Naltrexone II: no trials, just the power of prayer
One of the chief advocates for the controversial naltrexone implants, Perth-based Dr George O’Neil has defended the use of his experimental anti-heroin treatment, saying “the evidence is before our eyes,” but the treatment has not yet been evaluated in rigorous clinical trials.
Using naltrexone implants to treat heroin addicts is controversial because the treatment has not yet been evaluated in rigorous clinical trials, and is not formally approved by health authorities. In yesterday’s Crikey, leading drug experts called for a halt to the wide scale use of the implants until there is better evidence for its safety and effectiveness.
George O’Neil, who offers thanks to God on his website and has received financial support from the federal government, says he has implanted 2,000 implants into addicts through his Perth clinic. He says he has records on the treatment and follow-up of all 2,000, though that data has not yet been published in any medical journal.
The affable and softly spoken doctor argues that his records prove the implants are safe, because there have been no deaths in those using the treatment, but he concedes that in an ideal world good scientific trials should have been done a lot earlier. “The criticism is a very valid criticism, you should do trials first. But what if there are sick kids in front of you?”
A small trial comparing the implant with oral naltrexone, funded by the federal government’s National Health and Medical Research Council (NHMRC), is currently underway, though its results will be of limited value to those treating addicts. That’s because the trial does not compare naltrexone with the well established treatments including methadone and buprenorphine, both of which Dr O’Neil also supports as being valuable.
On top of the NHMRC grant, early last year the federal Health Ministry made a further one-off cash injection of almost $150,000 to complete the small trial, according to information given to Crikey by the health department. Health Minister Tony Abbott is seen as strongly supportive of the Perth clinic’s work. “He’s been sympathetic and he’s onside,” says a grateful George O’Neil. Via a spokesperson, Tony Abbott declined a request to talk about his views on the controversial therapy, saying the issues were handled by his colleague Christopher Pyne.
Corroboration of the Cabinet level enthusiasm for the treatment comes from another doctor who advocates the experimental naltrexone implants, Brisbane’s Dr Stuart Reece. “I’m aware that the senior people in the government support us strongly at an ideological level.”
In lengthy evidence to a current parliamentary committee inquiry into illicit drugs, being run by Bronwyn Bishop, Reece suggested one of the biggest problems at the moment was a disease called “drugs, s-x and rock and roll.” As part of his evidence, Stuart Reece cited Sodom and Gomorrah, the Biblical cities destroyed by God for their immorality.
Reece’s testimony then suggested Australia’s civilisation was under threat of being destroyed by the scourge of injecting rooms, give-away syringes, and methadone. These of course are the well-established strategies of “harm minimisation”, the approach that underpins the way Australia deals with the dangers of illicit drug use. In contrast to his attacks on harm minimisation, Stuart Reece spoke reverentially of the work of Dr George O’Neil, and the immense value of the still unproven naltrexone implant.
Asked during an interview whether he currently prescribed naltrexone implants to heroin addicts, Dr Reece answered cryptically, “Yes and No”.
Part three of this series tomorrow looks at the wider clash between the Zero Tolerance and Harm Minimisation approaches to illicit drugs.