MINISTERIAL COUNCIL ON DRUG STRATEGY
31 July 1997 Agenda Item 4
Treatment Options for Opioid Dependence
Final Resolution
The Ministerial Council on Drug Strategy:
endorses a comprehensive integrated approach to deal with the
problems of use of illicit drugs including heroin in Australia,
involving a balance between supply and demand reduction strategies;

agrees on the need for a national strategic approach to illicit
drugs including heroin, including primary prevention, with secondary
and tertiary initiatives to minimise harm to individual users and
the general community;

endorses a concerted national effort to develop a broad range of
effective and evidence based treatment options for people who are
opioid dependent, as outlined in the report of the subcommittee on
the controlled use of opioids;

notes that the controlled availability of heroin is only one of a
range of possible treatment modalities for heroin dependence, and is
unlikely to be more than a minor component of that range of options;

notes proposals for research and evaluation of the cost
effectiveness of different treatment modalities, incolving
maintenance treatment, withdrawal treatment, and relapse prevention,
including:

in Victoria, trials of oral morphine, buprenorphine, LAAM and
naltrexone; in NSW, trials of buprenorphine and naltrexone; in
South Australia, trials of buprenorphine, LAAM, tincture of opium and
naltrexone; in the ACT, trials of diacetylmorphine (heroin) and buprenprhine.

notes the Commonwealth will continue to contribute to trials and to
the coordination and evaluation of a suite of different treatment
modalities to ensure a concerted national effort in the development
of treatment options;

notes that a substantial amount of work also is under way to improve
the effectiveness of methadone services;

agrees on the establishment of a national expert advisory committee
on illicit drugs, to include in its terms of reference coordination
of research undertaken throughout Australia, evaluation of outcomes
of research activities, and identification of areas of deficiency,
with the aim of developing best practice treatment models;

notes that the ACT is prepared to proceed with the first stage of
the proposed heroin trial involving 40 participants with the support
of Victoria, South Australia, Tasmania and New Sout Wales. The trial
will be informed by detailed information from the Swiss heroin
trials including the evaluation by the World Health Organisation;

notes that the Commonwealth will make a contribution directed to
evaluation and security aspects, with the ACT arranging funding of
the diacetylmorphine;

notes that the pilot will only proceed on the basis that:

Australia meets its international treaty obligations under the
United Nations Single Convention on Narcotic Drugs 1972 and the
1988 Convention Against Illicit Traffic in Narcotic Drugs and
Psychotropic Substances;
it is formally put to the International Narcotics Control Board
and the Commission on Narcotic Drugs and is not opposed by the
Board or by a majority of the members of the Commission.

notes that the ACT intends to amend its trial design to:

ensure compliance with relevant international conventions;
include withdrawal treatment and long term abstinence in the trial
objectives; introduce charges equivalent to those for methadone
maintenance; take account of the World Health Organisation's
evaluation of the Swiss heroin trial, which is due to be released in
February. notes that any decision to proceed to the second and third
stages of the trial will be dependent on evaluation of the first stage;

while supporting a broad range of effective and evidencebased
treatment options, and research and evaluation of different
treatment modalities, Queensland, Western Australia and the Northern
Territory oppose the proposed ACT heroin trial;

agrees to the printing and public dissemination as a National Drug
Strategy publication, the report of the Subcommittee on the
Controlled Availability of Opioids.

The Canberra Times of 1st July summarised the above report and then
added:

Independent MLA Michael Moore, who proposed the trial in 1991, was
elated last night and said the agreement was a small step away from
the prohibition which had caused so many problems.
Mrs Carnell said illicit heroin use was causing a soaring death rate
on the streets, it was ading the spread of HIV and hepatitis C, and 80
per cent of crimes against property in Australia were believed to be
drugrelated, since users were desperate for money to pay for their
next fix.
There are believed to be about 1000 heroin users in the ACT.
ACT Opposition health spokesman Wayne Berry said he welcomed the new
range of drug treatments but called for an increased effort in drug
education and rehabilitation.