You rarely get to meet a person like Dr George O’Neil: A manufacturer, obstetrician, gynaecologist and inventor of a controversial opiate blocker which prevents certain narcotics from binding with certain brain receptors.
It’s just gone 10am and the waiting room in O’Neil’s Churchill Avenue clinic in Subiaco is crammed with more than a dozen people already. A man in a suit, a woman holding a baby and a girl who looks barely 17. These people have one thing in common — they’re addicted to drugs.
O’Neil’s story began in 1997 when he was looking after a pregnant patient whose husband was addicted to heroin. The woman asked George several times to help her husband.
The waiting list for the government-funded methadone program was nine months in Australia. After hearing about a doctor in China who had treated 11 patients with oral naltrexone, he jumped on a plane to investigate. Unlike methadone which is severely addictive, naltrexone works as a blocking agent to opiates eliminating the high from the drug. After returning to Western Australia with two bottles of naltrexone, O’Neil instructed the woman’s husband to take the dose, with promising results.
“Then there was a friend of his and a friend of a friend who needed treating, and then The Sunday Times found out what I was doing. The next day there was a line of people outside my door,” O’Neil says.
His faith in naltrexone drove him to create the O’Neil long-acting implant and the Fresh Start Recovery Program.
“Within three months of treating people it was obvious people needed something better than oral naltrexone. We’ve been using the implants at Fresh Start for ten years,” O’Neil says.
His implant can last 300 days, which he says allows the recovering addict the chance to rebuild a life.
Patients arrive at the Fresh Start clinic every Wednesday and Saturday to get their implants. George invites me into the small, dimly-lit room, where the first patient of the day is waiting.
Damien from Darwin used to be a fisherman. He says that was where he was introduced to heroin. Damien is here for his second implant. A nurse hands Dr O’Neil two needles, which alleviate the nausea and diarrhoea associated with detox. After an anaesthetic is injected, O’Neil makes an incision in the abdomen, the size of a pen, and in goes the implant. Fifteen minutes later, the patient is stitched up and accompanied to the recovery room to be monitored.
“I don’t think there’s any other place in the world where you can walk in and be cured of your addiction. That’s why we get people coming here from all over the world,” he says.
But proving the effectiveness and safety of naltrexone is taking time.
Naltrexone has not yet been approved by the Therapeutic Goods Administration for treating heroin dependence because of the limited data on its safety. However O’Neil has been manufacturing the implants since 2001 and a recent study on implant naltrexone found it was safe and significantly reduced opiate use in patients.
Gary Hulse, a medical professor who headed a 2009 National Health and Medicine Research Council funded trial, says there is a lot of merit in implant naltrexone.
“You’ll give someone an implant and if you get them early enough, then you don’t have that heroin dependant person. We can get them back out there in the community. So from that perspective it’s pretty impressive.”
Professor Hulse says a few things need to be done to sustain a future for naltrexone.
“We need to compile other studies about the efficacy of implants,” he says.
Until then it’s a daily struggle for O’Neil and the clinic to stay afloat.
He says the implant costs $6000, which patients don’t have to pay. The clinic costs $6 million per year to run, and the State Government provides $1.1 million per year. The shortfall is made up by donations and O’Neil says he is pouring a lot of his own money into the business. He says he pays himself $50,000 per year for a 70-hour week.
He would like to see more funding for his clinic and says the lack of support makes it hard.
Margaret is a volunteer at Fresh Start. She moved from Queensland to WA six years ago, after her husband’s addiction to heroin spiralled out of control. Two implants later, Margaret’s husband has been clean for four years.
“He was spending $1000 a day on heroin. He wouldn’t be around if it wasn’t for George,” Margaret says.
She acknowledges that there are naltrexone sceptics but says they are only sceptics because they are uninvolved and don’t have all the necessary information.
“You have to come here and see it for yourself. What George is doing is amazing.”
The future for naltrexone and O’Neil’s clinic is not assured. But he says as long as there are patients at his door, it’s up to him to help them.
Asked if he sees what he’s doing as giving people a second chance at life, he pauses, takes a minute to gather his thoughts, and answers.
“I see changed lives.”
Published in the Western Independent October 2010