LAAM Effective for Opioid Treatment, May Be Better Than Methadone, Says Study by New York VA Doctors

DRUG TREATMENT July-August 1998

Levomethadyl acetate hydrochloride (LAAM) is an effective treatment for opiate addictions, and may offer advantages over methadone treatment, according to a study presented at the June annual meeting of the American Psychiatric Association in Toronto ("New study shows LAAM effective for opiate-dependent patients," Brown University Digest of Addiction Theory and Application (DATA), July 1998, p. 6; Susan Ferraro, "High on LAAM," Philadelphia Daily News, July 8, 1998, p. 25).

LAAM, which is marketed as ORLAAM® by Roxane Laboratories, is a synthetic opiate that, like methadone, works to prevent the highs and lows associated with heroin use by blocking the neural receptors that process heroin. LAAM metabolizes slowly, requiring patients to take it only three times a week, compared to methadone, which must be taken every day. Patients report less of a narcotic effect with LAAM. The researchers said that, unlike methadone, LAAM will not have value as a drug of abuse. [However, heroin addicts may try to get LAAM illegally to reduce their heroin habits without enrolling in a treatment bureaucracy. -- EES]

According to researcher Paul P. Casadonte, M.D., from the New York State Department of Veterans Affairs Medical Center in New York City, among 19 patients who had been treated with methadone but were switched to LAAM, more than two-thirds preferred LAAM. The study showed a majority of the LAAM patients who were previously on methadone believe that there has been greater acceptance of LAAM than methadone by the clinic and that there will be greater acceptance by the community.

Addicts treated with LAAM are more likely to become completely drug-free, according to Casadonte. He said that LAAM patients experience fewer withdrawal symptoms than methadone patients. In addition, Casadonte said LAAM appears to reduce or eliminate opiate use significantly and may retain patients in treatment longer than those treated with methadone. "After more than three years of successful treatment, our staff is convinced LAAM can play an important role in the management of heroin addiction," said Casadonte, who has prescribed and studied the medication in more than 400 patients since the early 1993, when the FDA approved it for use in addiction treatment programs.

Paul P. Casadonte, M.D. - New York State Department of Veterans Affairs Medical Center, 423 East 23rd St., New York, NY 10010, Tel: (212) 686-7500 ext. 7985, Fax: (212) 951-3356.