The Search for Non Addictive Morphine

Commonly Available Drug Found To Treat Opioid Addiction

ScienceDaily

Feb 2009

Scientists at Stanford University School of Medicine have discovered that a commonly available non-addictive drug can prevent symptoms of withdrawal from opioids with little likelihood of serious side effects. The drug, ondansetron, which is already approved to treat nausea and vomiting, appears to avoid some of the problems that accompany existing treatments for addiction to these powerful painkillers, the scientists said.

Opioids encompass a diverse array of prescription and illegal drugs, including codeine, morphine and heroin. In 2007, about 12.5 million Americans aged 12 and older used prescription pain medications for non-medical purposes, according to the National Survey on Drug Use and Health, administered by the federal government's Substance Abuse and Mental Health Services Administration.

"Opioid abuse is rising at a faster rate than any other type of illicit drug use, yet only about a quarter of those dependent on opioids seek treatment," said Larry F. Chu, MD, assistant professor of anesthesia at the School of Medicine and lead author of the study that will be published online Feb. 17 in the Journal of Pharmacogenetics and Genomics. "One barrier to treatment is that when you abruptly stop taking the drugs, there is a constellation of symptoms associated with withdrawal." Chu described opioid withdrawal as a "bad flu," characterized by agitation, insomnia, diarrhea, nausea and vomiting.

Current methods of treatment are not completely effective, according to Chu. One drug used for withdrawal, clonidine, requires close medical supervision as it can cause severe side effects, while two others, methadone and buprenorphine, don't provide a satisfactory solution because they act through the same mechanism as the abused drugs. "It's like replacing one drug with another," said co-investigator Gary Peltz, MD, PhD, professor of anesthesia.

"What we need is a magic bullet," said Chu. "Something that treats the symptoms of withdrawal, does not lead to addiction and can be taken at home."

The researchers' investigation led them to the drug ondansetron, after they determined that it would block certain receptors involved in withdrawal symptoms.

The scientists were able to make this connection thanks to their having a good animal model for opioid dependence. Mice given morphine for several days develop the mouse equivalent of addiction. Researchers then stop providing morphine to trigger withdrawal symptoms. Strikingly, these mice, when placed into a plastic cylinder, will start to jump into the air. One can measure how dependent these mice are by counting how many times they jump. Like humans, dependent mice also become very sensitive to pain when they stop receiving morphine.

But the responses vary among the laboratory animals. There are "different flavors of mice," explained Peltz. "Some strains of mice are more likely to become dependent on opioids." By comparing the withdrawal symptoms and genomes of these different strains, it's possible to figure out which genes play a major role in addiction.

To accomplish this feat, Peltz and his colleagues used a powerful computational "haplotype-based" genetic mapping method that he had recently developed, which can sample a large portion of the genome within just a few hours. This method pinpoints genes responsible for the variation in withdrawal symptoms across these strains of mice.

The analysis revealed an unambiguous result: One particular gene determined the severity of withdrawal. That gene codes for the 5-HT3 receptor, a protein that responds to the brain-signaling chemical serotonin.

To confirm these results, the researchers injected the dependent mice with ondansetron, a drug that specifically blocks 5-HT3 receptors. The drug significantly reduced the jumping behavior of mice as well as pain sensitivity — two signs of addiction.

The scientists were able to jump from "from mouse to man" by sheer luck: It turns out that ondansetron is already on the market for the treatment of pain and nausea. As a result, they were able to immediately use this drug, approved by the Food and Drug Administration, in eight healthy, non-opioid-dependent humans. In one session, they received only a single large dose of morphine, and in another session that was separated by at least week, they took ondansetron in combination with morphine. They were then given questionnaires to assess their withdrawal symptoms.

Similar to mice, humans treated with ondansetron before or while receiving morphine showed a significant reduction in withdrawal signs compared with when they received morphine but not ondansetron. "A major accomplishment of this study was to take lab findings and translate them to humans," said principal investigator J. David Clark, MD, PhD, professor of anesthesia at Stanford University School of Medicine and the Palo Alto Veterans Affairs Health Care System.

Chu plans on conducting a clinical study to confirm the effectiveness of another ondansetron-like drug in treating opioid withdrawal symptoms in a larger group of healthy humans. And the research team will continue to test the effectiveness of ondansetron in treating opioid addiction.

The scientists warned that ondansetron will not by itself resolve the problems that arise with continued use of these painkillers. Addiction is a long-term, complex process, involving both physical and psychological factors that lead to compulsive drug use. "This is not a cure for addiction," said Clark. "It's naïve to think that any one receptor is a panacea for treatment. Treating the withdrawal component is only one way of alleviating the suffering. With luck and determination, we can identify additional targets and put together a comprehensive treatment program."

Collaborators on this study included De-Yong Liang, PhD, the study's co-lead author, previously a research associate in the Department of Anesthesia and currently a research associate at the Palo Alto Institute for Research and Education; Xiangqi Li, MD, a life science research assistant in the department; Nicole D'Arcy, a medical student: Peyman Sahbaie, MD, a research associate at the institute; and Guochun Liao, PhD, of the pharmaceutical company Hoffman-La Roche. This work was supported by grants to Clark from the National Institutes of Health and the National Institute on Drug Abuse, and grants to Chu from the NIH and the National Institute of General Medical Sciences.

The researchers are working with the Stanford University Office of Technology Licensing to seek a patent for the use of ondansetron and related medicines in the treatment of drug addiction.

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Stanford University Medical Center.

Related Articles: 

Researchers Separate Analgesic Effects From Addictive Aspects Of Pain-killing Drugs 

Strong Pain-killing Drugs Without The Addiction

Diary: Since Xmas

DIARY: Xmas is over and I did it without using heroin. The first time in over 11 years. Did I want to use heroin ... yes but my medication is responsible for my decision not to . This just would not have happened on methadone and everyday I am thankful to Allah/Buddah/Jimmy Page/Jesus/Yahweh & co. for being able to take SROM. Of course there is a downside. There’s always a downside and that’s one of the facts of addiction. This was the first time I have been alone for Xmas lunch. I wasn’t lonely like I thought I would be and it was only for about 4 hours or so. I was supposed to go to my brother’s Xmas lunch but I felt sick and Angela was coming home early from her family Xmas lunch. My brother was having several guests as well, many who I didn’t know very well. I really didn’t care too much being alone for Xmas lunch which is not my usual self. Xmas morning is the most important event for us. We go overboard with presents and Xmas morning we finally resolve the weeks of guessing of what’s in that box under the tree? We dress our dogs up in Santa outfits and as a reward they get ham and chocolates. The hats don’t hold very well and one of them always gets tangled up in the Santa suits but it a tradition for us. Everyone wins - our dogs get ham and we get 2 very cute little Santa dogs. I am starting to wonder about my predicament and where I am in the scheme of my addiction. I no longer crave heroin or even really think about it that much anymore. That’s a definitely an important advancement. The downside is now sleeping way too much and lacking ambition and drive. I was sleeping about 3-4 times a day for a estimated total of 10-12 hours. At least I didn’t have that ominous feeling of continuous depression that I did with methadone. I was glad to swap the day long depression with having to sleep so often. The biggest problem though is losing my drive. My need to socialise, my sex drive, work ambition etc. all suffer and many previous enjoyments are now painfully boring. I had a few days spare so I took this opportunity to learn a new computer program. I already knew the basics and the video tutorial should have been quick and easy but I could not for the life of me keep my interest up. Four times I started but after 30 minutes or so, I had to stop. I just had no interest. I started to get sick of this so I tried a few different techniques by altering my medication. I tried doubling my SRRIs (doctors suggestion) and then tried without it. I tried cutting my SROM by two tablets then by one. None of these worked. My latest trial is to cut my SROM by half a tablet per day which surprisingly had an enormous effect on me. My daily sleeping needs halved, I gained some drive but I feel signs of depression breaking through. The depression only last for a few minutes at a time so I am continuing this strategy for a while longer. It appears there is a delicate balance between the SRRIs and the morphine that determine depression versus being active. I investigated some more about morphine/opiates for depression and found that morphine has long been associated with depression treatment. To counter the lack of drive, I am going for a blood test to see if I should go on steroid treatment. My doctor jokingly said I would make the drug squad really happy if I lost my scripts and they raided my house ... morphine, steroids, injecting equipment, traces of heroin etc. etc. My main interests at the moment seem to be related to drug issues including this blog. I am an avid reader of news and current affairs so drug issues fit in well with my daily activities. As I discover more, I get a much greater ability to analyse the scope of the drug situation. This coupled with my own experience allows me a well rounded insight into the issues. I am starting to see my situation and the events that led to where I am a lot clearer now. I am beginning to better explain why people use drugs by remembering situations that involved my friends and myself. I see the peer pressure of people wanting to fit in, even into their 20s and 30s. I see more clearly now how many people took drugs simply because they wanted to. I recognise those who take drugs on special occasions or because a certain activity is much more fun under the influence. For example, drugs like speed and ecstasy are usually just extensions of drinking and having a big night out. The fact that 99% of drug users never have a major problem becomes much more obvious and I clearly see the distinct difference between drug use and drug abuse. The most enlightened subject for me though is how people perceive drug use and the politics involved. I now find that most anti-drug zealots are nothing more than a joke. It’s not those who are acting with noble intentions which is usually due to a family situation but those who purposely ignore any alternatives or evidence put before them. These people have an agenda and it’s certainly not for the benefit of others. It’s purely for selfish reasons whether it be political popularity, religious beliefs, conservative values or arrogance. The reason most people oppose Harm Minimisation or a new approach to the drug situation is because they can’t see past what they have learned through years of propaganda and misinformation. This is understandable but I find annoying are those who have a strong opinion about something they know jack-shit about. i.e. drugs. You often see these people making ridiculous statements in the News.com readers comments section. I wonder if these people would change their minds if they knew the truth or would they continue with their strong but misguided opinions. I must admit it would be hard to change your views with the amount of lies and misinformation that has bombarded us for all of our lives. The most sinister though are those who spend their life desperately trying to instil misinformation into the public psyche. They are not anti-drug heroes or pillars of society but liars, egocentrics and opportunists. Nearly 3 weeks after Xmas, I finally caved in and decided to use for the first time in about 4-5 months. As my luck would have it, my dealer's phone was off. I tried to contact another dealer but their phone was disconnected. My last hope didn’t answer when I rang. JESUS Q CHRIST!!!! Why was such a simple task so hard? Fed up, I went to my dealer’s house and he wasn’t home. I asked for his mobile number in case he had changed it but I was given the same number I already had. It was nearly dark by this time so I went home and had dinner. I tried the phone numbers again after dinner and decided to go back to my dealer’s house. When I pulled up I saw his car and I was much relieved ... finally! Knock knock. “Do you have anything?” I asked. “No, tomorrow midday”, he answered. Silly me. Why would a drug dealer have drugs? The next day, I decided not to score. I was going well with my treatment and I didn’t really need heroin. I could get by just fine without drugs. [2 hours later] After I had my hit, I noticed that my tolerance hadn’t really changed. I had .4 of a gram like usual which incidentally cost $150. The quality was exactly the same as it had been for the last 5 years or so. What I did notice though was how calm I felt for the next 4-5 hours. The effect didn’t drop off after 15 minutes like it usually did but it also wasn’t as potent in the initial rush. I felt good. I didn't experience the usual guilt associated with blowing so much money on drugs. I had gone so long without and I almost felt proud of this. Was I making excuses for myself or was it justified? That's what I need to work out. Will it be another 4-5 months before I use again? I am hoping at least that long but the memories of my last hit were fresh in my mind. I decided to give my EFT card to Angela for the next few weeks just in case.

Oh McCain ... You've Done It Again

John McCain who is turning 182 next week, has slipped up again. This time, in an effort to please the GOP conservatives, McCain was making sure that he wasn't going to stumble on any of the moral issue policies. It seems though with all this responsibility that he isn't sure if condoms stop HIV/AIDS. On the "Straight Talk express", a reprise of the bus tours that he used as part of his election campaign back in 2000, McCain stumbled, paused, mumbled and called on help from his advisors. What was his position? Help please...

The transcript: 

Reporter: “Should U.S. taxpayer money go to places like Africa to fund contraception to prevent AIDS?”

McCain: “Well I think it’s a combination. The guy I really respect on this is Dr. Coburn. He believes – and I was just reading the thing he wrote– that you should do what you can to encourage abstinence where there is going to be sexual activity. Where that doesn’t succeed, than he thinks that we should employ contraceptives as well. But I agree with him that the first priority is on abstinence. I look to people like Dr. Coburn. I’m not very wise on it.”

( McCain turns to take a question on Iraq, but a moment later looks back to the reporter who asked him about AIDS.)

McCain: “I haven’t thought about it. Before I give you an answer, let me think about. Let me think about it a little bit because I never got a question about it before. I don’t know if I would use taxpayers’ money for it.”

Q: “What about grants for sex education in the United States? Should they include instructions about using contraceptives? Or should it be Bush’s policy, which is just abstinence?”

McCain: (Long pause) “Ahhh. I think I support the president’s policy.”

Q: “So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?”

McCain: (Long pause) “You’ve stumped me.”

Q: “I mean, I think you’d probably agree it probably does help stop it?”

McCain: (Laughs) “Are we on the Straight Talk express? I’m not informed enough on it. Let me find out. You know, I’m sure I’ve taken a position on it on the past. I have to find out what my position was. Brian(press secretary), would you find out what my position is on contraception – I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.”

Q: “But you would agree that condoms do stop the spread of sexually transmitted diseases. Would you say: ‘No, we’re not going to distribute them,’ knowing that?”

McCain: (Twelve-second pause) “Get me Coburn’s thing, ask Weaver(senior adviser) to get me Coburn’s paper that he just gave me in the last couple of days. I’ve never gotten into these issues before.”

This must be scary for a many people. A potential US president who doesn't know if condoms stop HIVAIDS or sexually transmitted disease. Having to ask an aid what his own position is on government funded sex education including the use of condoms is more than just a McCain gaff. It is typical of how the GOP have allowed religion and neocons to overtake their core party ideology. I am sure The Republican party of old would be vastly unhappy with the direction the present day GOP has taken. Apart from minimalist governments, no nation building and personal rights, keeping people safe is another fundamental GOP cornerstone that the current Republican party members in power are happily ignoring.

Another Statistic

Recent surveys found that 79 per cent of adult males detained on property offences tested positive to a drug of some type (excluding tobacco and alcohol) 

- (Source: Australian Institute of Criminology, 2006)

It is more than likely that the 79% mentioned are addicts resorting to theft to feed a drug habit. It must be obvious, even to the most optimistic of us that there is an underlying problem not being addressed here. The current solution to this problem is jail. Not a good place to send someone with a medical condition especially addiction. It grates on me that when you are sick, you are normally sent to hospital unless that sickness is addiction. One growing solution is to treat addicts with the drug they crave. Some countries now take this approach with extremely successful results. England still provided addicts with their drug of addiction up until the 1970s when they fell in line with the US "War on Drugs" and switched patients over to methadone. Some doctors can still legally prescribe morphine, cocaine or heroin to addicts but the UK health department usually don't approve it. There are about 300-400 patients still prescribed heroin in the UK. Recently the British government embarked on a scientific trial with prescription heroin and cocaine to 500 addicts but this time carefully monitoring the success rate. The problem was that those who already received prescription heroin had very little crime activity and had caused no problems at all. It all seemed to be working well but to expand the program they needed scientific evidence and this was undertaken a few years ago. The results are still to come.

I don't endorse just handing out highly addictive drugs to anyone. Abstinence should always be the goal. The problem is that sometimes addicts take longer than expected to get clean and sometimes it just never happens. These are the cases where we should look to the past where drugs like heroin, cocaine & morphine were prescribed to treat addiction and drug related crime was almost unheard of. Interestingly, the addiction rate has not really changed since we first started recording this information over 100 years ago.

Marijuana & Reality / The Nutters from the INCB

Headline: Cannabis remains most abused drug: report

A recent international report from UN International Narcotics Control Board (INCB) shows that marijuana continues to be the most used drug in Australia. The INCB report found that 11 per cent of Australians over the age of 14 years old regularly use marijuana. It is estimated that over 60% of Australians between 14 - 50 years old have used marijuana previously. Recently the Federal Treasurer, Wayne Swann and Queensland Premier, Anna Bligh even admitted to smoking marijuana when they were younger. Even with a recent batch of hysterical reports trying to link casual marijuana use to lung cancer, psychotic disorders and gum disease, the fact is marijuana is relatively harmless compared to alcohol and tobacco. Arguments about marijuana being stronger now than 30 years ago don't hold up either. There seems to be a persistent group of anti-drugs crusaders who will bend facts and research to back their moral objection to people 'getting high'. 

One of those strange anti-drugs crusaders is Brian Watters member of the INCB and Salvation Army Major.

Commenting on the report, Watters said:

"They're quite serious drugs of addiction so people have the wrong perception of how dangerous they are. Countries like Australia have all the resources necessary to turn these things around, provided they have the will"

Marijuana is not addictive. The perception he talks about is from years of research debunking bombastic anti-drugs crusaders like Watters.  He is wrong to make such silly comments but it reflects the corrupt organisation that is the INCB. The INCB are notorious for spreading propaganda and interfering with countries like Australia to push the US 'War on Drugs' policy. Watters is also infamous for chairing the Australian National Council on Drugs, the peak body for providing drug policy advice to the Government.

Funny enough, not many 'pro' marijuana reports get headlines in Australia. Our media is very conservative regarding drug use, especially the Murdoch newspapers. Below is an extract from an article(non Murdoch) on recent Swiss research:

A study published in the Archives of Pediatrics and Adolescent Medicine was completed on 5,263 teenage students in Switzerland and is producing some hair raising results. In line with a lot of studies that have been released in 2007 and 2008, this study boldly claims that it has found that marijuana use does not produce the fearful symptoms spread by anti-drug groups. The study seems to make a case that teenagers who use only marijuana, opposed to students who use marijuana and cigarettes are more active in sports, have better grades, are more socially adept and have used less illegal drugs.

Drug laws will change eventually but until they do, reports like the latest INCB report will keep getting headlines. Most people know drug policy is flawed but whilst there are votes in it, the politicians will continue with their silly 'tough on drugs' rhetoric.  There are many arguments for marijuana law reform and we just need to ask some basic questions.

• Is casual marijuana use more harmful than alcohol?

• How many people have died from marijuana use?

• How many acts of violence has marijuana use caused?

• Is marijuana addictive?

• Has drug prohibition reduced marijuana use?

• Has drug prohibition put marijuana users at risk?

• Have current marijuana laws benefited society?

• Do we prefer criminals or a regulatory body to manage the sale of marijuana?

• Is the money spent on arresting users better spent treating those who do develop a problem?

• Does marijuana use really cause social decay?

• Where can I score?

I think we know the answers to most of these questions.

The Nutters from the INCB

From Wikipedia:

The International Narcotics Control Board (INCB) is the independent and quasi-judicial control organ for the implementation of the United Nations drug conventions. It plays an important role in monitoring enforcement of restrictions on narcotics and psychotropics and in deciding which precursors should be regulated.

NEWS.com.au yesterday reported on comments made by INCB member, Brian Watters. Ex Salvation Army Major, Waters, a well known anti-drugs pundit, surprised no one when he rattled off his familiar disgust of drug use in Australia. Using already biased information, he pushed blame on celebrities, courts, sports stars, the government, Australians and anyone else of the Homo sapiens species.

Brian Watters is not only stubborn and naive but also dangerous. His vision of a drug free world is unrealistic and even though nations like the US and Sweden support his zero tolerance strategy, they have worst drug problems than most other countries. Fuckwits like Watters do not care at all for addicts or their health but follow the lead of the religious right and their morals based ideology. They have no time for personal rights or medical facts but are focussed on zero tolerance. Blaming courts for not being tough on celebrities because it 'sends the wrong message' is straight out of the 1970s. Like Howard & Rudd who target sports stars, 'sending the wrong message' is much more important than results. Being a member of the INCB is the ultimate role for Brian Watters. Like minded nutters, paid to preach their ideals to the masses of us poor uninformed people.

An indication of Watters rhetoric is his ability to play along with AFP folklore. The AFP with government backing often claim success at making inroads into drug importation or hurting the illicit drug market. As the heroin surge died down in the early 2000s because of illegal drug manufacturers moving to amphetamine based drugs, the AFP and the government claimed they had beaten the 'heroin epidemic'. A fantasy at best.

Brian Watters bemusedly said:

"Australia had much more success controlling other drugs such as heroin and cocaine".

The INCB is supposed to control legal drug manufacturing and overlook illicit drug policy worldwide. Although it has power in the legal drug market, it doesn't have jurisdiction over individual countries for illicit drug policies. It likes to think it does though and the INCB is often criticised for overstepping their boundaries. The INCB is effectively controlled by the US via the UN and is how the US is able to enforce it's 'War on Drugs' policy. The Netherlands allow soft drugs like cannabis and psilocybin mushrooms to be tolerated but do not officially legalise them because the Dutch government wants to adhere to international treaties. Although their scientific and research based approach to drug use has proved extremely successful, they were still berated publicly by the INCB. That was backed up by a spate of lies and hysterical speeches from the US drug czar. The INCB was also partly responsible for the ACT heroin trials to be abandoned after a threat to 'revisit' Tasmania's approval to manufacture morphine putting their opium poppy industry in jeopardy. Not surprisingly, Brian Watters was the chairman of the Australian National Council on Drugs which was established after the heroin trials were vetoed by John Howard.

In April 2003, former United Nations Drug Control Programme Chief of Demand Reduction Cindy Fazey wrote a scathing review of the Board, accusing it of overstepping its bounds:

Unfortunately these individuals also see their role not only as the guardians of the conventions, but also the interpreters of them as well. In their annual report they have criticised many governments, such as Canada for permitting the medicinal use of cannabis, Australia for providing injecting rooms and the United Kingdom for proposing to downgrade the classification of cannabis, which would entail less serious penalties than at present. These criticisms go far beyond their remit, and indeed it is hubris to criticise the Canadian Supreme Court.

Luckily, the era of conservative governments and influence is swinging away to a more fact driven society. Eventually, obdurate moralists will make way for the inexorable rise of evidence based drug policies. With the continued interference into a sovereign countries affairs from the INCB and the massive damaged caused by the 'War on Drugs', societies worldwide will are becoming fed up and are demanding change. Barbaric government drug policies forced on their citizens is starting to take it's toll and out of touch crusaders like Watters will be pushed into the history books as some of the most dangerous ideologists ever.

Jail For Treating A Medical Condition

In 1999, The ABC reported on Dr Philip Nitschke, the founder of the pro-euthanasia group Exit. Only it wasn't about one of his 'right to die' campaigns but about events in his previous life as a GP in Darwin.

Darwin in the 1990s had an usual drug scene in that heroin was hard to get and was subsequently very low quality. This led to most opiate addicts using morphine. The road to heroin often starts with someone addicted to an opiate who has to feed their addiction and the limited choices on the street means heroin is usually the only opiate available. In Darwin though, a lack of heroin created an unusually large morphine market. Morphine is only available via a prescription from a doctor unlike heroin which is made by organised crime with unknown quality and added contaminants from being cut down by dealers. The advantages to a user is that morphine is made by legitimate drug manufactures so it's clean and has a set strength, Users know exactly how much they are taking so overdoses are rare. The opiate addicts in Darwin were little trouble to the police or society, aided by the fact that some addicts received their morphine through a prescription from a doctor for pain management.

During the late 1990s, the Health Insurance Commission noticed that Darwin's doctors prescribed more morphine that the whole of NSW. Alarmed at the heavy prescribing of morphine, the HIC issued severe warnings to local doctors which ended the balance in Darwin's illegal heroin/morphine scene. Instead of studying why the overdose rate was virtually zero and why crime to obtain opiate based drugs was so low, the government dished out harsh penalties to doctors who treated addicted patients. 

It's worth noting that most countries have always been allowed to treat addiction with opiates or the actual drug they were addicted to ... until the US declared a 'War on Drugs' in 1971. This included modifying the UN resolution for the control of narcotics which most countries had signed back in 1962. Prior to the 'War on Drugs', robbery, assaults and fraud by opiate addicts to obtain their drugs was virtually unknown and police drug squads are a modern day development.

Penalties of $2,000 or two years imprisonment for any doctor who treats addiction as an illness where that addiction does not arise in the context of any other medical condition.

Basically, doctors could not treat patients for addiction alone -  doctor could only treat a medical condition. If a doctor treats addiction, they are committing a crime. The irony is that addiction is a recognised medical condition - the law doesn't actually make sense in the strictest terms. More alarming though, is the need to prohibit certain drugs to certain people for an agenda. The welfare of the patient was secondary to this agenda which is not based on medical or scientific facts. The agenda was political and moralistic. The ACT heroin trials had just been rejected by the government and Howard had made it clear that drug policy was a moral issue. No amount of medical science or research was going to change that.

Dr Philip Nitschke:

'I found myself in the situation time and time again where the choice was either to turn your back on an addicted patient or to prescribe morphine. It was far better medically to prescribe morphine for people like this than to turn them back out on the street. No way is it reasonable to legally challenge or threaten doctors who try to act in those very unsatisfactory circumstances.'

Now the crunch. NT is the only jurisdiction which doesn't have a fully comprehensive drug rehabilitation service - NO methadone maintenance program. Suddenly, all these addicts had no realistic treatment option except street supplied heroin. This of course lead to a huge increase in crime, overdoses and extra police to fight this new problem. Darwin has never recovered. The government had this bizarre explanation. 

Stephen Dunham, NT Health Minister:

'In analysing the decision, the Government was not of the view that any of the States with methadone maintenance programs could adequately demonstrate that they'd reduce things they'd set out to do, like lawlessness, drug overdoses, the criminal behaviour that often accompanies illicit drug use, so our belief was that while the policy end of it would say that it's a very good intervention, a quick analysis would show that often that's not the case.'

The ABC report had the last word:

Habits previously supervised by doctor's script and financed by public money will now be subject to the hazards and vagaries of the street. - Watch Darwin's crime statistics.