IT'S 9AM AND AH-FAT IS LYING in a hospital bed, sporting a diaper and a goofy grin. He's still high - a couple of hours ago he staggered out of bed, poured some powdery white Number Four heroin on to a sliver of foil and hungrily sucked down the treacle-sweet smoke. This has been his morning ritual for more than five years; sickness and reality forced into fleeting abeyance, the dragon temporarily appeased.
That's all about to change. Within two hours, a different drug will be surging through his system, prising the heroin from its tenacious hold in his brain's pleasure centres. His smack-frozen flesh will begin its wracking thaw, the agony kept at bay by a potent blend of sedatives and ketamine. Four hours later, he'll be clean. A quick fix . . . and then a quick fix.
Welcome to the world of naltrexone, and of its Hong Kong high priest, Dr Wayne Moran - a recovered alcoholic and drug abuser who says he wants to use his experience with addiction to help others. He's the man in charge of today's chemical exorcism, sporting a blue medical gown in place of vestments, wielding his bag of drugs like a Bible.
It is not only in addicts' gaunt bodies that naltrexone is wreaking upheaval. It also has doctors in a spin. Some claim it is nothing less than a medical revolution; others see it as a cruel and dangerous hoax, targetting middle-class addicts and their families. Within the past 18 months, two young Hong Kong men who had been given implants went on to overdose and die - one after stopping the treatment for several months, the other a day before he was to receive a fresh implant. These deaths, and others overseas, have left doctors bitterly divided as to naltrexone's safety and merits.
To its proponents, like Moran, it represents the best hope for many heroin users of staying clean. He is one of a handful of doctors around the world using a controversial system of implants, instead of the more common oral form of the drug. A pellet is inserted under the skin just above the groin, releasing a steady stream of the chemical for around two months. After the 'rapid detoxification' - during which the usual three or four days of withdrawal is concentrated into a matter of hours - the addict is effectively forced to remain clean while the implant remains active. They can take all the heroin they want, but they won't feel a thing. Naltrexone is an 'opiate antagonist'. It clings stubbornly to the brain's opiate receptors, fending off heroin's insinuating tendrils.
Those less enamoured of the drug claim it is a costly - each operation costs between $25,000 to $35,000, depending on the choice of private hospital - and ineffective treatment which preys on the desperation of addicts and their families to find a 'magic bullet' while swelling the pockets of money-hungry doctors. They also say it leaves addicts more susceptible to death by overdose because their tolerance quickly drops after going on naltrexone.