File picture: Bor Slana/Reuters

DURBAN - Many heroin addicts relapse – a startling new study has found. The recent research showed that 34% of patients on treatment for drug addiction relapse to heroin use within three days, 45% within seven days, 50% within 14 days, and 60% within 90 days of completion of treatment 

This is according to UKZN’s Professor Nirmala Gopal with the Department of Criminology and Forensic Studies at the College of Humanities.

Gopal, working with academics from the university’s College of Health Science, is researching the low success rate of rehabilitating drug users in South Africa.

She said her research found that users often showed poor compliance to addiction treatment, and access to suitable pharmaceutical interventions was an issue. 

“We are referring to the cost factor involved in the treatment of addiction with a single treatment of 500 doses costing about R1 250, depending on the dispensing fee.”

She said from the available opioid receptor antagonists (these effectively prevent the body from responding to opioids), methadone is suggested to be the ideal intervention, followed by naltrexone. The administration of these drugs is coupled with counselling.

She said the problems begin when patients were weaned off methadone and put on to naltrexone. 

EXPERT: Professor Nirmala 
Gopal from the Depart- ment of Criminology and Forensic Studies at the University of KwaZulu-Natal.
EXPERT: Professor Nirmala 
Gopal from the Department of Criminology and Forensic Studies at the University of KwaZulu-Natal.

“Here we found that relapse rates increase drastically. Many studies show that naltrexone displayed the same efficacy as placebo drugs.”

The university’s Catalysis and Peptide Research Unit was part of collaborative research which, she said, was the first of its kind. The research used mass spectrometry imaging (MSI) to determine which parts of the brain methadone and naltrexone went to in rats in an effort to better understand their mechanisms of action.

“MSI is a technique that allows for the visualisation of drugs and drug metabolites in organs, without the need for expensive radio-labelling.”
She said the research also explored the neurobiology of addiction and showed addiction is a physiological problem. “MSI image analysis showed that the drugs were highly localised in the striatal and hippocampal regions, including the nucleus caudate, putamen and upper cortex.”

Gopal said these areas of the brain were strongly implicated in the development of addiction and were the major pathways that mediate brain stimulation during reward.

“The binding of narcotic agents to specific areas and receptors in the brain is what drives the physical sensations that a user experiences."
Gopal said recommendations included chronic treatment of addiction with methadone. 

“However, this is also a complex problem since patients can develop methadone addiction and dependence since they bind to the same opioid receptors as heroin in the brain,” she added. 

Her reason for embarking on this groundbreaking research, Gopal said, was that the impact of drug addiction on communities and families was devastating. 

“Drug addiction is correlated to gangsterism, and drug wars result in many deaths and they perpetuate violent communities. It was needed to research ways of treating addiction holistically.”

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