Clinic implants State’s first opiate ‘blocker’

The first procedure to fit an opiate ‘blocker’ has taken place in Ireland, with the clinic in charge forecasting that the process could help many others who want to break their heroin addiction.

While ‘blocker’ drugs have been used in different forms, albeit at relatively low levels, the person fitted in Dublin with the Naltrexone implant is understood to be the first to undergo such a procedure here.

The ‘bar’ is placed into the lower abdomen during a minor surgical procedure with the patient under local anaesthetic. Unlike tablets or injections of Naltrexone, the effects of the implant last for up to three months before it needs to be replaced.

Naltrexone effectively blocks the pleasure receptors in the body, and so blocks the effects of heroin in the user. It also works in the same way for alcohol and other substances.

The implant was fitted by the One Step Clinic from its base in Dublin City University two weeks ago, but a clinic has also been set up at Cork University Hospital.

Dr Hugh Gallagher of the One Step Clinic said a six-month implant was likely to be available for use by the end of the year and said the Naltrexone bar could play a key role in helping those who wish to break their heroin addiction to avoid relapse.

“We have talked to the Department of Health and the Health Products Regulatory Authority and they are aware of its availability and application,” Dr Gallagher said.“It is fully authorised for use.”

The clinic opened just six weeks ago and as yet there is no waiting list of potential clients. Anyone seeking to have a Naltrexone bar fitted would already have had to undergone a detox programme and be tested on the day of any procedure to ensure there are no drugs in their system.

“For people to get to the point of being able to avail of Naltrexone implants they will have to have gone through a process of stabilisation and detoxing and that will require changes in their lifestyle, with supports and family environment — all of these things,” he said.

At present the model is that the patient pays, with the cost of each implant coming in at €950.

Dr Gallagher said that based on evidence of its use elsewhere, a client was likely to have to use the implants for between 18 months and two years to minimise the chances of a relapse.

Earlier this year a consultant psychiatrist who treats both inpatients and outpatients at the St John of God Hospital in Dublin said there was strong scientific proof that ‘blocker’ drugs worked — but that not enough people knew about them.

Dr Colm O’Gara made his comments after figures released by the HSE show that the already small number of people receiving drugs such as Disulfiram and Acamposate to combat alcohol addiction had shrunk even further in the past three years.

The drugs can be prescribed under the State’s General Medical Services (GMS) scheme and the Drugs Payment Scheme, unlike the Naltrexone implants.

Dr Gallagher said said he was reluctant to give an estimate as to the number of clients that the clinic could deal with each year as the programme was in its infancy here.


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