First made available here seven years ago for special cases, it is designed to deter people from drinking by making them violently ill if they touch alcohol. Yet it doesn’t work for everyone, and some alcoholics will persist in drinking no matter how bad it makes them feel. “Think about your worst hangover and multiply it by 1000,” one alcoholic fitted with an anatabuse implant explained on an Internet forum. “Not only are the effects terrible (in my case, vomiting, nausea, dizziness, shaking), but they take effect about 10 mins after consumption so you don’t really get to experience the ‘good effects’ of alcohol.” Normally the liver quickly breaks alcohol down into water and carbon dioxide. But antabuse (or disulfiram to give it its proper drug name) blocks this from happening, causing the build up of a toxic chemical called acetaldehyde in the body. “It’s like a log jam,” Sydney University addiction medicine specialist Kate Conigrave says. “Acetaldehyde gives you the nasty effects of intoxication: nausea, flushing, palpitations, headaches. You feel as sick as a dog and it happens after only a few sips.” Even the small amount of alcohol contained in mouth wash can cause vomiting; in extreme cases continuing to drink with the implant can lead to heart failure, coma and even death.

Yet it’s a risk Tim Byrnes is prepared to take, having battled alcoholism for more than five years. The addiction has cost him his family, his job, financial stability, and even landed him in a correctional facility for four weeks. It was there, surrounded by “resentment and dysfunction” that Byrnes decided to go ahead with the implant. “It was the kick in the pants I needed,” he says. “If I don’t get sober I’m a dead man. I’m what they call a habitual buster – I spend six months rebuilding my life then destroy it in a couple of days.” A binge drinker, Byrnes can be sober for months at a time before something triggers a bender. He will start “quite classy with vodka” then drink around the clock for a few weeks, ultimately reduced to downing methylated spirits. “It was horrific, there was nothing social about it,” Byrnes reflects. “Once you start drinking it’s a very quick road to jail, death, or the park bench.” A former journalist, Byrnes succumbed to alcoholism when he returned to Australia after reporting on the Russia-Georgian war in 2008. He despaired over the vast disconnect between what was being reported of the conflict back in Australia, and what he had actually witnessed. Meanwhile few could relate to his experiences in a war zone.

“You put your life on the line,” he explains. “I saw lots of ugly stuff. I thought I was a bit of a hero. I got back home and I felt rejected by everything.” The he lost his new job with the federal public service just days after he started, amid fears he was a Russian spy. “I was able to hide behind my job,” Byrnes says. “That day I was terminated from the public service I knew where I was headed. When you’re stuck in Canberra and you’re not working and you’re depressed it’s a powder keg.” Attending Alcoholics Anonymous meetings and spending tens of thousands of dollars on a stint in an ultra-exclusive private Sydney rehab clinic have failed to work for the 39 year old. So last Monday Byrnes travelled to Brisbane in a last ditch attempt to get sober. At a clinic not far from the Gabba sports ground he paid $1100 for the implant the size of a marble to be inserted in his lower abdomen under local anaesthetic. It is difficult to find doctors here willing to fit an antabuse implant. They must order the implants from overseas, and can only do this for patients with a prescription.

One doctor who used to fit the implants believes previous controversy about inserting naltrexone implants in drug addicts who later died has led to the “demonisation” of antabuse impants by association. However addiction specialists do believe the antabuse implant can be useful for treating certain alcoholics. “I can see it could have a potentially valuable role in the future [if] the proper safety checks have been done,” Professor Conigrave says. Byrnes hopes his implant, which stays inside him for a year, will help him finally win his battle with the drink. “I know now no matter how much I want to drink alcohol, I can’t,” he says. “I’ve got some freedom for 12 months. I can go out and not fear walking past the pub. I can be part of society without living in fear of messing things up.” But Professor Conigrave warns that antabuse does nothing to quell an alcoholic’s intense cravings for a drink. “It just gives you a fear of drinking,” she says.

Sometimes that fear is not enough to override an addict’s craving. English footballer George Best continued drinking after being fitted with an implant, and ultimately died. “The biggest risk is not being able to abstain from alcohol, drinking on top of [having the implant], being hospitalised and potentially having a life-threatening reaction,” Professor Conigrave says. Often people who take antabuse in tablet form will negate its effects by planning their drinking around when they swallow the pill. One British doctor estimates half of all patients will experiment with anti-alcohol medication to see what level of drinking they can get away with. People opt for the implant so they can’t circumvent its purpose. However doctors warn the implant has variable effects on patients. Some get very sick from the tiniest bit of alcohol in cough mixture, while others can drink moderately and not feel any the worse. Yet Byrnes says he has no desire to test his implant’s efficacy with a beer or three. “I don’t drink for taste, I drink for effect,” he says. “I know that I can’t feel the effects [with the implant] so it takes away that spontaneous split second temptation.”

Addiction specialists warn that an antabuse implant alone won’t cure alcoholism. Alcoholics must also change their lifestyle, undergo counselling and develop coping skills if they want to get better. “There is no guarantee it will stop people behaving in the way they want to,” the doctor who used to fit the implants explains. “The idea of an implant is it gives people some respite from their addiction while they get other things sorted in their lives.” Byrnes calls alcoholism “the dark secret of Australia”, but he thinks the recent crackdown on licensing laws may be a sign the culture of drinking is finally changing. “I want to be a part of that.” He hopes publicising his radical decision to be fitted with an implant will give other addicts hope, and lead to better regulation of the treatment by local authorities. “I was prepared to take a risk no matter what,” he says. “I don’t want my son’s dad to be a bum or alcoholic. It’s imperative I don’t touch a drop of alcohol.” THE DAMAGE DONE

$36b cost to society of misuse of alcohol One in three people report being negatively affected by someone’s drinking 20,000 children are victims of alcohol-related abuse 60% of police call-outs involve alcohol 20% of Australians drink at risky levels

Males are twice as likely to drink daily as females One in 8 deaths of people under 25 involves alcohol 1200 deaths attributed to alcohol in NSW annually 51,000 people were admitted to NSW hospitals in 2011-12 for alcohol-related reasons Sources: Australian Education and Rehabilitation Foundation, - Australian Institute of Health and Welfare, Australian National Council on Drugs report, 2010 National Drug Strategy Household Survey, 2010 National Drug Strategy Household Survey, - Australian National Council on Drugs report, NSW Dept of Health