An interesting story sits hidden away in the June 2003 edition of Focus magazine – a QLD based fundamentalist Christian publication.
On page one we meet Graham Preston who was jailed back in June 2003 for pro-life antics. His sole direction was Proverbs 24, verse 11: “Rescue those being led away to death”.
The story on page two is about Drug Free Australia member, Dr. Stuart Reece (below). Thinking of the above proverb, it is disturbing to learn that over a period of twenty months, twenty five opioid dependent patients who sought his care, died following insertion of unregistered naltrexone implants.
Naltrexone is an opioid antagonist. In a 2013 position statement on naltrexone implants the Royal Australasian College of Physicians stated on page 6:
The World Health Organisation, UNODC (United Nations Office on Drugs and Crime) and UNAIDS (United Nations Program on AIDs/HIV) have endorsed treatment with methadone and buprenorphine. The World Health Organisation has included methadone and buprenorphine in its Essential Medicines List. Naltrexone has not been endorsed by any United Nations organisations nor is it included on the Essential Medicines List. […] The RACP does not support the routine use of sustained release naltrexone formulations (implants or depot injections) while the product is not registered with the TGA.
In 2003 when the Health Practitioners Tribunal adjourned Reece’s case indefinitely, such implants were available through the TGA Special Access Scheme. This 2008 article posing the question of safety, examines implications of the scheme and difficulty in securing sound data. The authors note:
The strong theoretical rationale for the usefulness of naltrexone in treating heroin dependence justifies further rigorous investigations. However, the uncontrolled use of unregistered products of uncertain quality hampers the development of proper clinical trials.
Above, we read that Reece was “deeply hurt” by the investigation that followed. The families of his dead patients are not considered. Incredibly, the above Focus article claims that the charges brought against Reece were “based on false reports by drug addicts”. No evidence is presented in support of this statement. No independent source has confirmed the existence of false reports. Brought by QLD Health, the charges were just and likely saved lives.
There’s a familiar, yet awkward tactic advanced in his defence. The type of logical fallacy that suggests if positive feedback is presented then to suggest otherwise is not only wrong but “false”. Someone has provided the Focus author with decontextualised data designed to be critical of methadone maintenance therapy. This argument is frequently used by the opponents of harm reduction and proponents of naltrexone. We read “590 patients died with methadone in their system”. It’s an underhanded attempt to suggest methadone was the cause of death. Note this doesn’t read, “died because of methadone overdose or complications”.
We don’t know the cause of death, but I’m certain if methadone was the cause this article would have made it abundantly clear. These figures are pulled from toxicity data in coronial reports. They include hospital patients receiving palliative care, out-patients receiving pain relief, road fatalities, suicides, homicides, poly-drug related deaths and so on. All opioids carry risks and fatalities do occur in the opioid maintenance demographic. Nonetheless, when prescribed by a GP and dispensed in a controlled environment as is the case in treatment of opioid addiction, methadone is a safe option.
I can’t comment much on a reference to a “recently published article” without the source, other than to note that rapid detoxification can pose a significant risk of overdose. Naltrexone has been used orally to block the effects of opioids. The National Drug and Alcohol Research Centre note in, Mortality related to naltrexone in the treatment of opioid dependence: A comparative analysis;
Because naltrexone blocks the actions of opioids, naltrexone rapidly removes a person’s tolerance to opioids so that a given dose of opioids would have more effect than previously. The lack of naltrexone, not its presence, exposes a naltrexone-maintained patient to risk of opioid overdose. If naltrexone treatment is ceased, individuals may be at risk of opioid overdose if they choose to return to opioid use.
Regarding the safety of naltrexone in comparison to the safety of methadone or buprenorphine in the management of opioid addiction, one reads:
When considering deaths per periods of high and low risk, the mortality related to naltrexone was approximately seven times that of methadone during the period of high risk and three times the rate during the period of low risk. […]
This study also found that the mortality related to oral naltrexone treatment was higher than that for buprenorphine and methadone… whether estimated as deaths per 1000 treatment episodes or per 100 person years of risk, the death rate for naltrexone was higher and we believe the estimate provided here is a conservative one. […]
The mortality rates suggest that oral naltrexone treatment, as it is provided in Australia, can place recipients at significant risk of death, and at higher risk than buprenorphine and methadone. However, it should be noted that naltrexone treatment is a useful option in some well-motivated patient subgroups that form a minority of the opioid-dependent population.
Regarding implant technology:
A number of potential issues also relate to this form of treatment, and rigorous research is certainly required to carefully examine the potential for this delivery system to represent a viable treatment option for opioid-dependent persons. Specifically, these issues are: the lack of randomised controlled trial evidence of naltrexone implant efficacy in the treatment of opioid dependence; considerable inter and intra-subject variability in the blood levels of naltrexone resulting from an implant (and so the level of opioid blockade); the lack of good monitoring of adverse events relating to the use of naltrexone implants; and the acceptability of the naltrexone implant preparation to patients and medical professionals.
The article also identified that an existing lack of systematic data reception by coronial databases, hinders accurate assessment of fatalities related to treatment with naltrexone. In 2008 The Medical Journal of Australia elucidated on this problem when it published a paper identifying twelve hospital admissions, related to implants, to two Sydney hospitals over a 12 month period beginning in August 2006. The Abstract conclusion read:
These severe adverse events challenge the notion that naltrexone implants are a safe procedure and suggest a need for careful case selection and clinical management, and for closer regulatory monitoring to protect this marginalised and vulnerable population.
Thus, in attacking methadone as a treatment modality, Reece raises concerns with this author about his impartiality. A read of Dr. Reece’s articles in the arguably biased Journal of Global Drug Policy and Practice is revealing. Also, purporting that methadone causes premature ageing and cell death, without presenting a mechanism and correcting for other variables such as smoking, nutrition and other lifestyle habits is poor science. In the above Focus article this is presented, without a source, as “new research suggests”.
The Focus article was in error to claim vindication. The QLD Health Practitioners Tribunal adjourned indefinitely over the twenty five deaths. It was beyond ambitious for Reece to claim, before a Parliamentary inquiry, to “hold the world safety record” in administering this very treatment. Such comments have little to do with supporting evidence, and more to do with misinformation.
By 1999 research indicated naltrexone was potentially unsafe despite seemingly miraculous stories of recovery. As an opiate blocker, it was emerging with the promise of a quick solution. Yet controlled trials were lacking. Wodak and Hall discussed the evidence in an editorial in the MJA, that also briefly noted the role of the media in confusing community attitudes. Under Parliamentary protection Dr. Reece accused Hall of “scientific fraud”.
In September 1999 the practice of Dr. Stuart Reece was raided following concerns with his approach to addiction treatment. Threatened with closure, he claimed that the QLD government would have blood on itʼs hands if he could not resume practise. Ultimately, he was not closed. Twenty months later, 25 of his patients were dead. ABC 7:30 reported on 4 June 2001.
KERRY O’BRIEN: When the anti-heroin addiction drug Naltrexone was introduced to Australia five years ago, it was hailed as a breakthrough.
Since then, thousands of addicts have been treated with Naltrexone, successfully breaking their deadly habit.
But despite initial expectations it hasn’t proved to be a universal remedy by any means.
Many addicts have lapsed back into heroin abuse and some have subsequently died from overdose.
In Queensland, an investigation is now under way into the practice of Naltrexone activist Dr Stuart Reece, after the deaths of 25 addicts who had undergone his program.
The investigation has already prompted a ban on the use of experimental Naltrexone implants, designed to take the place of tablets.
All had followed the Reece regimen. He was raided by the QLD Medical Board and again closed down. Rev. Fred Nile, speaking as leader of the Christian Democratic Party said at the time:
The action taken by Queensland Health is heavy handed intimidation against those who show true compassion toward heroin addicts. It would appear, by this move, that Queensland Health would prefer that addicts remain addicted to heroin. I fear that this is another step in the mounting campaign for government provided free heroin
Three months later he claimed twenty five “drug addicts” died as “part of a conspiracy”. In September 2003, The ABC featured Reece on their Sunday Nights programme:
Stuart Reece is a Brisbane doctor who finds himself in a bit of bother some of his fellow medico’s at the moment because of his conviction that faith can be instrumental in curing what ails one… The difference perhaps is that Stuart Reece is a born again Christian believer, and makes no apologies for his direct appeal to the Christian Gospel and the power of Christ.
Clearly, the largely untested naltrexone implants were in this case a problem. Had basic support, such as a contact or counselling been available, the recovering patients would have been more safely monitored. It is regrettable that there was undue faith in naltrexone combined with a moral objection to opiate replacement therapy. This is complicated further, in that had naltrexone been demonstrated as effective, financial rewards would have been significant.
In addition, the November 2009 Health Practitioners Tribunal transcript, Medical Board of QLD vs Albert Stuart Reece makes for compelling reading. An unrepentant critic of methadone Reece chose to illegally supply opioid dependent patients with morphine. The transcript includes:
It is clear from his evidence before the Tribunal that he is also very passionate about his practice and in strong disagreement about the continued use of Methadone as a treatment for heroin addiction. […]
Particulars of the referral notice in this matter are that the Registrant on 39 separate occasions supplied Morphine intended for use by drug dependent persons without obtaining approval from the Drugs of Dependence Unit in preparation either for Naltrexone treatment or other detoxification treatment. […]
He admits to doing so and to falsifying medical records when doing so and involving third parties in this conduct. […]
But it is also clear from his evidence, and as I’ve already said that he’s a man who has a somewhat evangelical approach to this area of medicine and because of that he does appear to lack a degree of insight and objectivity in relation to the treatment of his patients. Furthermore, he seems to feel that the ends justify the means in terms of treatment of patients.
In October 2005 Christian conservative MP Tony Abbott Liberal (then Federal Health Minister) funded Drug Free Australia to the tune of $600,000. They did not adhere to conditions under which they were awarded the funding, ultimately emerging as right wing lobbyists. They are followers of Swedenʼs zero tolerance policy and the USA hardliners [open letter]. Reece, a supporter of biblically driven abstinence and a Texas trained fundamentalist, was supported by Drug Free Australia.
By April 2007 Dr. Reece was testifying to the Standing Committee on Health and Human Services (see below) that the immoral policies that permitted condoms – the real cause behind AIDS – clean needles, opioid therapy for addicts, non-punitive cannabis laws, harm reduction and general tolerance for ill Aussies would be our doom. The Senate Standing Committee looked on as Reece introduced himself by saying, “I certainly know the science”. He then displayed a photo of “the archaeological site of Sodom” and a tree with snakes instead of branches. [Page 33/FHS 27]. He explained its relevance. “There will be consequences”.
Reece attempted to explain the moral consequences of policies such as Harm Minimisation, by blaming a tsunami on Divine punishment. He added:
I was interested to discover that the actual historical site of Sodom and Gomorrah has recently been found in Israel. On the bottom right of this slide are pictures of sulphur balls that have been found there. So consequences matter, and they can destroy a civilisation quickly, as we saw with yesterday’s tsunami and so on.This slide shows a tree with snakes, which to my mind is a lot of the stories that you hear from harm minimisation. Methadone, syringe giveaways, injectingrooms, medical cannabis, heroin trials all those are catered for by the same people. But, on the other side of the tree, you have all the downsides, the side effects, which are not talked about in this culture. It is of extreme concern to me that medical science which is known and understood overseas is not understood and not talked about and given no airplay whatsoever in this culture.These are old slides I made several years ago, charting a lot of these behaviours: this is condoms and the AIDS risk, charting the parallel between condoms and AIDS deaths.Ms GEORGE (Senate committee member): Sorry, I do not understand. What are you saying – condom protection andAIDS deaths are correlated?Dr Reece: Yes, condom sales and AIDS deaths. I am saying that there is a statistical association between the two.
As reported in Crikey by Ray Moynihan Reece decided the “disease drugs, sex and rock-n-roll” was the problem. Asked about the safety of naltrexone, Dr. Reece chose instead to attack internationally renowned scientist, Dr. Alex Wodak [Page 59/FHS54], who specialiseʼs in blood born viruses and epidemiology. Put differently, this means Wodak supports condoms, clean syringe access and used syringe collection: dire threats to our very civilisation, contended Reece. Yet Australian communities with dozens of dispensaries and hundreds of clients report no methadone deaths.
How did Committee Chairperson react to this? Bronwyn Bishop abused public health scientists (who had outlined the success of decriminalisation in Europe), yet she gushed in support of Dr. Reece. A pre-determined agenda in what was billed as the most important family-relevant inquiry of Howardʼs government spoke volumes. Bishop’s final report was rejected nationwide by all but religious fundamentalists and Christian lobbyists. Not one publically funded treatment or advocacy agency missed the opportunity to criticise the report. Bishop went on to call for the removal, and adopting out, of the children of parents struggling with addiction. Should parents conquer their addiction there would be no chance of reunion:
Their [Liberal-led House of Representatives] controversial plan – which also includes compulsory treatment for teenage addicts, restrictions on methadone programs and withdrawing funding from drug programs that promote harm minimisation – was dismissed as “a disgrace” and “frightening” by some anti-drug campaigners.
Gordon Moyes, the “Christian voice in politics” is also quoted on rumours in Drug Free Australia’s recent attack upon Lancet authors, of which Reece is a co-author. This involves quoting Moyes, who is quoting drug addicts he happened to speak to. Moyes also praised naltrexone despite the concerns of our medical community about it remaining unregulated. Regrettably, regulators have not prevented its use by the same people year in, year out.
When the Medical Journal of Australia exposed the fact these same prescribers were not reporting adverse reactions, despite TGA requirements under the Special Access Scheme, Drug Free Australia published a rebuttal. It made direct reference to Dr. Stuart Reece himself. Offensively, it reported that Reece “studies” death rates post naltrexone treatment. It was titled, Australia could be the biggest loser.
Dr. Reeceʼs motivation is arguably reflected in his obsession with teenage and childhood sex and sexual assault, murder, violence… all due to “the depraved advertising industry” which catalysed “the disease sex, drugs and rock-n-roll”. Advertising womenʼs nudity, outside of “a strictly medical context” is “incredibly powerful pornography”, he has observed.
Today, a decade plus since this evidence-free pursuit began, Reece is arguably a pin up boy for religious fundamentalism. Five or more years ago he promised Parliament that his results were “statistically powerful” and “revolutionary”. Of course, there are no results. Itʼs the same certainty that only faith can sustain. If prayer cures homosexuality, addiction is a certainty. His latest work “proves” naltrexone is safer than opioid therapy.
As reported on ABCʼs 7:30 Report, in 2006 multiple disciplinary teams have steadily found naltrexone has a fatality rate over four times that of opioid therapy. Dr. Reece, and others who seek funding and likely lucrative contracts seem to have a formula no others can find. More recent work with implants by his colleague, gynecologist George O’Neil, show ambiguous results, despite claims of success.
Regrettably this work is tainted with poor practice and again, Christian healing. Their biggest problem is the fraud published in the MJA surrounding suppression of negative outcomes – some almost fatal. Failure and coercion to boost sample numbers seems to be the norm. W.A.’s Freshstart clinic observes on its website chaplaincy page:
Our Christian Beliefs
The Nature and Character of God: we believe in one God, who has existed forever as Father, Son and Holy Spirit in a community of pure and eternal love.
The Fresh Start Statement of Belief embodies the second of the core commitments of the organisation:
The Creation of Humanity: men and women were created in God’s likeness with God-given dignity and worth in order to know, love and serve him forever.
Sin and Evil: sin came into existence through human rebellion against the good purposes of God. Sin is self-centred opposition to the love of God that separates humans from God and leads to death and eternal lostness.
There is no problem with having a strong faith. Yet there’s a difference between faith based welfare and faith based practices. When the supernatural impinges on your objective reasoning in managing the lives of others, no amount of friendly lobbyists can assuage this conflict of interest.
Today, Drug Free Australia bill Reece as “an expert in naltrexone” and in fatalities. Is this a joke? I honestly don’t know. What’s certain however is that his role in the recent DFA misleading outing to attack Vancouver’s Insite and the research backing it is not based upon any skill in harm reduction.
Drug Free Australia have many secrets. This one is quite shameful.
- Comments posted online from a relative and a friend of Reeceʼs patients.
Just Jules says: June 5, 2010 at 6:01 am Ahhh there is none so blind as those who can not see .. Dr Reece in my eyes is a discusting (sic) human being .. I am the mother of a child he treated .. He also treated my daughter in law and the mother of my first grand child .. If you want to see what his methods leave you with, go see my daughter in law who for the last 11 years has been in a home for the severely brain damaged .. In is own words to me ” they are just reoffending drug addicts”. He is a wolf in sheeps clothing and should of been stopped before he started.
Vicki PS says: July 5, 2010 at 12:02 pm I came across this site looking for help for a friend of my daughterʼs. This young woman has been increasingly unhappy with her treatment under Dr Reece. He is treating her addiction with Suboxone, a subutex/naltrexone combination drug. Her big concern is that this unethical, immoral disgrace to the profession reduces her dosage if she has not been to church! This girl is now in early pregnancy and is scared that she could miscarry if this idiot messes around with her medication to suit his pathological world view. I find it frankly incredible that Dr Reece is still permitted to practice.
- MORTALITY RELATED TO NALTREXONE IN THE TREATMENT OF
OPIOID DEPENDENCE: A COMPARATIVE ANALYSIS – NDARC (HTML) (Download PDF)
- Unplanned Admissions to two Sydney Public Hospitals after Naltrexone Implants – MJA. (HTML) (PDF)
- IMPACT OF ILLICIT DRUG USE ON FAMILIES: HOUSE OF REPRESENTATIVES – Tuesday, 3 April 2007 (Download PDF)
Last update: 12 February 2023
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