New heroin treatment option yielding positive results among patients at Melbourne injecting rooms

Summer’s* fascination with heroin started when she was just a teenager, but she never thought she would become addicted.

Key points:

  • The 34-year-old’s life was completely controlled by her six-year heroin addiction
  • She says she would still be dependent if it wasn’t for a new form of opioid replacement therapy
  • More doctors urged to get on board and prescribe the treatment

“When I was 27 I met someone who was using casually and I begged them to let me try it,” the 34-year-old said.

“Everyone thinks it won’t happen to them, the addiction side of it, but it didn’t take very long before I was hooked.”

She said the next six years of her life were spent barely talking to her parents, refusing treatment, and working full-time and casually to finance the habit.

“I was suffering from depression for a lot of years so I just wanted to be asleep rather than awake,” she said.

It was only when she used heroin at the North Richmond supervised injecting room that she was offered a new treatment — a once-a-month injection.

“If it wasn’t for the injection, I’d still be in the same cycle,” Summer said.

“If you put heroin in front of me, I’d kick it in the drain, I just have no interest in using ever again.”

The ‘freeing’ treatment option

Up until 2019, there were two main treatment options for people addicted to heroin and prescription opioids.

There was the decades-old methadone treatment in which a person is prescribed it by their doctor and must present to a pharmacy every day to take it supervised by a pharmacist.

Buprenorphine, available under the brand name Suboxone, was listed in Australia in 2005 as a film that dissolved on the tongue, again under the daily supervision of a pharmacist.

Typically, these cost $6 per dose as a dispensing fee at the pharmacy.

These medicines, known as opioid replacement therapy, have their limitations, said Nico Clark, the medical director of the North Richmond injecting rooms.

“Initially we worked on prescribing methadone and buprenorphine and linking them in with treatment providers, but we realised a lot of people are disorganised and it’s a challenge for people to pay the dispensing fee,” he said.

“They describe it as a constant reminder that they have a problem with heroin, that it’s going to be difficult to get a job, difficult to plan a holiday, and difficult to imagine any kind of different life, no matter how nice the pharmacist is.”

“It often doesn’t work and they feel like it’s all too hard, so when this injectable came along, I thought it would be perfect for this group.”

The injectable is a slow-release version of buprenorphine available for patients to take once a week, once a month, or in Summer’s case, once every six weeks.

It was approved for use in Australia after a randomised, double-blind study in the US of more than 500 people with moderate or severe addictions was published in the medical journal Lancet.

It found 45 per cent of people weren’t using opioids illicitly in the last week of the trial, week 24, compared to 2 per cent of those on placebo.

Dr Clark began prescribing and administering it to patients at the injecting room who were suitable and open to treatment at no cost.

He said because the injection produced stable levels of the drug, most patients experienced few or no side effects.

Fitzroy-based GP Paul McCartney is one of the few doctors who prescribes the buprenorphine injection and said it helps patients overcome the tendency to solely focus on the substance they’re addicted to.

“One of the advantages of the long-acting formulation is it allows for different patterns in the brain to develop, which can be part of the pathway out of being dependent on a substance,” he said.

“Having an injection that removes that daily struggle, that daily choice is quite freeing for people … they can get on with their normal lives.”

Summer said that’s exactly what she had done.

“I’ve leased a beautiful apartment in Southbank on the 21st storey, I’ve handmade all timber furniture for the apartment,” she said.

“I never thought I’d make anything again, but I’ve made a dining table, a TV unit, a coffee table.

“It’s completely given my life back.”

See this full story by Erin Cooper here on the ABC News website

*Name changed to protect privacy

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