A longer-acting alternative to methadone that never quite caught on following its FDA approval in 1993 may now greatly increase the number of addicts who stick with treatment, thanks to a new Johns Hopkins study.
The study suggests better ways of taking LAAM (levomethadyl acetate hydrochloride), a drug similar to methadone in its capacity to discourage heroin use and block withdrawal symptoms. However, unlike methadone, which addicts must use daily, LAAM can be taken three times a week, making it far more convenient and potentially less expensive.
LAAM isn't widely used, because of both uncertainties about how effective it is in the first stages of addiction treatment and doubts that it would be accepted by addicts. Earlier this year, for example, only about 3,000 U.S. patients were getting the drug.
"Use of LAAM has been less than hoped for since its approval by the Food and Drug Administration," says Rolley E. Johnson, Pharm.D, associate professor of psychiatry, who headed the Hopkins study. Early studies didn't test participants' responses at various dosages, and under the cautious little-by-little approach to giving the medication, it appeared less effective than methadone at the first stage of treatment. Because of this, many assumed that LAAM lacked the necessary opiate-like effects early on. "Users said they couldn't feel the drug working and were more likely to drop out of treatment," Johnson noted.
The new Hopkins study, however, reported in this month's Archives of General Psychiatry, shows that at the proper dosage on the proper schedule, LAAM is safe, effective and acceptable to addicts. "It could become a valuable addition to heroin addiction programs. Its convenience compared with methadone is a great advantage for addicts who hold jobs," says Hendree Jones, Ph.D., one of the investigators. "They can earn a living more easily while continuing to receive treatment."
To test LAAM, researchers gave 180 heroin-add
'"/>
Contact: Marjorie Centofanti
mcentofanti@jhmi.edu
(410) 955-8725
Johns Hopkins Medical Institutions
11-Aug-1998