Assessing naltrexone implant or methadone maintenance treatment on mental and physical health outcomes in heroin users [ 2005 - 2006 ]

Research Grant

Researchers: Prof Gary Hulse (Principal investigator) ,  A/Pr Diane Arnold-Reed ,  Dr Robert Tait

Brief description The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral naltrexone has proved problematic, with medicine non compliance and relapse common. Surgical insertion of subcutaneous implants is an alternative method of naltrexone delivery. 441 heroin users have received naltrexone implants (3.4g) under Special Access in WA. Although naltrexone implants have yet to be comprehensively assessed, early results are encouraging. Pilot study data has shown a significant reduction in hospital emergency department (ED) attendance for accidental overdose, and mental health events following implant. The aim of this study is to more rigorously assess outcomes associated with implants compared to heroin dependent persons treated by MMT . The DLS collates general hospital and mental health admissions plus mortality data for individuals. This allows the health of an individual to be monitored over time. An electronic version of hospital ED data has recently become available. The study will validate these records by comparing the electronic data against hospital ED records for the implant group. We will then combine the electronic ED and DLS data. Morbidity and mortality rates for heroin users are significantly greater than those for the general population. If the preliminary findings are replicated, naltrexone implants may offer significant benefits over current pharmacotherapies in reducing general and psychiatric morbidity in dependent heroin users.

Funding Amount $AUD 216,200.00

Funding Scheme NHMRC Project Grants

Notes Standard Project Grant