Atoda
Alcohol Tobacco and Other Drug Association ACT
  • Home
  • News
  • About
    • About ATODA
    • Governance & Advisory Structures
      • ACT ATOD Workers Group
      • ACT ATOD Chief Executive Officers/Executive Directors Group
    • Contact Us
    • Links
      • ACT Links
      • National Links
  • Activities
    • Annual General Meetings
    • Canberra Drug Policy Series
    • Past Activities
      • ACT ATOD Awards
      • Annual ACT ATOD Sector Conference
      • Drug Action Week
      • Comorbidity Bus Tour
      • Training and Professional Development Calendar
      • World No Tobacco Day: 31 May
  • Projects
    • ACT AOD Qualification Strategy
    • ACT ATOD Services Online Directory
    • ACT eASSIST
    • ACT Specific ATOD Training and Education
    • Domestic and Family Violence Tools for Alcohol and Other Drug Settings
    • E-cigarette Information Series
    • Impact Alcohol Project
    • Nicotine Replacement Therapy
    • Previous Projects
      • Canberra Collaboration
      • Capacity Buidling Project
      • Collective Impact and Evaluation Project
      • Consumer Participation
      • Fund Assist: Prepare, plan and write successful funding applications
      • National AOD Peaks Capacity Building Evaluation Report
      • Reconciliation Working Group
      • Reducing smoking in the ACT among Aboriginal and Torres Strait Islander women who are pregnant or who have young children
      • Research, Scope and Design a Safer Families Project for the ACT AOD Sector (AOD Safer Families Project)
      • Tackling Nicotine Together (TNT) – Systems Change for Smoke-Free Drug and Alcohol Centres
      • Women Affected AOD and Domestic and Family Violence
      • Workplace Tobacco Management Project
    • Safer Families AOD Baseline Assessment Project
    • Service Users’ Satisfaction and Outcomes Survey
    • University Drug and Alcohol Network
    • We CAN Project
    • Workforce Profile
  • Archives
    • Archived ANCD Website
    • Archived NCPIC Website
    • Archived NIDAC Website
    • National Projects
      • Overview
      • Care Packages
      • Mapping
      • AOD Workforce Development Strategy
      • Patient Pathways
      • Quality Framework
      • Review
      • Funding Applications
    • Alcohol and other Drugs Council of Australia (ADCA) Defunded
  • Policy
    • ATODA 2020 ACT Election Priorities Statement
    • ACT Budget
    • ACT Infringement System
    • Drug Thresholds
    • Justice Reform
    • Liquor Act Review
    • Medicinal / Therapeutic Cannabis
    • Methamphetamine
    • Naloxone (Narcan)
    • Naltrexone
    • National AOD Peak Body
    • Ngunnawal Bush Healing Farm (NBHF)
    • Prison Based Needle and Syringe Program
    • Public Health Partnerships
    • Withdrawal Review
    • Working With Vulnerable People Check
    • Youth Drug and Alcohol Court
    • More
  • Publications & Communications
    • ATODA Monograph Series
    • ATODA Publications
    • ACT ATOD eBulletin
    • ACT Research Spotlight
    • ACT ATOD Research eBulletin
    • ACT ATOD Services Directory
    • Media
    • Resources Guide
    • Supporting AOD Services with Recruitment
    • Update and Drugtalk Mailing Lists
Search the site...

Sustained release naltrexone (e.g. implants) are not recommended for treating opioid dependence

ATODA understands that Canberrans (including those in detention) continue to be referred to (or supported to access) interstate services that provide sustained release naltrexone (e.g. implants) for the treatment of opioid dependence.

ATODA wishes to re-iterate that sustained release naltrexone products are not registered with the Therapeutic Goods Administration

ATODA has recently updated its advice to members and stakeholders that sustained release naltrexone (e.g. implants) are not recommended for treating opioid dependence.

According to the National Health and Medical Research Council (NHMRC):

“Evidence is currently at an early stage and as such, naltrexone implants remain an experimental product and should only be used within a research setting. Until the relevant data are available and validated, the efficacy of the treatment, alone or in comparison to best practice, cannot be determined. NHMRC’s position on naltrexone implants is that further research on adverse effects is required before a statement on safety can be confidently made.”

The Australian National Council on Drugs (ANCD) is an expert advisory council to the Australian Government and appointed by the Prime Minister. Its members include some of the country’s leading experts in their respective fields related to alcohol, tobacco and other drugs. The ANCD recently released a position statement on Naltrexone Sustained Release Preparations (Injectable & Implants). Their position statement agrees with the conclusion of the NHMRC review that further clinical trials are necessary to ensure the efficacy and safety of naltrexone.

The findings from the NSW State Coroner regarding the deaths of three people have continued to raise concerns about the use of naltrexone. The Coroner’s recommendations include strongly endorsing the statements and recommendations of the ANCD that naltrexone is not recommended for the treatment of opioid dependence.

ATODA calls on its members and stakeholders to raise awareness of this advice with consumers, families, support people and the broader community; the alcohol, tobacco and other drug sector; and allied sectors (including mental health, legal services, the courts and corrective services) to ensure that Canberrans are not referred for treatment for opioid dependence with sustained release naltrexone until there is sufficient evidence to ensure its safety and efficacy.

Efficacy and safety of naltrexone

National Health and Medical Research Council (2011). Naltrexone Implant Treatment for Opioid Dependence: Literature Review – 2010. Canberra: NHMRC.

Lobmaier P, Kornor H, Kunoe N, Bjørndal A. Cochrane: Sustained-Release Naltrexone for Opioid Dependence.

National and ACT guidelines in the treatment of opioid dependence

Gowing L, Ali R, Dunlop A, Farrell M, Lintzeris N (2014) National Guidelines for medication-assisted treatment of opioid dependence. Canberra: Commonwealth of Australia.

Note: the above national guidelines are the updated version of these guidelines  these are the Intergovernmental Committee on Drugs. (2007) National Phamacotherapy Policy for People Dependent on Opioids. Canberra: Australian Government.

ACT Health. (2010) ACT Opioid Maintenance Treatment Guidelines. Canberra: ACT Government.

Note: The ACT guidelines are currently being reviewed, for further information contact the Opioid Treatment Advisory Committee Secretariat through ACT Health on aodpolicy@act.gov.au

Positions and statements

Australian National Council on Drugs

Their position statement agrees with the conclusion of the NHMRC review that further clinical trials are necessary to ensure the efficacy and safety of naltrexone.

 

Australian National Council on Drugs (2012). Naltrexone Sustained Release Preparation (Injectable & Implants). ANCD Position Statement – March 2012. Canberra: ANCD.

 

The Royal Australasian College of Physicians

The Royal Australasian College of Physicians (RACP) recognises that long-acting naltrexone products may ultimately prove to be a safe and effective treatment approach for opioid dependence. Accordingly, it is appropriate to support the development of registered products that safely and effectively deliver this treatment. However, until suitable product(s) have undergone normal regulatory assessment procedures and are licensed with the Therapeutics Goods Administration (TGA), unregistered products should not be used on a routine basis and a range of safeguards are required to protect patients, their families, and health professionals.

The Royal Australian College of Physicians (2013). The Use of Sustained Release Formulations of Naltrexone in Opioid Dependence Position Statement. Sydney: RACP.

 

ATODA

In 2012, ATODA developed a position, consistent with the NHMRC and ANDC, against the use of sustained release naltrexone for the treatment of opioid dependence in 2012. ATODA has updated this position to reflect further developments in the field. The most recent

Sustained release naltrexone (e.g. implants) is not recommended for treating opioid dependence in Australia (2012, Updated October 2014)

Following requests from ATODA, we are pleased that the Opioid Treatment Advisory Committee developed a formal statement in 2013 (see below).

ACT Opioid Treatment Advisory Committee

The Opioid Treatment Advisory Committee, as the advisory body on matters relating to opioid maintenance treatment in the ACT, supports the Royal Australasian College of Physicians (RACP) Position Statement, developed by RACP’s Australasian Chapter of Addiction Medicine.

 

Opioid Treatment Advisory Committee (OTAC)

Formal Statement: Naltrexone Sustained Release Implants

OTAC, as the advisory body on matters relating to opioid maintenance treatment in the ACT, supports the Royal Australasian College of Physicians (RACP) Position Statement, developed by RACP’s Australasian Chapter of Addiction Medicine (attached).

As no long-acting naltrexone product is registered currently for use in Australia by the Therapeutic Goods Association (TGA), until one or more suitable products have undergone normal regulatory assessment and are registered by the TGA, they should not be used on a routine basis.

It is essential that individuals who are opioid dependant and their families are informed regarding the lack of sound scientific evidence on the efficacy and safety of naltrexone sustained release implants. Their use may put the individual at risk of harm or death.

OTAC looks forward to receiving news on the research developments in this area.

The Australian Injecting & Illicit Drug Users League

The Australian Injecting & Illicit Drug Users League (AIVL) has welcomed a recent coronial inquest into the deaths of three people in NSW associated with naltrexone implants and the media coverage earlier this week and today that has followed the report’s release. Unfortunately however, we also believe the recommendations of the inquiry do not go anywhere near far enough in addressing the seriousness of the apparent medical negligence issues and fundamental human rights abuses at the heart of these 3 cases.

 

Dr Alex Wodak

Injecting drug users are a marginalised group in Australia. It is particularly important that medical research and the provision of health services to marginalised groups is handled with even greater care than usual. Cutting corners in research and clinical treatment undermines the processes adopted over the years to minimise the chances of errors of judgment, both in research and in treatment.

If you are thinking about having naltrexone treatment (including a naltrexone implant), make sure that you do your homework first. Find out all you can about the benefits and risks. Get information from more than one source, and certainly from more than just the clinic providing the implant.

Media coverage

Warning over addicts’ implant (Canberra Times, 06 May 2013)

Drug addiction treatment divides opinions (ABC’s 7:30 Report, 23 October 2012)

Detox clinic reignites implant debate (The Brisbane Times, 20 October 2012)

Patient deaths don’t deter detox clinic (Australian Doctor, 15 October 2012)

Nile wants funding for heroin ‘cure’ (Sydney Morning Herald, 19 October 2012)

A dangerous method with tragic consequences (The Canberra Times, 16 October 2012)

Coroner slams clinic’s treatment of addicts (ABC News, 28 September 2012)

Coroner blames poor treatment for detox deaths (ABC’s Lateline, 27 September 2012)

Naltrexone and “naloxone” are not the same thing

ATODA notes that often naltrexone is confused with “naloxone” (or Narcan ®) which is a schedule 4 opioid antagonist used to reverse the effects of opioid overdose.  For further information about “naloxone” please see:

  • Information about the ACT program
  • Naloxone Question & Answer document

For more information contact:
Alcohol Tobacco and Other Drug Association ACT
(02) 6249 6358
info@atoda.org.au

Last updated 23 October 2014

Subscribe to our eBulletin


Our monthly eBulletin is a concise summary of developments, publications, events and other information relevent to ATOD and allied workers in the ACT.
Subscribe NOW

Acknowledgement


We acknowledge the traditional owners and continuing custodians of the lands of the ACT and we pay our respects to the Elders, their families and ancestors.

Contact Us

Phone: (02) 6249 6358 / (02) 6257 2661
Fax: (02) 6230 0919
Email: info@atoda.org.au
Mail: PO Box 7187,
Watson ACT 2602
Visit: 11 Rutherford Cr, Ainslie

Contact Page

News

  • Join the ATODA Team
  • Family Drug Support volunteer training course in Canberra – January 2021
  • ACT Pill Testing – Fixed Site Announcement
©2016 ATODA – Home | ABN 50 515 216 820 | Privacy Statement | Disclaimer | Need help or support? In an emergency call the police, ambulance or fire on 000.
Alcohol, tobacco and other drug information & support is available through the Alcohol and Drug Program 24-hr Helpline on (02) 6207 9977. Lifeline offers 24-hr confidential counselling on 131 114.