Levo-alpha-acetylmethadol (LAAM) versus methadone: treatment retention and opiate use.

Abstract

AIMS:

To compare the effects of levo-alpha-acetylmethadol (LAAM) and methadone maintenance (MM) on treatment retention and abstinence from opiate use.

DESIGN:

A two-group experimental design with patients randomly assigned (2 : 1 LAAM : MM) to receive LAAM (three doses per week) or methadone (daily dosing).

SETTING:

A community clinic in Los Angeles, California.

PARTICIPANTS:

A total of 315 patients seeking LAAM or methadone maintenance.

INTERVENTION:

LAAM or methadone maintenance, plus ancillary services available to all patients. LAAM and methadone dose levels varied according to clinical judgement. Electrocardiograms were administered to LAAM patients monthly.

MEASUREMENTS:

Treatment status at 26-week follow-up and number of days retained in treatment, weekly clinical urine tests and 26-week research urine test.

FINDINGS:

LAAM and methadone patients did not differ on treatment retention. LAAM patients were less likely to test positive for opiate use during treatment (40% versus 60%) and at 26-week follow up (39.8% versus 60.2%). Benefits of LAAM were confined to patients (n = 204) still in treatment at 26 weeks (33% positive in patients receiving LAAM and 61% in patients receiving methadone). No adverse events, cardiological or otherwise, were observed with LAAM administration.

CONCLUSIONS:

LAAM is an effective medication for the treatment of opiate dependence with clinical advantages due not only to the reduction of opiate use but also to the alternate-day dosing schedule. LAAM may be more effective than methadone in promoting abstinence from opiate use among patients for whom LAAM is an acceptable alternative to methadone.

• Authors: Douglas Longshore, Jeffrey Annon, M Douglas Anglin, Richard A Rawson
• Journal: Addiction (Abingdon, England) (Addiction) Vol. 100 Issue 8 Pg. 1131-9 (Aug 2005) ISSN: 0965-2140 [Print] England
• PMID: 16042643 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Narcotic Antagonists
• Narcotics
• Methadyl Acetate
• Methadone

Topics

• Adult
• Female
• Heroin Dependence (rehabilitation)
• Humans
• Male
• Methadone (administration & dosage, therapeutic use)
• Methadyl Acetate (administration & dosage, therapeutic use)
• Middle Aged
• Multivariate Analysis
• Narcotic Antagonists (administration & dosage, therapeutic use)
• Narcotics (administration & dosage, therapeutic use)
• Patient Compliance