Health: So what is this new cure for addiction?

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What is naltrexone?

Naltrexone is a medication used in drug addiction. It blocks the

effects of opiates including heroin, methadone, morphine, palfium, codeine, DF118 and Temgesic.

How does it work?

Naltrexone is an "opioid antagonist". For an opiate, such as heroin, to produce its effects, it must

attach itself to small areas called receptor sites in the brain and

nervous system. Naltrexone stops this from happening, by getting to the receptor sites first. The

implants are 1.4cm in diameter and 9mm thick. They are inserted through a 2.5cm incision in the back of the upper arm or lower

abdomen.

Who is it suitable for?

The implants (also known as

pellets) are suitable for opiate

addicts who want to come off drugs but have failed with will-power and/or counselling. It may not be appropriate for patients with renal or hepatic impairment. Once inserted, the patient does not need supervision (as they might if they take naltrexone orally). It should only be used on a patient who has undergone complete detoxification and is "clean" of opiates.

Why is the implant better than oral doses?

The implants last for about five to eight weeks. The oral form must be taken every day, or sometimes addicts take tablets every two or three days. With implants, addicts don't need to worry about

forgetting a dose.

How effective is it?

Although no long-term statistics have been compiled, it is believed to be highly effective. Toby Burton, detox co-ordinator for the Stapleford Centre, where Shaun Ryder was treated, says that the implants ensure that a relapse is "virtually impossible" for the first six weeks when the risk is highest. If an

addict takes opiates after being

fitted with a naltrexone implant, they will not get high.

Any side effects?

Some patients may experience slight indigestion or drowsiness, but this is not necessarily connected to the naltrexone. Other side-effects may include sickness, dizziness, cramps, joint and muscle pain. There is a risk of turning to non-opiate drugs, including

alcohol, as a substitute. Naltrexone

implants do involve surgery and will leave a small scar with some temporary tenderness and

bruising. One of the main worries is that if an addict starts using heroin when the implants have worn off, the usual dose may now be too strong and could result in an over-dose and death.

How long do they last?

It is recommended that addicts should have naltrexone implants for at least six months. However, all cases are different and

treatment plans should be under constant review. Each implant lasts six to eight weeks.

Is naltrexone addictive?

No - and there are no withdrawal symptoms from the implants.

Is it a new drug?

The pellet form of naltrexone was pioneered in the United States by Dr Lance L Gooberman of New Jersey. The first documented use of the implants in the UK was in 1997 by Dr Colin Brewer at The Stapleford Centre in London. The oral variety has been used in the US for more than 25 years and in Britain for more than 10 years.

Is it available on the NHS?

Some GPs prescribe naltrexone orally and a few refer patients on the NHS to the Stapleford Centre.

Otherwise, how much does it cost?

If you opt for a detox programme, the insertion of pellets and six months' aftercare, it will cost pounds 3,900 at the Stapleford Centre. Top-up doses cost pounds 285

Oral naltrexone costs pounds 140.11 for a 50-day supply; or pounds 5.80 with a NHS prescription.

How can I find out more?

Ask your GP or contact The Stapleford Centre, The Medical Addiction Treatment Centre, 25a Eccleston Street, Belgravia, London SW1W 9NP. Detox Line: 0171-730 0680

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