh Start Recovery

O'Neil's Fresh Start Recovery Clinic has received $5 million from the

Western Australian Government and

last year Health Minister Tony

Abbott awarded a $100,000 grant.

The Minister has previously been

reported as supporting greater

access to naltrexone services, and

in a statement to the 7:30 Report,

he said:

But Dr O'Neil wants the Government

to go further and subsidise

naltrexone, like methadone and

buprenorphine. It's a ridiculous

situation to meet a family and say

if we want you to get better and

if we want you to get better and you have a heroin addiction, the

Government is going to give nothing

unless you take an addictive

substance and they're not going to

fund the non-addictive substance at

all. The problem is that while

naltrexone is registered in

Australia to treat alcohol depen

dance, it's so far failed to get

approval from the Therapeutic Goods

Administration for treating drug

addiction and can only be

addiction and can only be prescribed under a special regulatory

under a special regulatory exemption for experimental drugs. The

for experimental drugs. The implants are a new and a good idea, it's

worth trying, and the implant

research is being conducted in many

countries around the world,

including Australia. And the

including Australia. And the results aren't available yet and in

aren't available yet and in medicine we have a strict rule these days

that, until a new medical

intervention has been carefully

researched, we take the attitude

that it is ineffective and unsafe

until proven otherwise. If you've

got a child with cancer and you go

down the children's hospital,

there's a good 50% chance you will

have to use a #34edication that is

not yeah yet passed by the TGA as

well. So if you have a really

serious condition, as a parent or

serious condition, as a parent or as an individual, you've got the

privilege of using a medicine that

is not yet registered. So in that

case, as a parent or as an

individual, and as a doctor, you

have to take responsibility.

Naltrexone treatment can cost up to

$4,000, depending on which clinic

$4,000, depending on which clinic an addict attends. Dr O'Neil says he

charges only those who can afford

charges only those who can afford it and subsidises the rest. So the

first bit is the local, which

stings. And then it goes numb.

The First Step Recovery Clinic many

Melbourne offers naltrexone as well

as methadone and buprenorphine.

It's highly selective about who it

treats, reflecting the National

treats, reflecting the National Drug and Alcohol Research Centre's view

that naltrexone is suitable for a

minority of well-motivated addicts.

We're looking for people whose

We're looking for people whose lives are reasonably stable, so they've

got somewhere they're living,

preferably if they're working -

preferably if they're working - that certainly is a big aid - people

certainly is a big aid - people with other social supports, either

family, friends, spouses, and

family, friends, spouses, and people who are looking to finally get

who are looking to finally get right away from the drug scene. I just

pray this is the time. Otherwise I

don't know what we're going to do.

Shaun and his family are sprending

$2,000 on implants they hope will

give him 12 months breathing space

to turn his life around. They're

well aware it's an experimental

treatment but when all else has

failed they're prepared to try

anything. I'm prepared because he

could overdose on heroin. That's a

chance. A chance we've got to take.

Like it wouldn't brother me if I

Like it wouldn't brother me if I had to get one for the rest of me life

every year. What's $2,000 a year to

be normal. It's priceless. It's a

bargain, I reckon.