Aboriginal Health

Adolescent Medicine

Anaesthetics

Complementary Medicine

Dermatology

Emergency

ENT

Geriatrics

ICU

Internal Medicine

Musculoskeletal

Paediatrics

Palliative Care

Psychiatry

Sexual Health

Surgery

Women's Health

Drugs and Alcohol

Medicinal Cannabis Survey

Benzodiazepine Dependence

Confessions of an English Opium Eater

Common Questions about Methadone

Heroin Detox - A panacea?

Methadone Maintenance Treatment

Rapid Heroin Detoxification

The Heroin Trial

Observations on Naltrexone Rx

Naltexone prescription for heroin addiction

- The Waismann technique

Dr Waismann was brought to Australia following the media publicity concerning the treatment in his clinic of a North Coast heroin addict. The woman, an addict for some 18 months, had developed the usual sequela of the addiction - physically, morally and socially.

She had sought help from me as her family doctor, several of my partners and through us, the psychiatric, and drug and alcohol rehabilitation services. The whole situation was on a progressive downward spiral. She said she knew she ought to give up heroin, but couldn't; the hold was far too strong. Finally, in desperation, she attended Dr Waismann's clinic for one day, and was away from Australia for one week. She is now off heroin and has a full-time job.

Dr Waismann's technique, known as Rapid Opiate Detoxification, or Opiate Receptor Neuroregulation, involves keeping a patient in an intensive care unit for four to six hours. During this time they are intubated to protect their airway and given the opiate antagonist Naltrexone via an orogastric tube.

Dr Waismann's theory is that the opiate receptors responsible for the craving are totally blocked during this time and are kept blocked by oral Naltrexone taken once a day for the following 12 months, during which time the receptors progressively atrophy.

Dr Waismann claimed he had successfully detoxified 3000 heroin addicts and that at the 18 month follow-up, 80 per cent were still off heroin and 40 per cent were back in full time employment. The percentage involved with crime was also dramatically reduced.

In response to questions as to why no double-blind trials have been performed, Dr Waismann maintained that the results were so obvious this would not be ethical. He also said that as a private clinic, he did not have the time to do the required research for publication, but that he would be happy to send the preliminary follow up papers done by another group on his patients. This was requested by the group.

In response to a question as to why Naltrexone worked in the long-term on his patients and not on others (Naltraxone has been available for 20 years), Dr Waismann said the difference was that the receptors required total blocking to suppress the craving before the maintenance Naltraxone was successful in preventing the recurrence of the craving. He also said that drug counselling, rather than lifestyle counselling, helped to stimulate the craving.

At the end of our quite frank discussion with Dr Waismann, all were interested and the numbers who thought it should be further looked into outnumbered the cynics.

What we do know for certain is that a young woman who wasn't able to be helped by our best endeavours locally, was very much helped by Dr Waismann's technique. At this stage we need further evidence that the proven results from this one case can be extrapolated to a significant number of other heroin addicts.

Dr Waismann himself seemed only too willing to show and teach others his technique for the treatment of heroin addiction which he regards as a medical problem that should be treated medically and not psychologically.

Dr Paul Earner Alstonville NSW Australia 2477